When should a caesarean be planned?

Sometimes during labour things do not go according to plan and ultimately the decision is made that the safest way for the baby to be born is by caesarean section. In some circumstances though, the decision for a caesarean is made in advance for the safety of the mother and/or baby. This is called a planned (or elective) caesarean section.

You don't have an automatic right to demand a caesarean if it's considered not to be in your best interests medically. So when would it be in the best interests of you or your baby to have a caesarean?

A low lying placenta is also called placenta praevia and sometimes this may mean the baby will be born by caesarean. If the placenta is covering the birth canal a caesarean will be planned. If the placenta lies close to the birth canal the distance can change later in pregnancy and this will be monitored before a decision for the need for a caesarean is made.

If you have had a baby before and needed an emergency caesarean because it was found that your baby’s head was too big to get through your pelvis, a caesarean will be planned for future births.

If you are having twins, you may be able to have a vaginal delivery if the first one is lying head down. A caesarean will be planned for other situations, and where there are more than 2 babies.

• if the baby is breech (bottom down)
• moderate to severe pregnancy induced hypertension (high blood pressure)
• if the mother is diabetic
• if the baby is much smaller than expected
• if there has been bleeding in the pregnancy

If you have had a caesarean before, this does not always mean that you will have to have a caesarean again. Many women will have a successful vaginal birth after having a caesarean. The decision in this case will be made based on why you had a caesarean in the first place. However, if you have had more than one caesarean before you will need a planned caesarean.