In a vaginal birth, the baby travels through the birth canal during labor and delivery. But in a cesarean delivery, the baby is surgically removed from the womb.

Almost 4 million babies are born in the United States every year. Most of these babies are born vaginally. However, the number of caesarean births has increased over the last two decades. This is partly due to medical necessity and partly due to choice. Today, nearly one in three deliveries is a caesarean.

Cesarean deliveries are a kind of surgery, and like all surgeries, they come with risks. But in some cases, cesarean deliveries are a pregnant woman’s safest option.

Read on to learn some of the common reasons why a doctor might perform a cesarean delivery.

Your Labor Has Stalled

Labor that fails to progress is one of the most common reasons for a cesarean delivery. The baby can’t exit the birth canal if the mother’s cervix doesn’t soften and dilate, or open normally.

Stalled labor may occur if:

  • your baby is very large and cannot pass normally down the birth canal
  • your baby is not in the normal delivery position, facing your back with it’s head down
  • your contractions are too weak to push your baby down the birth canal

Stalled labor can’t be prevented, but your doctor may try to manage it with additional measures. For example, they may try using forceps or a vacuum to pull the baby out through the vagina if it’s partway through the birth canal.

If weak contractions have stalled your labor, your doctor may give you a hormone called Pitocin (oxytocin). This hormone will make contractions stronger.

A doctor may recommend a cesarean delivery if these interventions are unsuccessful.

You Have an Infection

Obstetricians commonly perform cesarean deliveries in mothers with infections. These infections include:

  • HIV
  • genital herpes
  • trichomoniasis

Vaginal births put babies into contact with mothers’ blood and body fluids. This is particularly dangerous in mothers with active infections. Cesarean deliveries can prevent potentially life-threatening infections from being transmitted from mother to child.

Pregnant women should avoid infection in the first place and seek treatment once diagnosed. Some infections can be treated rapidly. This allows for a safe vaginal birth.

Your Birth Canal Is Obstructed

Your birth canal can be obstructed by:

  • uterine growths
  • displaced pelvic fractures caused by strong contractions
  • a placenta that covers the opening of the cervix

In these cases, it’s either impossible or dangerous for a baby to fit through the birth canal. A cesarean delivery is the safest and sometimes only delivery option.

Some birth canal obstructions can be prevented if diagnosed and treated early. It’s important to get regular checkups while you’re pregnant to screen for obstructions and other possible complications.

You’ve Had a Previous Cesarean Delivery or Uterine Surgery

Mothers who have had previous cesarean deliveries or other uterine surgeries are more at-risk of uterine rupture. This is a serious pregnancy complication. During labor and delivery, contractions and pressure in the birth canal can cause uterine scars to tear. This leads to excessive bleeding in the mother, and can even be fatal to the baby.

A doctor may go ahead with a vaginal delivery if they decide the location of the uterine scars makes it unlikely to tear. However, in many cases, doctors will recommend a cesarean delivery to avoid a possible uterine rupture.

You’re Carrying More Than One Baby

Doctors usually recommend vaginal delivery to mothers of twins, unless the babies have health problems or are positioned dangerously in the womb.

For single births of three or more babies, doctors usually perform cesarean delivery. This speeds up delivery. It also reduces the risk of abnormal positions that could make vaginal birth dangerous.

Your Baby’s Health Is at Risk

Vaginal deliveries can be dangerous to babies in certain situations. Doctors will perform a cesarean delivery when:

  • a baby isn’t getting enough oxygen
  • a baby’s heartbeat is irregular
  • a baby is in an abnormal position, such as feet or buttocks first, breech, side or shoulder first, or transverse
  • a baby gets entangled in the umbilical cord

There’s often no way to prevent such situations. That’s why cesarean deliveries are usually necessary.

Careful monitoring during labor and delivery can help your doctor make informed decisions. This will lead to the best possible outcome for both the mother and the baby.