Are "unplanned c section" and "emergency c section" often used interchangeably?

[Claire98909]

I've always wondered if many women who say that they had an "emergency c section" actually mean that they had an "unplanned c section".  From what I've read, an emergency c section is one that is performed, as the name implies, in the event of a fetal or maternal emergency, in which the baby has to be removed as soon as possible or else death will ensue.  I've often read stories, however, of women who had unplanned c sections due to reasons such as ineffective pushing, head not fitting, maternal exhaustion, failed forceps/vacuum attempt, etc.  Very few of those cases sound immediately life-threatening, yet they still say that they had "emergency c sections".  So are they simply using the wrong terminology, or are those situations actually life-threatening, and has the term "emergency c section" in place of "unplanned c section" even become accepted within the medical community?

[fruitfulmomma]

I would make the same distinction you have, but I've never had one and not being present at one would make me hesitant to define someone elses birth for them. I suspect it is often presented to the woman by her hcp as an emergency even when it is not immediatly life threatening. Somewhat like the difference between driving to the emergency room yourself for something that reaaly needs to be addressed asap but not life threatening *yet* vs. calling 911 and being flighted there. 

I would define any section which required mom to be under ga because there was no time for a local as an emergency, but it may be broader than that.

[JoyFilled]

Claire - have you had a c-section?  A lot of your posts are about c-sections and seem more to be pot stirring then actually knowledge wanting.

[CatsCradle]

Never thought about it...probably because I don't care about the distinction.  And, I've had a c-section.

[slmommy]

I would say an emergency c/s is unplanned but unplanned is not always emergency. Although I guess it really depends on what people mean by emergency. Probably a lot of unplanned c/s would turn emergent if waited longer... so while maybe it was done with enough time to not need ga or full emergency mode, probably the mother who is using the term(s) in her story knows best.

I don't know that this is really the right place for these threads, the birth stories forum? 

[McGucks]

I've never thought about it either way.  Maybe it's just my mood, but...who cares, really?  I guess what I'm asking is this:  under what circumstances does it matter, and to whom, and for what reason?

[fruitfulmomma]

I think it would for the momma being told she needs one...Does she she have time to think about things, try some alternatives, or do we have to move *now*? Medical reports should also make a distinction. But as far as momma telling her birth story after the fact, yeah it probably doesn't matter...If mom felt it was emergent and wants to frame her story that way it isn't my business to tell her otherwise.

[katelove]

In hospital-speak there are two types of c/s; emergency and elective. An emergency c/s is one the was not arranged prior to labour commencing, nothing to do with how urgent it is at the time. An elective c/s is one which was arranged prior to labour regardless of the reason. A c/s for complete placenta praevia is still called elective.

The terms " mother requested", "social", "unplanned" etc are used by lay-people and sometimes by medical staff but are not formally accepted descriptions ( at least in Australia). People will know what you mean but they aren't uses officially in hospitals.

[rnra]

"Hospital speak" varies from region to region, and even hospital to hospital.  The hospital system I am familiar with has essentially three types of c/sections.

Indicated=Breech baby, mother with prior c/section who does not desire or is not a good candidate for a VBAC, mother with active genital herpes, placenta previa, etc.

Emergency=Placental abruption, umbilical cord prolapse, baby shows significant signs of distress that require emergent action, etc.

Unanticipated=Failure to dilate, labor stalls/stops, many hours of pushing without progress, etc.

[CatsCradle]

I understand that hospitals, etc. may have different types of "speak" for c-sections, but I keep asking myself, why does it matter in the long term to the OP?  Is one more valid than the other?  Does one have more bragging rights?  I'm concerned about why the distinctions are important, especially to the lay person.  

[womenswisdom]

Originally Posted by katelove 

In hospital-speak there are two types of c/s; emergency and elective. An emergency c/s is one the was not arranged prior to labour commencing, nothing to do with how urgent it is at the time. An elective c/s is one which was arranged prior to labour regardless of the reason. A c/s for complete placenta praevia is still called elective.
The terms " mother requested", "social", "unplanned" etc are used by lay-people and sometimes by medical staff but are not formally accepted descriptions ( at least in Australia). People will know what you mean but they aren't uses officially in hospitals.

Agreed, same distinction in the US, but IME the correct term for a cesarean occurring in an immediately life-threatening situation is typically "emergent" or sometimes "crash" as opposed to "emergency", which just means that it took place during labor and was not planned.

[34me]

Maybe the original poster was pot stirring and/or nosy.  But, honestly it does matter to me.  My almost 16 yo son was born by emergency c - section.  After 10 hours of labor he no longer tolerated labor, his heart rate went down to 23 and stayed there for the duration.  I was folded up on a bed run through the halls, my dh was left in the dust.  The last thing I remember as they were putting the mask over my face is the doc saying "we don't have time to count the instruments" .  I woke up 2-3 hours later with a vertical incision from my belly button down.  I apparently asked my dh what sex the baby was repeatedly for hours, and still had to take all his clothes off and inspect him when I was finally coherent in the morning.  And FWIW, I had had an unmedicated hospital birth 30 months before.  So for me it does make a difference, to me.

[Emma Bryan Fuller]

Never thought of it either or to question a mama who had one!

I considered mine an emergency. The hospital maybe only considered it urgent?

