A cesarean section or C-section refers to the surgical delivery of a baby. Instead of bringing the baby through the vaginal canal, your doctor makes an incision in the mother’s abdomen as well as uterus to bring out the baby. It is a common procedure used for delivering babies around the world. It has reduced the risk associated with unexpected problems arising during natural birth. The un-planned and planned cesarean surgery has reduced the complications to the mother drastically. But, many women still feel guilty over the surgical delivery method. They feel less of a mother compared to women who have had natural births. It is a misconception that women need to overcome. Read ahead to know more about the procedure.
Reasons For A Scheduled C-Section
In some cases, your doctor can detect any problem with your health or the baby. So, the doctor pegs you for the invasive procedure in advance. So, you need to undergo an invasive procedure before the due date to deliver the baby safely. The factor that increases your need for C-section includes:
Certain Medical Conditions
Pregnant women suffering from serious health conditions cannot go through vaginal delivery. The medical condition can make vaginal delivery dangerously stressful. So, your doctor suggests a cesarean section when you suffer from the following:
- High blood pressure
- Diabetes
- Kidney disease
- Infections
If the pregnant woman suffers from certain types of infection, then vaginal delivery is not safe. It is because the virus gets transmitted to the child during delivery. Therefore, the doctor opts for cesarean surgery when the mother suffers from active genital herpes or HIV/AIDS infection.
Baby’s Health
A baby suffering from a congenital condition or other illness cannot make the journey through the birth canal. The journey is treacherous for the baby and affects the baby’s health.
A Large Baby
During the prenatal scans, your doctor can detect a large baby. Delivering a large baby through the vaginal canal is risky. The baby too large (a condition called macrosomia) cannot move safely through the birth canal and have high chances of becoming wedged in the canal. It can lead to baby sustaining injuries or facing other complications. So, babies weighing more than 4,000 grams (8 pounds and 13 ounces) need a scheduled cesarean section for delivery.
Mother’s Weight
Expectant mothers who are obese can suffer from several health complications like high blood pressure or gestational diabetes. These risk factors make vaginal birth difficult. Obese mothers can also experience longer labors. So, the doctor plans for C-section to avoid any complications.
Mother’s Age
While older mothers can deliver vaginally. But, the risk of complications associated vaginal birth increases with maternal age.
Breech Position
The breech position refers to your baby is butt-first or feet-first. In normal cases, the breech position changes before birth or your doctor manages to turn it. But, a cesarean becomes necessary when it becomes impossible to change the position. A breech baby faces a high risk of getting stuck in the birth canal or suffers from oxygen deprivation due to the blocking of the umbilical cord.
Multiple Birth
The pregnancy with twins or more babies can increase the likelihood of having a cesarean section. Monitoring two babies at the same time during the labor becomes logistically difficult. Along with that, the increase in the number of babies in a single pregnancy enhances the risk associated with fetal and maternal problems. So, to avoid any mishaps during the birth due to cord compression from babies or high blood pressure of mother, your doctor suggests invasive procedure.
Placental Problems
An expectant mother suffering from the placenta problem needs a cesarean section for delivery. The conditions, making the vaginal delivery difficult are:
- Placenta previa (placenta sits too low in the uterus, blocking the cervical opening)
- Placental Abruption (Separation of the placenta from the uterine wall)
Birth Defects
If the baby suffers from any birth defect like a severe case of hydrocephalus, then the doctor suggests C-section.
Other Complications
If a pregnant woman develops high blood pressure, it can lead to a dangerous condition known as preeclampsia. It needs medical attention. But, in some cases, it escalates to eclampsia. The condition affects the pregnant woman’s central nervous system, leading to seizures. So, your doctor can recommend cesarean delivery to protect the mother and the baby.
Prior C-Section Delivery
When having a cesarean delivery the first time, it increases your risk of subsequent procedures. In such cases, your doctor recommends VBAC (Vaginal Birth After Cesarean).
Reasons For Unplanned C-Section
In some cases, a pregnancy proceeds like a normal one. You are progressing fine without any complications. But, the need for cesarean section arises well into the labor. It occurs unexpectedly due to some complications. The most common reasons for an unplanned or unscheduled cesarean section are:
Trouble With Starting Of Labor
Some mothers do not start labor, even after carrying the baby to term. No signs or symptoms appear to indicate the start of labor. For example, the cervix does not dilate even when you feel the contractions. In such cases, your doctor suggests emergency cesarean. It is usually opted by the doctor when your cervix does not dilate after 24 or 35 hours of having contractions (in first-time mothers) or less in subsequent deliveries.
Labor Stalls
Like normal cases, you may sail through the early stages of delivery. So, your cervix will dilate three centimeters to proceed with the labor. But, suddenly it grinds to a halt. Your doctor waits for the labor to proceed naturally. If it does not start by itself, then a labor stimulator is provided to jump-start the contractions. Such problems occur commonly when the baby’s head does not fit through the pelvis. Squeezing a big baby through the vagina becomes impossible. So, your doctor opts for the cesarean birth.
