Caesarean Delivery

C section delivery

What is a C-section?

A cesarean section (or C-section as it is called) is the delivery of a baby through a surgical cut in the mother’s abdomen and uterus. In some cases, a C-section is scheduled in advance, while in most first pregnancies; it could be done in response to an unexpected complication.

Reasons for a C-section

A C-section is considered safer for both mother and baby when:

  • Baby is too large – and may not be able to pass safely through the mother’s pelvis
  • Labour is not progressing and the cervix is not opening enough
  • The expectant mother has a medical condition like diabetes, high blood pressure or herpes infection
  • Placenta Previa – when the placenta blocks the path of exit from the uterus
  • Breech baby – If your baby is the breech position with feet or butt down  and can’t be turned,  a C-section is imperative
  • Twins or multiples need to be delivered
  • The baby is in distress – like for e.g, an abnormal heart rate
  • The expectant mother has had a previous cesarean birth or surgery
  • Fetal anomalies that were diagnosed in prenatal testing
  • Infections – If the expectant mother is HIV positive or has genital herpes infection, a c-section is necessary to avoid the virus being transmitted to the baby during deliver
  • The expectant mother or her family opts for a C-section by choice

The Procedure

General anesthesia or a regional anesthesia such as an epidural or spinal block may be required for the C-section. In these days it is rare to give general anaesthesia unless its an emergency situation. Most women prefer spinal or epidural anesthesia so that they can be fully conscious during the surgery and can see their new baby immediately.

What Happens Before  a C-section?

  • Your abdomen will be washed and shaved before surgery
  • A catheter (tube) will be placed in your bladder to empty it
  • The anaesthesiologist will review your case before administering pain relief medications
  • You will be put on intravenous (IV) fluids and medication during surgery
  • Your Doctor will cut through the layers of your abdomen and uterus to deliver the baby

What are the Different Types of Incisions?

There are three basic types of incision and your Doctor may choose one of these:

  • Low Transverse Incision – also called the “Bikini Cut”, this horizontal cut across the lower portion of the uterus is commonly used as it bleeds less, heals well and has a lesser danger of rupture during subsequent labours
  • Classical Incisions – also called the “High Vertical Incision” or the “Granny Cut”, this incision is associated with the highest risk of bleeding and subsequent rupture of the uterus, and is now used only in emergency situations
  • Low Vertical Incision – similar to classical incisions, but is done lower on the uterus where the uterine wall is thinner. It may be done to deliver a baby in an awkward position or when an incision may have to be extended into a classical incision
  • The uterus will then be closed with stitches that later dissolve on their own

Pain During A C-Section

Though anesthesia prevents you from feeling pain during the procedure, you may however feel some pressure and tugging sensations as the uterus is opened and the baby and placenta are removed. If you have an epidural in place, your Doctor may continue the pain medication to keep you comfortable. Otherwise, you may receive pain medication through IV or by mouth.

The Risks of a C-section

As a C-section is major abdominal surgery, it is riskier than a vaginal delivery. Expectant mothers who have a C-section are easily prone to infection, excessive bleeding, blood clots (in the legs and pelvic organs)  more post-partum pain, extended hospital stay depending on the severity  of the surgery and longer recovery time. The surrounding organs like the bladder and bowel could be injured and may need additional surgeries to fix it.

Each C-section also increases the future risk of these complications as well as placenta previa and placenta accreta in subsequent pregnancies. However, not all C-sections can (or should) be prevented. In some situations, a C-section is warranted for the well-being of the mother, baby or both.

Studies show that babies born out a c-section surgery performed before week 39 of pregnancy are at a higher risk of breathing problem, as their lungs are not fully mature.

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