If medical management of dystocia has failed or is inadvisable, a Cesarean section is indicated. The necessity of surgery is primarily based on the condition of the dam, progression of labor, and fetal heart rate. Timely intervention is crucial for optimal fetal and maternal survival. Surgical technique may vary, based on the needs of each individual case. There are many options for each portion of the surgery, including the choice of anesthetic protocol, abdominal approach, uterine incision location, and post-surgical pain management. Indications for surgery and some of the options for each step of the procedure are presented. Episiotomy is rarely used to treat dystocia and therefore, it is discussed only briefly.
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