Cesarean Section
From Encyclopedia of Sex and Sexuality
The removal of the fetus from the uterus through an abdominal incision in lieu of a vaginal delivery. Cesarean section is indicated when labor is considered unsafe for either mother or fetus, when delivery is necessary but labor cannot be induced, when dystocia or fetal characteristics present significant risks for vaginal delivery, and when an emergency mandates immediate delivery and the vaginal route is not possible or suitable.
The origin of the term cesarean section is not certain. There is a popular explanation that Julius Caesar was born this way, but this is surely a myth since his mother lived on for many years after his birth—a virtual impossibility considering the crude surgical techniques of that era. A more plausible explanation is that cesarean section takes its name from the Roman code of law, the lex cesara, which required an unborn fetus to be removed from its dead mother. The first modern operation was said to have been performed in 1610. Successful cesarean sections took another two centuries to develop.
Cesarean section is one of the most important operations performed in obstetrics and gynecology. Its lifesaving value to both mother and fetus has increased over the decades, although specific indications for its use have changed. The initial purposes of preserving the life of a mother with obstructed labor and delivering a viable infant from a dying mother have gradually expanded to include the rescue of the fetus from more subtle dangers. Four major forces have reduced maternal risk from cesarean section: improvement in surgical techniques, improvement in anesthetic techniques, the development of safe blood transfusions, and the discovery of antibiotics.
There has been a progressive increase in the incidence of cesarean section in relation to total deliveries. Because maternal risk is acceptably low, cesarean section can be chosen in preference to those vaginal deliveries known to be associated with increased prenatal morbidity and mortality, including unfavorable breech presentations. Cesarean section is also preferred should the fetus become compromised during labor, as evidenced by an abnormal heart rate, monitor tracing, or scalp sampling, and when fetal distress in labor can be predicted on the basis of prenatal testing. Finally, a cesarean section is now indicated for a larger number of premature or compromised infants because of their increased chances for survival with intensive neonatal care.
