C-Section

1 What is a C-Section?

Also known as Cesarean delivery, a C-section is a surgical procedure that is usedto deliver a baby by making incisions in the mother's abdomen and uterus.

A C-section might be planned before time if you develop pregnancy complications or you have had a previous C-section and are not considering vaginal birth after cesarean (VBAC).

However, the need for first-time C-section does not become obvious until labour has commenced.

If you are pregnant, it can be helpful to prepare by knowing  what to expect during C-section both during and after the procedure.

2 Reasons for Procedure

Here are the most common reasons to undergo a C-section procedure.

Sometimes a C-section may be safer for your baby than a vaginal delivery.

A C-section can be recommended if:

  • Your labour is not progressing, which can be due to the cervix not opening enough despite contractions for long periods of time or the baby's head is too big.
  • It can also be done if the baby is not receiving enough oxygen, your baby is in an abnormal position, especially if the feet or buttocks enter the birth canal first called a breach or if the baby is positioned sidewards or shoulder first (transverse).
  • Another reason for a C-section is if you are carrying multiples, if there is a problem with your placenta, if there is a problem with the baby's umbilical cord, if you have a health concern like complex heart problems, high blood pressure requiring urgent delivery or infection that can be passed on to the baby during vaginal delivery.
  • You can also consider C-section when there is a mechanical obstruction (fibroid obstructing the birth canal) or if you've previously had a C-section. Some women request C-section for their fist babies, this is done to avoid labour or the possible complications of vaginal birth or just to take advantage of the convenience of a planned delivery. However, this is discouraged in the situation where you plan on having several children. Women who have several C-section increase their risks of placenta problems as well as heavy bleeding which might require a hysterectomy. If you are considering a planned C-section for your delivery, it is advised that you work with your health provider to make the best decision for you and your unborn child. 
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3 Potential Risks

The process of recovery usually takes longer than a vaginal birth recovery.

C-sections carry potential risks which include:

Breathing complications

It is more common for babies born due to scheduled C-section to develop transient tachypnea. This is a breathing complication characterized by rapid breathing during the few days after birth.

C-sections that are performed before 39 weeks of pregnancy or without proof of the baby's lung maturity might also increase the risk of breathing problems.

Another potential risk is surgical injury

Although a rare occurrence, accidental nicks to the skin of the baby can happen during the procedure. The lining of the uterus can be inflamed an infected, a condition widely known as endometritis. This condition can cause fever, foul-smelling vaginal discharge, and uterine pain.

A woman is more likely to experience vaginal bleeding with a C-section than a normal vaginal birth. Some women can have an adverse reaction to the anaesthesia used for the operation. Blood clots can also form a vein in the leg and the especially the pelvic area, this risk is higher in a C-section than a vaginal birth.

In general, wound infections are more likely to occur with C-sections compared to the vaginal deliveries. This infection usually occurs on the incision site on the uterus. In rare cases, C-section may pose a threat to organs around the uterus such as the bladder.

Surgical injuries are more likely to occur if you have multiple C-sections. After a C-section, you might face a potential complication in a future pregnancy. These complications may include problems with the placenta. The risk of uterine rupture, when the uterus tears open along the scar line from a previous C-section is also higher if you attempt vaginal birth after a prior C-section.

4 Preparing for your Procedure

In preparing for your C-section procedure, you must follow your doctor’s orders. This can include:

IF the C-section has been scheduled in advance, your health care provider might suggest talking with an anesthesiologist about any possible medical conditions that would increase your risks of anaesthesia complication.

He or she might also recommend a number of blood test prior to the procedure. This blood test will show your blood type and your level of hemoglobin. These components are crucial to the health care team in the unlikely event that a blood transfusion is necessary during a C-section.

If your C-section has been planned for a period of 39 weeks for a non-emergency reason, the maturity of your baby's lungs may be tested before the C-section. This is usually done using a process known as amniocentesis.

In this procedure, a sample of amniotic fluid is removed from the uterus for testing. Maturity amniocentesis can give assurance that the baby is ready for birth. Even if you are planning a vaginal birth, it is very important to make preparations for the unexpected.

Discussing the possibility of a C-section with your health care provider before the due date is vital. Ask questions, share your concerns, and also review  the situations that might make a C-section the best option.

After a C-section, you are required to rest and recover. Consider searching for help ahead of time for weeks following the birth of your baby.

5 What to Expect

Read on to learn more about what to expect before, during, and after your C-section procedure.

While the process is not uniform, depending on the reason why the procedure was done, most C-sections involve the following steps:

At home

While research suggests that the benefit is not vivid, you might be asked to bathe with antiseptic soap before a C-section to lower the risks of infection. Don't shave your pubic hair as this can increase the risk of surgical site infection. At the hospital. Before the operation, your abdomen will be cleansed.

A tube (catheter) will be placed into your bladder to collect urine. Intravenous lines will then be placed into a vein in your arm to provide fluid and medication. You might also be given an antacid to lower the risks of an upset stomach during the procedure.

Anaesthesia

Most C-sections are done under regional anaesthesia, which numbs the lower part of your body, allowing you to stay awake during the procedure.

A common choice is a spinal block, in which medication is injected directly into the sac surrounding your spinal cord. In an emergency, general anaesthesia is sometimes required. With general anaesthesia, you will not be able to see, feel or hear anything during the procedure.

Abdominal incision

The doctor will make an incision through your abdominal wall. This is usually a horizontal incision along the pubic hairline. If a large incision is required or your baby mus be delivered very quickly,the doctor might make a vertical incision just below your navel to just above the pubic bone.

Your doctor will then make incisions, layer by layer, through the fatty and connective tissue and separate the abdominal muscles in order to access your abdominal cavity.

Uterine incision

A uterine incision is then made. This incision is usually horizontal across the lower part of the uterus. Other types of uterine incisions may be used but depend on the baby's position in your uterus and whether you have complications such as  placenta previa, characterised by a partial or complete blockage of the uterus by the placenta.

Delivery

The baby will be delivered through the incisions made. The doctor will clear our 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.

Most mothers and babies stay for two to three days after a C-section. You might  use a pump that allows you to adjust the dose of intravenous pain medication to control the pain as the anaesthesia wears off. Soon after your C-section, your health care team will proceed to monitor your incision for signs of infection.

They also monitor your movement, fluid intake and bladder and bowel function. It is possible to commence breastfeeding as soon as you feel up to it. Ask your nurse or a lactation consultant on how to position your baby so that both of you are comfortable.

Your health care team will select medications for  your post-surgical pain without breastfeeding in mind. Before you leave the hospital, talk to your health care provider about any preventive health care you might need.

Including vaccinations

Making sure your vaccinations are current can help yours and your baby's health.

When you go home during the process of recovery, it is important to keep the following in mind: Take it easy and rest when possible.

For the first few weeks, avoid lifting from a squatting position anything heavier than your baby. Support your abdomen by using pillows for extra support while breastfeeding.

Drinking plenty of fluids can help replace those lost during delivery and breastfeeding.

Take medication as directed

Your health care provider might recommend acetaminophen or other medications to help relieve pain. Do not participate in sexual intercourse until your health care provider has given you a signal to. This often four to six weeks after the surgery.

Contact your health care provider if you experience the following

  • Any signs of infection such as a fever higher than 38 C or 104 F,
  • 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 a C-section.

Postpartum depression

Which can cause severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life — is sometimes a concern as well. Contact your health care provider if you suspect that you're depressed.

It's especially important to seek help if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.

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