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Second-Stage C-Sections: Understanding Risks and Ensuring Safer Deliveries

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"A deep dive into the factors driving second-stage cesarean sections, their impact on maternal and infant health, and strategies for safer childbirth."

Cesarean sections (C-sections) are a common surgical procedure, but their increasing rates raise concerns about potential risks for both mothers and babies. Of particular concern is the rise in second-stage C-sections, performed when labor is already well underway. Understanding the factors driving this trend and the associated risks is crucial for ensuring safer deliveries.

A recent study conducted at a tertiary center in Nepal sheds light on the complexities of second-stage C-sections. The research examines the indications for these procedures, the complications that can arise, and the impact on maternal and infant health. By analyzing data from over 40,000 deliveries, the study provides valuable insights into optimizing childbirth practices.

This article breaks down the key findings of the study, explains the potential risks associated with second-stage C-sections, and explores strategies for promoting safer labor and delivery. Empowering expectant parents with knowledge is the first step toward making informed decisions and ensuring the best possible outcomes.

Why Are Second-Stage C-Sections on the Rise?

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Several factors contribute to the increasing rates of second-stage C-sections. These include:

The study from Nepal highlights cephalopelvic disproportion (CPD) – where the baby's head is too large to pass through the mother's pelvis – and fetal distress as the most common reasons for performing C-sections in the second stage of labor. These situations often require a quick decision to ensure the safety of both mother and child.

Decreased use of instrumental delivery: Fewer doctors are using forceps or vacuum extraction to assist with vaginal deliveries.
Lack of training and supervision: Junior staff may not have sufficient experience in managing difficult deliveries.
Concerns about maternal and neonatal morbidity: Doctors may opt for C-sections to avoid potential complications and lawsuits.

While C-sections can be life-saving, they also carry risks. Understanding these risks is essential for making informed decisions about childbirth.

The Takeaway: Informed Decisions for Safer Deliveries

Second-stage C-sections can present increased risks compared to vaginal deliveries. However, with careful monitoring, skilled healthcare providers, and informed decision-making, these risks can be minimized.

Expectant parents should discuss their concerns and preferences with their healthcare providers. Understanding the potential risks and benefits of both vaginal delivery and C-section is crucial for creating a birth plan that prioritizes the health and safety of both mother and baby.

By promoting normal labor progression, utilizing pain relief measures, and employing effective pushing techniques, healthcare providers can help more women achieve vaginal deliveries and reduce the need for second-stage C-sections. Prioritizing training for instrumental deliveries can also contribute to improved outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3126/jnhrc.v15i2.18210, Alternate LINK

Title: Caesarean Section During Second Stage Of Labor In A Tertiary Centre

Subject: General Medicine

Journal: Journal of Nepal Health Research Council

Publisher: Nepal Health Research Council

Authors: Padma Gurung, Sameer Malla, Sushma Lama, Anagha Malla, Alka Singh

Published: 2017-09-15

Everything You Need To Know

What exactly is a Second-Stage C-section?

Second-stage C-sections are performed when labor is already well underway, typically during the pushing phase. These procedures involve surgical intervention to deliver the baby after the mother has been in labor for some time. The rising rates of Second-Stage C-sections raise concerns because of potential risks to both mothers and babies, and are influenced by various factors. These factors are instrumental in understanding why this specific type of C-section is becoming more prevalent and how to approach them safely.

Why are Second-Stage C-sections becoming more common?

The increasing rates of Second-Stage C-sections are influenced by several factors. A primary reason is cephalopelvic disproportion (CPD), where the baby's head is too large to pass through the mother's pelvis, and fetal distress. Additionally, there's a decreased use of instrumental delivery methods like forceps or vacuum extraction, possibly due to concerns about complications. Lack of training and supervision among junior staff in managing complex deliveries can also play a role. Furthermore, concerns about maternal and neonatal morbidity, as well as the potential for lawsuits, can lead doctors to opt for Second-Stage C-sections.

Why is the study conducted in Nepal significant in understanding Second-Stage C-sections?

The study conducted at a tertiary center in Nepal is important as it provides valuable insights into the complexities of Second-Stage C-sections. By analyzing data from over 40,000 deliveries, the research examines the indications for these procedures, the complications that can arise, and the impact on maternal and infant health. This data helps in understanding and optimizing childbirth practices, offering a better understanding of the risks and allowing for strategies to improve safety for both mother and baby.

What are the potential risks associated with Second-Stage C-sections?

Potential risks associated with Second-Stage C-sections include increased maternal morbidity, such as higher chances of infection, bleeding, and longer recovery times. For the baby, there can be a higher risk of respiratory issues or other complications related to surgical birth. These risks highlight the importance of careful monitoring and skilled healthcare during labor and delivery. It is important to understand that while Second-Stage C-sections can be life-saving, they also carry inherent risks.

How can we ensure safer outcomes during labor and delivery, especially when a Second-Stage C-section is necessary?

To promote safer labor and delivery, it's crucial to make informed decisions. This involves educating expectant parents about Second-Stage C-sections, potential risks, and alternative options. Skilled healthcare providers are essential for careful monitoring and timely intervention. The decreased use of instrumental deliveries, like forceps, underscores the need for training and experience among healthcare professionals. By addressing factors contributing to the rise in Second-Stage C-sections, and focusing on the mother and child, potential risks can be minimized.