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Long Labor

When labor continues over a long period of time, doctors tend to take extra precautions to ensure
that both mother and baby show no signs of extreme exhaustion or over exertion. If the baby´s heart rate slows or accelerates too quickly or shows no signs of activity, most often he is considered to be showing signs of fetal distress. Because the risk of infection and oxygen deprivation is high after a prolonged labor, any sign of distress usually calls for an emergency C-section.

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Breech Presentation

If the baby is in the breech presentation, without the possibility of turning, than a Caesarean is necessary.
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Genital Herpes

If the mother has an active genital herpes infection, a Caesarean will most likely be necessary in order to avoid passing the infection onto the newborn.
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Placenta Previa

If the mother has placenta previa, in which the placenta blocks the cervix, a Caesarean is necessary for the safety of both mother and baby.
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The Statistics

Over 800,000 babies are delivered every year via caesarean sections. Some of the most common reasons are:

40%-Failure of labor to progress
21%-Repeat caesarean
15%-Other (multiples, premature labor)
13%-Breech Baby
10%-Fetal Distress

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Preeclampsia

If the mother is suffering from Preeclampsia, and there are signs that it is getting worse and possibly dangerous, a Caesarean is necessary for the safety of both mother and baby.
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Multiples

Often, with multiple births, the mother will go into preterm labor. Sometimes, in those instances, an emergency c-section is required. In instances where the mother carries full term, a caesarean may be a better choice for both mother and babies, as to avoid any complications.
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Cord Prolapse

An emergency Caesarean is usually required when a woman suffers from a prolapsed cord. This occurs when the umbilical cord falls through the cervix, thus cutting off the baby´s oxygen supply.
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Mother´s Age

Because mothers are having their babies later in life, their chances of a complicated delivery increase. Having a C-section minimizes the risk to the mother and the baby.
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Fetal Monitoring

Research has clearly shown that the use of
external fetal monitors gives NO improvement
in any measurement of fetal outcome...in other
words, no fewer babies die, APGAR scores are
no higher, and there are no fewer admissions to neonatal intensive care.

There has been only only one thing correlated
with use of external fetal monitoring...an
increase in number of cesarean sections. (And,
again, these babies show no better outcomes.)

It is important to periodically monitor how
baby is coping with contractions. This can be
done using intermittent fetal monitoring, but
can also be done using a handheld Doppler or
even with a traditional fetoscope. These provide
the same information without the disadvantage
of restricting your mobility.

What are the drawbacks of external fetal
monitoring? Besides the increased likelihood
of cesarean section, they also decrease your
mobility by confining you to a flat-on-the-back
position. This not only increases pain, but
also can actually cause the problem it is
supposed to be catching...decreased oxygen
supply to the baby.

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Transverse Position

If the baby is in the transverse position (vertical), without the possibility of turning in time for a vaginal delivery, than a Caesarean will be necessary.
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Failure To Progress

In order for a natural labor to occur, three factors must be achieved. There must be strong enough contractions to dilate the cervix to ten centimeters, the fetus must be able to transcend through the birth canal, and the pelvis must be large enough to allow the baby to make the trip down the birth canal. If these three factors do not occur, then it is called "failure to progress." In a case, where little dilation has occurred, a doctor will let a laboring mother continue to labor 24 hours or more to allow the opportunity for a natural delivery, as long as neither the baby nor the mother are showing any signs of distress. If, after twenty-four to forty-eight hours, dilation has not progressed, a C-section will most likely be performed.

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