Fetal Distress
The fetal monitor picks up your baby’s heartbeats. During the labor, if your baby experiences any signs of distress, it is picked by the fetal monitor. Low heartbeats indicate the baby is suffering from some issues inside the womb. So, your doctor decides on the immediate surgery to take the baby out from the womb to avoid any fatal complications.
Exhaustion
During a natural birth, you need to push the baby out of your womb. As the birthing progresses, you may feel exhausted. It becomes impossible to push the baby out. In such cases, your doctor suggests cesarean.
A Prolapsed Umbilical Cord
If a prolapsed umbilical cord makes it way to the birth canal before the baby comes, it can compress the space. So, the baby can face difficulty getting oxygen in the restricted space. The cutting off of oxygen supply during birth can have severe complications in the baby.
Uterine Rupture
When the uterus ruptures, it becomes an emergency. So, to save you and your baby, the doctor opts for cesarean surgery.
While the cesarean section is major surgery, it becomes the safest option to bring the baby into the world without complications. The medical necessity can make it the best option to deliver the baby without any dangers. It is a safer option for mothers when vaginal delivery becomes risky.
Risks Of C-Section
While cesarean delivery is considered as a safe option for the mother as well as the baby, it has some risks. Like any invasive procedure, you and baby can experience some risks. But, skilled doctors try to overcome the risks with their skill and following proper guidelines. But, the risks associated with the invasive delivery method are:
- Blood clots
- Bleeding
- Infection
- Longer recovery time compared to natural birth
- Surgical injury to organs
- Hernia, adhesions, and other complications of abdominal surgery
- Increased risks for future pregnancies
- A C-section scar
The invasive method of delivery can also pose some risks to your baby. You need to know that opting for a cesarean birth can cause:
- Breathing problems (for a child that has not completed 39 weeks of gestation)
- Injury to the child during surgery
You and your doctor need to talk about birthing options before the due date. You need to prepare yourself for any unexpected situation arising during the birthing. During the prenatal visits, your doctor can determine any issue you or your baby shows that can lead to requiring a cesarean surgery. So, keep your mind open and get all the information. In the end, the right decision is the one that will not affect the mother and baby’s health.
Preparing For C-Section Delivery
Some women decide early that cesarean delivery is an ideal option for them. In such cases, the doctor offers you complete instructions. So, you have to follow the instructions to lower the risk of complications. It will ensure a successful delivery without any complications. Like normal pregnancy, you need to go for all the checkups. It is also essential to undergo blood tests as well as other examinations to ensure your overall health. The examination also determines the possibility of cesarean delivery. When you go for a planned C-section, your doctor will record your blood type. Some women may need a blood transfusion after the surgery due to excess bleeding. Recording the blood type will allow your doctor to prepare for any complications.
At times, unexpected events happen with pregnancy. So, you must always prepare yourself for the unexpected. You need to discuss your risk factors leading to the cesarean delivery during the prenatal appointments with your doctor. Discuss all the possibilities with your doctor and the steps to lower them. Try to make sure you get all the answers to the question. It will help you mentally prepare for the unexpected if any complication arises before the due date. You need more time to recover from cesarean delivery compared to normal birth, you need to arrange assistance. The extra set of hands will help you take care of the baby and perform other tasks without stressing too much. Arrange help at home as you need to recover from surgery along with taking care of the baby.
Procedure For C-section Delivery
Your gynecologist suggests the cesarean delivery when the child feels distressed inside the mother’s womb. It is also opted by the doctor during emergencies. In such cases, you need to plan to stay in the hospital for three to four days. It is to recover from the surgery. You need to undergo several steps to deliver baby surgically. So, the steps your doctor follows are:
Preparing For The Surgery
The gynecologist prepares you for the surgery. Your abdomen is cleaned and you are prepared for receiving IV (intravenous) fluids in your arm. It allows your doctor to administer any medication or fluids necessary during or after the surgery. A catheter is also placed in the bladder. It is to empty the urine from the urinary bladder during the surgery.
Anesthesia For The C-Section Surgery
Since you are about to undergo an invasive procedure, your doctor gives you anesthesia. There are three types of anesthesia preferred for cesarean delivery, namely:
- Epidural
- Spinal Block
- General Anesthesia
In most cases, an epidural or spinal block is preferred for surgical delivery. It is because the method exposes the baby to only a low amount of medication. Along with that, the mother can also actively participate in the delivery process. But, in rare cases of emergency, your doctor suggests general anesthesia.
