Emergency C-Section: Why They’re Needed and What to Expect

An emergency C-section is one that happens very quickly due to immediate concern for the health of the mother and/or baby. The goal is that no more than 30 minutes pass between the decision to perform an emergency C-section and delivery, but it can take up to 75 minutes.

Any kind of C-section is a major surgery that requires a room full of healthcare professionals and a great deal of organization. This means that when a patient needs an emergency C-section, a lot of doctors and nurses have to get ready faster than normal.

You can end up having an emergency C-section even if you already had a scheduled, planned, or even unplanned C-section in the works. All of these are sometimes called medical C-sections, as they happen for health reasons. In comparison, an elective C-section is one that you choose to have.

What’s the difference between the types of C-sections?

• Scheduled C-section. This is when you and your doctor decide that it’s safest for you and your baby to deliver via C-section, potentially because you’ve had a C-section before. Your doctor will schedule a C-section date around your estimated delivery date, possibly months in advance.

• Unplanned C-section. This is when you were planning to have a vaginal birth, but a little while before your delivery, your doctor decides that a C-section is best for you and your baby. This decision can be made a few weeks, days, or even hours before you’re about to give birth. With an unplanned C-section, there’s no emergency, but the change in plans is made to get you and your baby onto the safest birth route.

• Emergency C-section. This happens when delivery must occur urgently to make sure both you and the baby are safe. This can happen whether you’re planning to have a vaginal birth or a C-section.

They might seem like the same thing, but not all C-section experiences are created equal. Your experience, as well as the actual procedure for an emergency C-section, will be different than those of a scheduled or unplanned C-section.

What will happen during an emergency C-section?

One main difference is how you might be prepared for it. Everything must move quickly, including administering pain medications and getting the baby delivered.

Most scheduled C-sections are performed with local or regional numbing (anesthesia). This means you’ll still be awake, but you won’t feel pain during the procedure. Local anesthesia is usually administered via a spinal injection, and this can take time.

In an emergency C-section, the timing and details of your situation, along with hospital policies, can affect your options for anesthesia.

Your doctor and the anesthesiologist may decide that it’s time to administer a spinal injection. Or, you may already have an epidural in place, which helps with the surgery preparations. However, depending on multiple factors, some of these options may not be possible.

Alternatively, you may have general anesthesia, using both injected and inhaled drugs to make sure you’re pain-free during the surgery. This will allow the C-section to happen more quickly, but this combination means you’re not able to be awake during the procedure.

Another difference may be the incision used during the surgery. In non-emergency C-sections, a horizontal (bikini) cut is typically performed. If you’re at term, you’ll likely have this type of incision, even in an emergency.

However, during an emergency surgery in which your baby’s health needs immediate attention, the surgeon may opt to use a vertical incision on your uterus to get to your baby faster. This type of incision may be necessary in cases of preterm birth, as well as due to adhesions from previous surgeries or fibroids that may be in the way of the uterus.

Again, this is dependent on the circumstances of your birth. Your surgeon’s training, as well as your and your baby’s health needs, are taken into consideration.

The reasons you might need an emergency C-section are also different than the reasons you might have a scheduled C-section.

Basically, an emergency C-section means that your baby isn’t cooperating with the planned exit or decides they want to come out before a scheduled or unplanned C-section. It may also mean that your health is a concern, and waiting for progress isn’t the right choice.

In most cases, there’s nothing you or your doctor can do to change the need for an emergency C-section.

The following are several reasons why this might happen:

Very long labor

Prolonged or delayed labor is when labor goes on for much longer than normal. This can sometimes cause health problems for both the baby and mom. Prolonged labor is the most common reason for an emergency C-section. About 8 percent of pregnant women who are about to give birth have prolonged labor.

When this happens, your doctor may decide that it’s much healthier for you and your baby to have an emergency C-section than to try to deliver vaginally. You might have a prolonged labor because:

• Your labor didn’t really start. Sometimes you’ve had contractions for years, but they don’t seem to be doing anything. Plus, you may not be dilating as much as you should.
• Your labor stalls. Everything might be on track as you start having contractions and even begin dilating, but then everything stops. Sometimes this happens because your baby’s head cannot fit through your pelvis.