1. The baby isn’t positioned properly. Some breech babies can be delivered vaginally by an experienced practitioner, but certain breech and sideways positions require C-section.
2. Labour isn’t going well or the baby isn’t fitting through the pelvis. Called dystocia, this can be caused by multiple factors (not necessarily the size of the baby).
3. The baby is at risk. The baby’s heart rate may indicate it’s not handling labour well, necessitating a quick C-section rather than a long labour.
4. Placenta problems. The placenta may be covering the cervix, impeding birth. Other times, the placenta may separate from the uterus unexpectedly or too early, or fail to separate at all, among other problems.
5. You have triplets. Twins can be delivered safely vaginally, but it’s safer for the babies and mom to deliver triplets by Caesarian section.
6. You had a C-section less than 24 months before. Vaginal birth after Caesarian has a 75 percent success rate, but trying before 24 months may increase the risk of uterine rupture.
A version of this article appeared in our November 2015 issue with the headline “C is for Crisis,” pp. 74-8.