Epidural
When you opt for an epidural for your C-section, the doctor numbs the small area on the back with a local anesthetic injection. Then, the anesthesiologist inserts a catheter (a tiny tube) in the expectant mother’s lower back using a needle. The catheter is left after removing the needle. Your doctor uses the catheter to deliver the anesthesia medication as per requirement. The anesthesia can numb the entire abdomen for the surgery. You may not feel any pain. But, you can experience pressure during the needle insertion.
Spinal Block
If your doctor suggests a spinal block, then the anesthesiologist injects the medication in the lower back. The needle injects the medication into your spinal fluid. Your doctor removes the needle after administering the medication. You can experience relief from the pain immediately. The pain relief lasts for a few houses (1.5 hours to 3 hours). So, the mothers feel numbness in the abdomen to the legs.
General Anesthesia
It is only a pain relief method that makes you lose consciousness during labor. So, the expectant mother remains unconscious during the birth of the baby. Using the general anesthesia for the surgery can expose your child to the medication before delivery. So, it is opted by gynecologists during rare cases.
The type of anesthesia your doctor chooses depends on the mother’s and baby’s health. The underlying reason for performing cesarean surgery also influences the decision. For a planner cesarean surgery, you can choose anesthetic. But, while deciding to take into account the safety of your child. Therefore, opt for an epidural or spinal block that offers safety to both you and the unborn baby. In some cases, the anesthesiologist places the catheter for an epidural in normal delivery and then the mother requires emergency surgery. So, the doctor injects a stronger dose of drugs using the same catheter. It offers you pain relief. Always talk to your doctor before choosing the anesthesia to determine the best option for you.
Making Incisions For Delivery
After properly medicated and numbed, the doctor starts making incisions on the abdomen. In normal cases, the doctor opts for horizontal incisions just above the pubic hairline, across the pelvis. But, in emergencies, your doctor opts for vertical incisions. The incisions expose the uterus. So, your doctor makes the incision into the uterus to remove the baby. The opening of the uterus is covered. Therefore, the mother cannot see the procedure.
After taking the baby, your doctor cleans the bay by clearing the mouth and nose of fluids. The baby is separated by clamping and cutting the umbilical cord. The nursing staff checks the baby’s breathing and other conditions. The doctor takes care of the after birth.
Close The Incisions After Surgery
Women who plan to have no more children after the delivery undergo tubal ligation. It is the procedure performed by the doctor after getting a signed consent to tie the tubes. The doctor repairs the uterus using dissolving stitches. Finally, the abdomen incision is closed using sutures. You remain in the post-operative area for at least an hour. It is to monitor your vital signs and signs of heavy bleeding. If you have stable vital signs and normal bleeding (you bleed vaginally from a healing uterus), then the doctor suggests transferring you to the postpartum room. You spend the remaining days in the hospital in the room.
Recovery Process After C-Section
After undergoing the invasive procedure, you and your baby need to stay in the hospital for three days. You have to remain on an IV after the surgery. It allows your doctor to adjust the painkiller levels after the surgery to relieve pain. The painkillers delivered directly into the bloodstream after the anesthesia wears off. So, you will not feel immense pain.
The day after the surgery, your doctor will encourage you to get up and walk around. It is to prevent constipation as well as blood clots. Your doctor or nurse will also teach you the right position for breastfeeding. It is to avoid additional strain on the incision area, which can cause pain. Your doctor recommends home care after the surgery. You need to follow all the instructions suggested by the doctor religiously to avoid any complications. But, in most cases, you must follow the guidelines like:
- You must take it easy. Avoid lifting heavy objects or perform a strenuous activity that can affect the stitches. So, take rest for the first few weeks after the procedure.
- Use the correct posture. It is to support your abdomen and avoid pressure on the sutures.
- Drink plenty of fluids. It is to replace the fluid lost during the C-section.
- Like natural delivery, you have to avoid sex for four to six weeks. It is better to get the all-clear from the doctor before the intimate act.
- You need to take the pain medications as per the suggestion from the doctor.
- Some women can suffer from postpartum depression. If you see signs of overwhelming fatigue or severe mood swings, then seek assistance from a professional.
In some cases, women who have undergone cesarean can suffer from signs that indicate some serious issues. So, you need to call your doctor immediately after you see the signs:
- Foul-smelling vaginal discharge
- Breast pain with fever
- Bleeding with large clots
- Pain while passing urine
- Signs of infection (like fever, discharge from the incision, redness, swelling)
Conclusion
Many women feel like a failure after having a C-section. But, no matter how you go there, the important point is, you have reached the finishing line of pregnancy with a healthy baby. Having an emergency cesarean delivery does not make you less. Most women feel regret due to the studies suggesting long-term health complications for babies delivered by cesarean. They tend to suffer from metabolic disorders like diabetes or obesity in their later life. But, mothers who opt for the surgical method of delivery prevent the risk to their unborn baby. So, you have made a brave and right decision to protect your baby from harm.
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