Cesarean Delivery

In general 20 % pregnancies end up in a cesarean delivery for various reasons. Some of these reasons might be predictable before hand leading to a planned or elective cesarean section where as some can happen as an emergency.

Elective cesarean decision although can be disappointing, is atleast planned and gives you time to think and plan the procedure.

However, if you end up having an emergency Cesarean, it can be quite upsetting, as there is not much time to absorb and think about the decision.

So what is a Cesarean Section?

A Cesarean section (also known as C-section or cesarean birth) is a surgical procedure that involves making abdominal and uterine incisions to deliver a baby. Cesarean sections are typically avoided before 39 weeks of pregnancy to allow the child to develop properly in the womb. However, if complications arise, a cesarean section is done before 39 weeks.

When is Cesarean Section Recommended?

A C-section may be recommended if:

• You've had a more than one C-section before

• The mother has infections such as HIV and active herpes

• The placenta is obstructing your cervix.

• The placenta separates from the uterus

• Multiple pregnancies may necessitate a C-section.

• Your baby is too big or in an awkward position for successful vaginal delivery.

• Your baby has birth defects that necessitate a C-section

• When complications arise during vaginal birth

• Labor stops progressing

• The baby shows signs of distress

How Long Does a Cesarean Section Surgery Take?

In general, the entire cesarean section surgery roughly takes 20 to 40 minutes. In certain situations, like in an emergency C-section, the cesarean birth will be quite speedy, with the baby arriving in less than 5 minutes.

How Do You Prepare for Cesarean Section?

When a caesarean section is recommended, your doctor will provide you with detailed instructions on how to minimize the risk of complications during a cesarean delivery. Your doctor will tell you to:

• Avoid solid foods eight hours prior to the C-section

• Bathe or shower using a special soap to reduce the possibility of infection following the procedure

• Avoid shaving your pubic area or stomach to lower the risk of infection after delivery

There are a variety of options available for pain management following surgery, these include IV drugs delivered continuously through a pump or as scheduled dosages, or medication administered by an epidural catheter or spinal.

What Happens During a Cesarean Section?

Before the surgery, your doctor will clean your abdomen and prepare you to receive IV fluids into your arm. This enables doctors to deliver fluids and medications as needed. A catheter will also be inserted to ensure your bladder stays empty during the procedure.

Different types of anesthesia are offered to expectant mothers:

Epidural: an epidural is common for both cesarean and vaginal deliveries. It is administered into the lower back outside the spinal cord sac

General anesthesia: a type of anesthesia that induces a painless sleep. It is typically reserved for emergency situations.

Spinal block: this type of anaesthesia is directly injected into the sac surrounding your spinal cord, to numb the lower section of your body.

Once you have been appropriately medicated and numbed, the surgery can begin. The area of the surgery will be covered throughout the procedure. The first incision will be made just above the pubic hairline. Typically, this is done horizontally across the pelvis, but for emergency situations, a vertical incision may be necessary. Once the incision is made and the uterus is revealed, another incision will be made into the uterus.

Following the second incision, your newborn will be delivered from your uterus. The doctor will first attend to your newborn by removing fluids from their nose and mouth, as well as clamping and separating the umbilical cord. 

At this point, the baby will  be handed over to hospital personnel, who will ensure that he or she is breathing normally and will prepare your baby for placement in your arms. Your uterus will then be restored using dissolving stitches, and your abdominal incision will be closed with sutures.

Recovering from a Cesarean Section

After the procedure, you will most likely be hospitalized for two to three days. The first few weeks following the surgery will be quite painful. Coughing, sneezing, or even laughing may be uncomfortable. Your pain management options will be discussed with you by your doctor.

You'll be advised to stay hydrated and walk after the effects of your anaesthetic wear off. This aids in the prevention of deep vein thrombosis and constipation. Your doctor will keep an eye on your wound for symptoms of infection. The bladder catheter will be removed as quickly as possible

You can begin breast-feeding your new-born as soon as you are ready. Your nurse will show you how to support your baby and position yourself so you're both comfortable. 

When you get home, take it easy and prioritize rest. You should also avoid sex for at least 6 weeks. If you experience symptoms such as overwhelming fatigue or severe mood swings, pain when urinating, signs of infection, foul-smelling vaginal discharge, breast pain accompanied by fever, or bleeding with large clots, consult your doctor.

What are the Risks of Cesarean Section?

The major risks involved with a cesarean section include

• Risks from anesthesia

• Excessive blood loss requiring blood transfusion

• Infection

• Bladder or bowel injury

• A blood clot may break off and make its way into the bloodstream

• Fetal injury rarely

Conclusion

Regardless of the type of birth you're hoping or planning for, a Cesarean section should not be completely ruled out. With adequate preparation, a C-section doesn’t have to be a negative experience.

Dr. Usha Kiran FRCOG

Consultant OBGY

Prime Hospital

Whatsapp no +91 90043 38835