Dr. Robert Grayson introduces himself and recalls the typical reasons a woman would have a cesarean section (C-section). Dr. Grayson is on staff at Banner Desert Medical Center in Mesa, Arizona.
Hi, I am Dr. Robert Grayson. I am an obstetrician here in the East Valley practicing at primarily out of Banner Desert Hospital. I am also one of the Directors of the in-house OB program. So we are here for emergencies should they occur for pregnant women in labor.
Well there’s probably too many reasons for having cesarean section to talk about one setting, but she can probably put them into two general categories – first category would be causes that are related primarily to the mother, and those would include things like sheer size disparities where the baby is too big to pass through the normal size of the maternal pelvis.
The second thing that you would think about, as far as the maternal cause, would be things like prior cesarean section and that’s probably a big evolving one in this day and age in medicine. Once someone has a cesarean section, there’s a growing tendency to have a repeat cesarean section. It’s not mandated that women have a second cesarean section, but there are certain criteria that have to be met in the labor environment for a woman to accept those risks and pursue a trial of labor after cesarean and those include being at a tertiary facility where there is 24-hour availability of obstetricians, anesthesiologists and nursery teams, so that if a consequence or catastrophe occurs, prompt intervention can take place.
The other general category for causes for cesarean section would be ones that primary involve the baby, and the most obvious one is just intolerance of the labor process. So a baby that just doesn’t do well when it comes time to have contractions, and that can be something that happens very subtly at the early part of the labor and something that you could even reverse and have time to think about and have an alternative plan for delivery, or it could be something that happens catastrophically all at once without any warning and we see that commonly with cord compression, the umbilical cord being compressed during a contraction that just doesn’t go away, a cord prolapse where the cord gets down in front of the baby’s head and as the baby descends on in the cord it cuts off its own circulation, or things like placental separation like placental abruption where the placenta kind of comes off the uterine wall all at once, and that can cause very emergent catastrophic cause for cesarean section.
Another common fetal cause would be something related to the presentation of the baby. So most babies like to come down and enter the world head first, but they are not always so cooperative and sometimes they will come down breach or with an arm or a leg or a cord and that’s not conducive to a vaginal delivery.
It’s also much more common as we see more and more multiple gestations. So twins, triplets, things like that. So that would probably be the second most common cause of fetal causes for cesarean section.
About Dr. Robert C. Grayson, M.D., F.A.C.O.G.:
Robert C. Grayson, M.D., F.A.C.O.G., is board-certified in Obstetrics and Gynecology and on staff at Banner Desert Medical Center in Mesa, Ariz. He received his undergraduate degree in biology at University of California, Riverside and his Masters of Public Health from the University of California School of Public Health in Los Angeles before completing his Doctor of Medicine at the University of Southern California School of Medicine in Los Angeles.
Condition: Placenta Accreta, Pregnancy, High-Risk Pregnancy
Related Terms: Cesarean Section, C-Section, Vaginal Birth, Elective C-Section, Emergency C-Section, Labor, Umbilical Cord Prolapse
Health Care Provider: Banner Hospital, Banner Medical Center, Banner Health, Banner Desert Medical Center, Banner Desert Hospital, Maternity Services at Banner Desert Medical Center
Location: Mesa, Arizona, AZ, 85202, East Valley, Tempe, Chandler, Gilbert, Apache Junction, Phoenix, Maricopa County, Guadalupe, Phoenix Metropolitan Area
Expert: Dr. Robert C. Grayson, Robert Grayson, M.D, Doctor Grayson, Obstetrician Robert Grayson, High-Risk Pregnancy Expert Robert Grayson, Robert Grayson, OB/GYN
Expertise: High-Risk Pregnancy, Cesarean Section, C-Section, Obstetrics and Gynecology, Maternal Fetal Medicine, Prenatal Education, Perinatal Care, Birthing Services, Fetal Assessment, Breastfeeding Support, Fetal Therapy, Fetal Intervention, Premature Babies