We both would've died without intervention. I am sure of that. Once things started to go wrong they rushed me in there.

You can call it whatever you would like:)

[katelove]

Originally Posted by womenswisdom 

Originally Posted by katelove 

In hospital-speak there are two types of c/s; emergency and elective. An emergency c/s is one the was not arranged prior to labour commencing, nothing to do with how urgent it is at the time. An elective c/s is one which was arranged prior to labour regardless of the reason. A c/s for complete placenta praevia is still called elective.
The terms " mother requested", "social", "unplanned" etc are used by lay-people and sometimes by medical staff but are not formally accepted descriptions ( at least in Australia). People will know what you mean but they aren't uses officially in hospitals.

Agreed, same distinction in the US, but IME the correct term for a cesarean occurring in an immediately life-threatening situation is typically "emergent" or sometimes "crash" as opposed to "emergency", which just means that it took place during labor and was not planned.

Ah ok, interesting. In Australia the term "emergent" is used to describe something which is done *before* it is an emergency. Usually believing that the situation would become an emergency without intervention.

"Crash c/s" is very much an American expression and not one I have ever heard used here.

[Storm Bride]

OP: I call my first one an "emergency" c-section (including the quotes), because I was wheeled off with great drama and fanfare and urgency, and not given any choice in the matter whatsoever. That said...I have no idea why. My son was frank breech. But, the hospital policy at that time was vaginal delivery of breech babies, not c-section. I was almost fully dilated, but my waters hadn't broken yet. To this day, I don't know why it was done as an emergency. And, my GP, who was going to look at my records and talk to me about it, never got back to me on the subject. So...yeah.

I had one other emergency one, and it was a true emergency (and was too late, as my son couldn't be resuscitated). My other three were all scheduled.

However, OP, I do want to address one part of your post, where you said this:

"and has the term "emergency c section" in place of "unplanned c section" even become accepted within the medical community?"

The term "emergency c-section" in place of "unplanned c-section" originated with the medical community. This isn't something that over-dramatic moms started saying to make their birth stories more interesting. It's something moms were told, at the hospital, by medical professionals. You do seem to have some kind of issue with c-section moms and/or with women telling their own birth stories, their own way. You might want to work on that. Someone describing her failure to progress or maternal exhaustion c-section as an emergency doesn't affect you in any way at all.

[Haelmoon]

The definition of c-sections it a moving target, and there are attempts to standardized them in the medical community.  The terms currently used are such that they can track outcomes in different birthing situations (such as pre-labour and in labour C-sections).

Essentially, there are "elective" C-section which are booked ahead of time.  As mentioned early, a stable, non-bleeding placenta previa patient have an "elective" C-section, but really it was not an elective choice, but an "elective" medical procedure because it was booked ahead of time.  Elective C-sections occur before the onset of labour.

Emergency c-sections are any occurring emergently or in labour.  This is a surgical term because operations not pre-booked are therefore deemed emergent.  The surgical classification does not fully capture the obstetrical reality, but it is what hospitals use to track outcomes.

There are new classifications that try to differentiate the events proceeding the C-section.  Robson's criteria have ten categories, such as primip, multip, previous c-section, premature infant, no vertex presentation, etc.  The categories are subdivided into pre-labour, spontaneous labour and induced labour.  It is medically a better way to track c-sections because it may help to identify unusually high rates at certain centers.

However, for moms, this classifications does not address their experience of their C-section.  However a mom wishes to describe her c-section is the appropriate way for that c-section to be describe.  Words and labels do not fully capture the experience for many different women in many different situations.

[roadfamily6now]

I want to agree with everyone.

based on my own experience, I had an "emergency" c-section however it was hardly an emergency. It took them over 1 hour to get ready to do the surgery. Why did I have my c-section? My baby was breech, however it was not until I was 6 cm dilated and I had arrived at the L&D to be check in did anyone find out this information.

Where I come from, (Western US) the medical establishment refers to an "Emergency" cesarean as one that was no planned ahead of time. It can be a true emergency or it can be a simple breech baby during labor.  Whereas a "elective" cesarean is one that was planned PRIOR to labor starting.

[Just1More]

Hmm.  I don't see this question as putting moms on the spot when telling their birth story.

I see it as more of a statistical question.  When a hospital reports, for example, that x% of their c-sections were emergency c-sections, that legitimizes many (from stories told here) that were not necessary, or even truly consented to.  If there were another term, or if the definitions of terms were more accurate/nailed down, then the reporting would be more clear.

(Sorry for my horrible grammar.  It's late and I'm too tired to fix it. :) )

[CatsCradle]

Sorry, edited out.  Was a bit too harsh in my post.

Edited by CatsCradle - 3/29/12 at 9:17am

[AlexisT]

My first section (NHS) was coded as emergent. Not in labor, unscheduled, performed due to fetal distress in the context of severe preeclampsia. It was not "crash", in American colloquial parlance.

NICE recommended a 4 point coding system--elective, and then subdivide the "emergency" group. Studies do look at CDMR (caesarean delivery by maternal request) but there is no accurate record keeping for it. (MR means no medical indication at all--elective repeats are not counted in this group as previous CS is considered an indication. Ditto twins and breech; these may be delivered vaginally, but they're still reasons.)