Cesarean Section – C-Section

Cesarean delivery — also known as a C-section — is a surgical procedure used to deliver a baby through incisions in the mother’s abdomen and uterus.
A C-section might be planned ahead of time. Often, however, the need for a first-time C-section doesn’t become obvious until you are in labor.
Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your doctor might recommend a C-section if:
Your labor isn’t progressing. When your cervix isn’t opening enough despite strong contractions over several hours.
Your baby isn’t getting enough oxygen. For example when There’s a problem with the umbilical cord.
Your baby or babies are in an abnormal position.
You’re carrying multiples.
There’s a problem with your placenta. For example if the placenta covers the opening of your cervix (placenta previa)
You have a health codition. complex heart problems, high blood pressure requiring urgent delivery or an infection that could be passed to your baby during vaginal delivery — such as genital herpes or HIV.
Mechanical obstruction. You might need a C-section if you have a large fibroid obstructing the birth canal, a severely displaced pelvic fracture or your baby has a very large head.
You’ve had a previous C-section. Depending on the type of uterine incision and other factors, it’s often possible to attempt a vaginal birth after a previous C-section. In some cases, however, your doctor might recommend a repeat C-section.
Some women request C-sections with their first babies — to avoid labor or the possible complications of vaginal birth or to take advantage of the convenience of a planned delivery. However, this is discouraged if you plan on having several children.
Recovery from a C-section takes longer than does recovery from a vaginal birth. And like other types of major surgery, C-sections also carry risks to you and your baby.
Risks to your baby include:
Breathing problems. C-sections done before 39 weeks of pregnancy or without proof of the baby’s lung maturity might increase the risk of breathing problems for babies.
Surgical injury. Although rare, accidental cuts to the baby’s skin can occur during surgery.
C-section babies have a slightly higher risk of developing obesity, asthma and other ailments than do children born vaginally. There are differences between the microbial communities on their skin and in their guts than babies born vaginally.
Risks to the mother include:
Inflammation and infection of the endometrium (membrane lining the uterus). (endometritis) — can cause fever, foul-smelling vaginal discharge and uterine pain. It’s a dangerous condition that requires urgent medical help.
Increased bleeding. You’re likely to lose more blood with a C-section than with a vaginal birth.
Reactions to anesthesia. Adverse reactions to any type of anesthesia are possible.
Blood clots. The risk of developing a blood clot inside a vein — especially in the legs or pelvic organs — is greater after a C-section than after a vaginal delivery. If a blood clot travels to your lungs (pulmonary embolism), the damage can be life-threatening. You will be given medications to prevent it at the hopistal. You can aslo help prevent clots by walking frequently soon after surgery.
Wound infection. Infections are more common with C-sections compared to vaginal deliveries.
Surgical injury. Although rare, surgical injuries to nearby organs — such as the bladder can occur during a C-section. If there is a surgical injury during your C-section additional surgery might be needed.
Increased risks during future pregnancies. After a C-section, you face a higher risk of potentially serious complications in a subsequent pregnancy — including problems with the placenta — than you would after a vaginal delivery. The risk of uterine rupture, when the uterus tears open along the scar line from a prior C-section, is also higher if you attempt vaginal birth after C-section (VBAC).
If your C-section is scheduled in advance, certain blood tests will provide information about your blood type and your level of hemoglobin. These details will be helpful to your health care team in the unlikely event that you need a blood transfusion during the C-section.
If your C-section is planned before 39 weeks for a non-emergency reason, your baby’s lung maturity might be tested before the C-section. This is done with amniocentesis — a procedure in which a sample of the amniotic fluid is removed from the uterus for testing. Maturity amniocentesis can offer assurance that the baby is ready for birth.
Even if you’re planning a vaginal birth, it’s important to prepare for the unexpected. Discuss the possibility of a C-section with your health care provider well before your due date.
After a C-section, you’ll need time to rest and recover. Consider recruiting help ahead of time for the weeks following the birth of your baby.
During the procedure
While the process can vary, depending on why the procedure is being done, most C-sections involve these steps:
At home. Take a shower. Don’t shave your pubic hair. This can increase the risk of surgical site infection. If your pubic hair needs to be removed, it will be trimmed just before surgery.
At the hospital. Before your C-section, your abdomen will be cleansed. A tube (catheter) will likely be placed into your bladder to collect urine. Intravenous (IV) lines will be placed in a vein in your hand or arm to provide fluid and medication. You might be given an antacid to reduce the risk of an upset stomach during the procedure.
Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body — allowing you to remain awake during the procedure. A common choice is a spinal block, in which pain medication is injected directly into the sac surrounding your spinal cord. In an emergency, general anesthesia is sometimes needed.
Abdominal incision. The doctor will make an incision through your abdominal wall. It’s usually done horizontally near the pubic hairline (bikini incision). If a large incision is needed or your baby must be delivered very quickly, the doctor might make a vertical incision from just below the navel to just above the pubic bone. Your doctor will then make incisions – layer by layer – through your fatty tissue and connective tissue and separate the abdominal muscle to access your abdominal cavity.
Uterine incision. The uterine incision is then made — usually horizontally across the lower part of the uterus (low transverse incision). Other types of uterine incisions might be used depending on the baby’s position within your uterus and whether you have complications, such as placenta previa — when the placenta partially or completely blocks the uterus.
Delivery. The baby will be delivered through the incisions. The doctor will clear your baby’s mouth and nose of fluids, then clamp and cut the umbilical cord. The placenta will be removed from your uterus, and the incisions will be closed with sutures.
If you have regional anesthesia, you’ll be able to hear and see the baby right after delivery.
After the procedure
After a C-section, most mothers and babies stay in the hospital for two to three days. You might use a pump that allows you to adjust the dose of intravenous (IV) pain medication.
Soon after your C-section, you’ll be encouraged to get up and walk. This will help prevent constipation and DVT.
You will be monitored for signs of infection, how much fluid you’re drinking, and bladder and bowel function.
You will be able to start breast-feeding as soon as you feel up to it. Your nurse or a lactation consultant will teach you how to position yourself and support your baby so that you’re comfortable. Your health care team will select medications for your post-surgical pain with breast-feeding in mind. Pain control is important since pain interferes with the release of oxytocin, a hormone that helps your milk flow.
When you go home
While you’re recovering:
Take it easy. Rest when possible. Get help from the family. For the first few weeks, avoid lifting anything heavier than your baby.
Support your abdomen. Use pillows for extra support while breast-feeding, straining or coughing. A pregnancy belt might provide additional support but it’s not necessary.
Drink plenty of fluids. Drinking water and other fluids can help replace the fluid lost during delivery and breast-feeding, as well as prevent constipation.
Take medication as needed. Most pain relief medications are safe for women who are breast-feeding, but avoid Aspirin.
Avoid sex. Don’t have sex until four to six weeks after surgery. But repmember to spend some time with your partner. Express your love to each other, even if it’s just a few minutes in the morning or after the baby goes to sleep at night.
Contact your health care provider if you experience:
Any signs of infection — such as a fever higher than 100.4 F (38 C), severe pain in your abdomen, or redness, swelling and discharge at your incision site
Breast pain accompanied by redness or fever
Foul-smelling vaginal discharge
Painful urination
Heavy bleeding that soaks a sanitary napkin within an hour or bleeding that continues longer than eight weeks after delivery
Postpartum depression — which can cause severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life
Wishing you a speedy recovery and a happy new role in life.