If the baby has to be delivered in an emergency and there's no time to place an epidural or spinal, general anesthesia may be needed. In that case, you are asleep during the cesarean and totally unaware of the procedure. Also, general anesthesia may be needed in some cases because of complications in pregnancy that make it unwise to place epidurals or spinals.

Reasons for a c-section:

• All surgical procedures involve risks, and cesarean delivery is no exception. Fortunately, these problems are not common.

The main risks of cesarean delivery are:

• Excessive bleeding, rarely to the point of needing a blood transfusion
• Development of an infection in the uterus, bladder, or skin incision
• Injury to the bladder, bowel, or adjacent organs
• Development of blood clots in the legs or pelvis after the operation

If your practitioner feels that you need a cesarean delivery, he or she will discuss with you why it is needed. If your cesarean is elective or it's done because your labor isn't progressing normally, you and your partner have time to ask questions.

In cases in which the baby is in a breech position, you and your practitioner may consider together the pros and cons of having either an elective cesarean delivery or a vaginal breech delivery. Both carry some risks, and often your practitioner asks you which risks are most acceptable to you.

If the decision to perform a cesarean is due to a last-minute emergency, the discussion between you and your doctor may happen quickly, while you're being wheeled to the operating room.

Your practitioner may suggest that you have a cesarean delivery for one of many different reasons. This list describes the most common ones.

Reasons for elective c-section:

• The baby is in an abnormal position (breech or transverse).
• Placenta previa.
• You've had extensive prior surgery on the uterus, including previous cesarean deliveries or removal of uterine fibroids.
• Delivery of triplets or more.