7 Signs Your Hospital or Doctor Will Probably Push for a C-Section

A lot of women, upon finding out they’re pregnant, start planning ahead to their labor and delivery. It’s only natural to want to figure out the hows and whys of such a huge life event! The tricky thing about labor and delivery, however, is that it’s pretty unpredictable. You can plan and plan all you want, but when the big day comes, things take on a life of their own. But, the good news is, there are things you can look for that may help you determine if you’re more likely to have a c-section. Some of these c-section signs are out of your control (but better to be prepared than not!). Others have to do with the doctor and hospital or center you choose for your delivery. You can’t foresee the future, sure. But you can be prepared for any and all situations that may come your way.

Image: Giphy

C-section signs that are largely out of your control have to do with your health and the health of your baby. For example, certain pregnancy complications increase your chances of having a c-section.

During your pregnancy, complications can arise that will definitely increase your chances of having a c-section. These include problems with the placenta, like placenta previa (when your uterus lays too low and blocks the cervix). Placenta previa makes a vaginal delivery nearly impossible and very dangerous. If you have an infection like HIV or herpes, your doctor may encourage a c-section early on in your pregnancy, as these infections can be transmitted during a vaginal delivery. Also, if you’re pregnant with multiples, your doctor will probably recommend a c-section, for your safety and the safety of the babies.

{Also read: Can I Choose a C-Section? You’ll Want to Consider Your Options}

Complications that arise during labor and delivery.

You made it to the big day! Your water broke, you’re on your way to the hospital, everything is falling into place. Except … it might not. Even women who have perfectly normal pregnancies can experience complications during labor and delivery that make their birth plan obsolete. If you get to the hospital and discover that your baby is breech, there’s a good chance you’ll be having a c-section (unless they flip back, which does happen!). Or, during labor, your umbilical cord can slip into the birth canal and get compressed during delivery. Umbilical cord prolapse may result in a c-section if the baby starts showing signs of distress during labor.

Sometimes, labor gets going and then just slows down or stops completely. Once your water has broken, most doctors will insist on delivery within 24 hours. Which is a big window of time! But if labor has slowed or stopped completely, even with medical intervention, a c-section may be the next step. The doctor’s main concern will be the health of the baby and mother, and if either one start exhibiting signs of distress (decreased oxygen or heart rate, for example), they may insist that it’s time to head to the OR.

There are other c-section signs that aren’t necessarily related to maternal or fetal health. These require a bit more research on your part. For example, if you’re concerned about being pressured into a c-section, you’ll want to ask about the hospital’s c-section rate.

Roughly 1 out of 3 babies in the U.S. is born via c-section. Which seems incredibly high, given that 1 in 3 women likely don’t want a c-section. Approximately 26% of women with no pregnancy or labor complications ends up having a c-section. For comparison, the World Health Organization says 10-15% is a normal rate. C-section rates can vary wildly from one hospital to the next, which leads experts to believe there’s no biological or medical reason for the increase.  You can check your own hospital’s c-section rates at on the hospital website, as well as your state’s official website. If the hospital you’re delivering at has a rate of 50% or higher, there’s a good chance they push them more than necessary.

Your doctor doesn’t know what you want in the labor and delivery room.

This is a big one. You have to be your own best advocate, and make sure your doctor knows from the very beginning what you want and don’t want. Most women will discuss their demands as far as pain meds, epidurals, skin-to-skin, etc. But if you want to ensure that you and your doctor are on the same page, you have to thoroughly research possible complications and scenarios that may arise, and how you want them to be handled. And if your doctor isn’t amenable to listening and working with you, then you may want to consider finding one who will.

The hospital (and labor and delivery department in particular) is incredibly busy.

This is another one of the c-section signs that is largely out of your control, unfortunately. And it varies from hospital to hospital; some facilities are equipped to deal with “high traffic”. But you also have to think of the hospital as a hotel: they want to turn that room as quickly as possible to get the next person in. When you tour the facility, ask questions about how the staff handles extremely busy times, and what their protocol is when they run out of beds. It’s rare, but it can happen, and you want to be prepared.

You get to the hospital too early.

Listen, labor takes a long time! Usually. We all hear the stories of women giving birth in the car on the way to the hospital. But remember: those stories make good news blurbs, but they don’t happen very often. If contractions have started but your water hasn’t broken, you’ve got some time. Even after your water breaks, most women are still in labor for at least a few more hours.

It’s not an exact science. And there’s no guarantee you won’t end up as one of those 10 o’clock news stories. But the longer you labor at home, the less time you’ll be taking up space in the hospital. Dr. Neel Shah is a assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. He says, “The later you go into the hospital, the lower odds you have of having a C-section.” So keep that in mind before you rush off at the first signs of labor.

Your doctor is a little old-fashioned.

C-section signs go beyond stats and complications. A lot of the pressure to have a c-section can come from your own doctor. Doctors used to believe that progressed faster, and when it didn’t follow those standards, a c-section was recommended. But now, it’s believed that allowing a woman to labor longer may actually prevent unnecessary c-sections. A 2014 statement by The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine suggests that doctors allow more time for labor to progress naturally into the active phase, and that women be allowed to push for at least 2 – 3 hours with an epidural. Knowing where your doctor stands on these recommendations could mean the difference between being allowed to labor and deliver vaginally, or being forced into a c-section.

These c-section signs aren’t universal by any means. But knowing what can lead to a c-section, and knowing what research to do and which questions to ask, can go a long way toward preparing you for your own labor and delivery.

(Image: iStock/mvaligursky)

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