Anatomy and Physiology

The uterus or womb is a pear shaped organ that is found in the pelvis at the top of the vagina. The uterus in a woman that is not pregnant does not extend above the pubic bone (Figures 1, 2 and 3)

Figure 1 - Anatomy of the uterus and Figure 2 - Uterus as seen from in front. surrounding organs as seen in a section through the middle of the body.

Figure 3 - View of the uterus, ovaries, Fallopian tubes, and round ligament through a laproscope.

In the pregnant woman at the end of pregnancy, the uterus enlarges to approximately 40 centimeters (16 inches) above the pubic bone The cervix is found at the lowermost portion of the uterus and is the opening through which the fetus passes during delivery. Normally, this opening is closed until late in the pregnancy

Fertilization occurs within the fallopian tubes. The fallopian tubes are found at the top of the uterus, one on each side. The end of each fallopian tube has fingerlike projections called fimbria which guide the egg from the ovary into the Fallopian tube The fertilized egg then passes from the Fallopian tube into the cavity within the uterus where the fertilized egg implants into the wall of the uterus. The site of implantation becomes the As the egg develops into a fetus the remains attached to the fetus through the umbilical cord. Thus the blood supply to the fetus originates in the uterine wall The umbilical cord extends from the to the fetus where it inserts at umbilicus (belly button) of the fetus

Reasons for the Increasing Rate of C-sections

Greater emphasis on "quality survival" for the newborn, not simply survival Continuous fetal monitoring of heart rate increases the number of C-sections for fetal distress More women are waiting to start childbearing until later in life because of their careers. With advancing age of the mother there is a greater risk of having other medical problems, thus the C-section rate increases There has been a decrease in the number of forceps deliveries, which in turn increases the number of C-sections Many obstetricians no longer wish to take the risk of a vaginal breech (bottom first) delivery Women with prior a C-section often choose or are required to have a repeat Csection