A 7-week-old<unk>  scar and linea nigra visible on a 31-year-old mother: Longitudinal incisions are still sometimes used.<unk>  is recommended when vaginal delivery might pose a risk to the mother or baby.<unk> s are also carried out for personal and social reasons on maternal request in some countries. Medical uses Complications of labor and factors increasing the risk associated with vaginal delivery include: * Abnormal presentation (breech or transverse positions). * Prolonged labor or a failure to progress (obstructed labour, also known as dystocia) * Fetal distress * Cord prolapse * Uterine rupture or an elevated risk thereof * Uncontrolled hypertension, pre-eclampsia, or eclampsia in the mother * Tachycardia in the mother or baby after amniotic rupture (the waters breaking) * Placenta problems (placenta praevia, placental abruption or placenta accreta) * Failed labor induction * Failed instrumental delivery (by forceps or ventouse (Sometimes, a trial of forceps/ventouse delivery is attempted, and if unsuccessful, the baby will need to be delivered by<unk> .) * Large baby weighing > 4,000 grams (macrosomia) * Umbilical cord abnormalities (vasa previa, multilobate including bilobate and succenturiate-lobed placentas, velamentous insertion) Other complications of pregnancy, pre-existing conditions, and concomitant disease, include: * Previous (high risk) fetus * HIV infection of the mother with a high viral load (HIV with a low maternal viral load is not necessarily an indication for<unk>  * An outbreak of genital herpes in the third trimester (which can cause infection in the baby if born vaginally) * Previous classical (longitudinal)<unk>  * Previous uterine rupture * Prior problems with the healing of the perineum (from previous childbirth or Crohn's disease) * Bicornuate uterus * Rare cases of posthumous birth after the death of the mother Other * Decreasing experience of accoucheurs with the management of breech presentation. Although obstetricians and midwives are extensively trained in proper procedures for breech presentation deliveries using simulation mannequins, there is decreasing experience with actual vaginal breech delivery, which may increase the risk. Prevention The prevalence of<unk>  is generally agreed to be higher than needed in many countries, and physicians are encouraged to actively lower the rate, as a<unk>  rate higher than 10-15% is not associated with reductions in maternal or infant mortality rates, although some evidence support that a higher rate of 19% may result in better outcomes. Some of these efforts are: emphasizing a long latent phase of labor is not abnormal and not a justification for<unk> ; a new definition of the start of active labor from a cervical dilatation of 4 cm to a dilatation of 6 cm; and allowing women who have previously given birth to push for at least 2 hours, with 3 hours of pushing for women who have not previously given birth, before labor arrest is considered. Physical exercise during pregnancy decreases the risk.
Caesarean section
Labor induction
Natural childbirth
Forceps
Trial of labour
Cordotomy
Obstetrical forceps
Vaginal delivery