C-Section or Cesarean Section
Also known as a cesarean section, a c-section is when a mother delivers her baby through an incision made in her abdomen and uterus. The process generally takes 40 minutes to an hour to complete. C-sections can be pre-planned or they can happen at the spur of the moment if a complication arises. In studies conducted a few years ago, c-sections are on the rise. According to the Centers for Disease Control and Prevention, in 2005, 30% of births were done by cesarean compared to 6% 30 years earlier.
On occasion it’s obvious that a woman will need a c-section. In most cases, this is clear before labor begins. There are several indications before and during the hospital stay that indicates to the doctors what type of birth will be taking place. If the labor is prolonged or if the mother isn’t progressing, a planned c-section may take place. Other indications include:
- Overly large baby
- Fetal distress
- Cord prolapse
- Uterine rupture
- Induction failure
- Multiple births
- Pre-eclampsia
- Hypertension
- Contracted pelvis
- STD’s such as genital herpes
- Baby is in a breech position
- Previous invasive uterine surgery
- Baby has a known illness
- Previous babies received trauma during vaginal delivery
In many hospitals, partners of the expectant mother are encouraged to take part in the entire process, and are even asked if they’d like to watch as the baby is pulled from the abdomen. It’s important that the mother is supported during this event, and sharing the experience is known to decrease the stress and anxiety of the situation.
Risks of C-Sections
This procedure is much riskier than vaginal deliveries since it’s a major abdominal surgery. Other risks involved from the procedure include:
- Infections
- Blood clots
- Excessive bleeding and/or blood loss
- Longer recovery
- Longer hospital stay
- Postpartum pain
- Injury to bladder or bowel
- Post-operative adhesions
- Incisional hernias
- Emergency hysterectomy
- Placenta accrete
- Placenta previa
- Malpresentation
- Uterine rupture
- Preterm birth
- Prolonged labor
- Low birth weight
But these aren’t the only risks. In fact, having one cesarean births reduces, not eliminates, your chance to give birth vaginally in the future. Although VBAC’s (vaginal birth after caesarean) are possible and gaining popularity, the risks continue to increase with each scar left on your uterus. Each c-section leaves a scar on your uterus. Therefore, it’s not the first c-section that presents the greatest risk to pregnancy and birth; it’s the second, third and fourth.
Types of Cesarean Sections
There are many different types of c-sections, mainly due to the type of incision made on the uterus, apart of the skin’s incision.
Classical C-Section: Because of the commonness of complications, classical c-sections are rarely performed these days. They involved a midline longitudinal incision which made a larger opening to deliver the baby.
Lower Uterine Segment Section: This is the most popular procedure done today and involves a crosswise cut just above the edge of the bladders. This procedure is proven to result in less blood loss, plus it’s easy to repair.
Emergency C-Section: This happens once labor has begun. Generally the doctor doesn’t have enough time to explain the process.
Crash C-Section: Similar to an emergency c-section, crash c-sections take place after a pregnancy complication arises suddenly during the process of labor. A crash c-section is done to prevent death to mother and/or baby.
Repeat C-Section: A repeat c-section happens when a patient has had previous c-sections. Generally, doctors will re-enter the womb through the old scar.
Cesarean Hysterectomy: This is a c-section followed by the removal of the uterus. If the placenta can not be separated from the uterus, or if there is intractable bleeding occurring, a hysterectomy will follow the removal of the baby.
During the C-Section
As mentioned, a typical c-section takes about 40 minutes to an hour to complete. Unlike other surgeries, your spouse or partner is able to stay with you in the operating room and during the procedure. The first thing that takes place is the cleaning of your abdominal area. A catheter is usually placed into your bladder to gather the urine, and an IV is placed in one of your veins (hand or arm) to provide you with fluids and medications. Then an anesthesiologist will come in and give you a regional anesthesia (most common type since it only numbs your lower half and leaves you awake during the procedure). Only in emergencies do you receive a general anesthesia, which does not allow you to be awake.
Next are the actual incisions through your abdomen, and then your uterus. Depending on the baby’s position, urgency of the birth and/or if you have complications, your doctor will either cut a small or large incision in both your abdomen and uterus to deliver the baby. Even though you may not be able to hold your baby immediately, you will be able to see and hear your baby right after he/she is born.
Recovering from a C-Section
Generally, mom and baby stay in the hospital for up to 3 days after a cesarean birth. Within the first 24 hours, mom is encouraged to walk around to help with constipation and to prevent blood clots. Catheters and IV’s are usually removed within 12-24 hours. Once you’re home, it’s important that you follow simple, yet challenging rules. These rules include:
- Resting
- Drinking plenty of fluids
- Supporting abdomen
- Avoid sex for up to 6 weeks
- Take medications prescribed
- Contact doctor immediately if problems arise
