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C-Section (Cesarean Birth)

WHAT IS A CESAREAN BIRTH 

A Cesarean delivery or birth, also known as a C-section is the procedure for surgical delivery of a baby.  It is a very common procedure that is used to deliver babies where normal vaginal deliveries can cause complications. Cesarean deliveries are generally avoided before 39 weeks of pregnancy so the child has proper time to develop in the womb, however, sometimes complications arise and a cesarean delivery must be performed prior to 39 weeks.

WHY A CESAREAN DELIVERY IS DONE?

A cesarean delivery is typically performed when complications from pregnancy make traditional vaginal birth difficult, which puts the mother or child at risk. Sometimes cesarean deliveries are planned early in the pregnancy, but they are mostly performed when complications arise during labour. Cesarean delivery is considered in following conditions:

  • Complications in pregnancy
  • Mother’s health problems, such as high blood pressure or unstable heart disease etc
  • When baby has developmental conditions
  • Baby’s head is too big for the birth canal
  • When the baby is coming out feet first (breech birth)
  • When the baby is coming out shoulder first (transverse labor)
  • Previous cesarean delivery
  • Problems with the placenta, such as placental abruption or placenta previa
  • Problems with the umbilical cord
  • Reduced oxygen supply to the baby
  • Stalled labor

WHAT ARE THE RISKS OF A CESAREAN DELIVERY?

Even though cesarean deliveries have become very common, it is still a major surgery that carries risks for both mother and child. Natural childbirth remains the preferred method because of lowest risk of complications. The risks of cesarean delivery include:

  • Bleeding and blood clots
  • Breathing problems for the child, especially if done before 39 weeks of pregnancy
  • Increased risks for future pregnancies
  • Infection, injury to the child during surgery
  • Longer recovery time compared with vaginal birth
  • Surgical injury to other organs
  • Adhesions, hernia, and other complications of abdominal surgery

HOW IS CESAREAN DELIVERY DONE?

Preparation for a cesarean delivery

In case of a planned cesarean delivery, the doctor will give the complete instructions about what patients can do to lower the risk of complications and have a successful delivery. Detailed check-ups including blood tests and other examinations will be done in preparation for the delivery. 

How a cesarean delivery is performed

Before the surgery, the abdomen will be cleaned and prepared for receiving intravenous (IV) fluids into the arm. This allows doctors to administer fluids and any type of medications required. Patient will also have a catheter put in to keep the bladder empty during the surgery.

There are three types of anesthesia offered to delivering mothers:

  • Spinal anesthesia: Anesthesia that is injected directly into the sac that surrounds the spinal cord, thus numbing the lower part of the body
  • Epidural : A common anesthesia for both vaginal and cesarean deliveries, which is injected into the lower back outside the sac of the spinal cord
  • General anesthesia: anesthesia that puts patient into a painless sleep, and is usually reserved for emergency situations

When patient has been properly medicated and numbed, the doctor will make an incision just above the pubic hairline. This is typically horizontal across the pelvis. In emergency situations, the incision may be vertical. Once the incision into the abdomen has been made and the uterus is exposed, the doctor will make an incision into the uterus. Baby will be removed from the uterus after the second incision is made. The doctor will tend to the baby by clearing their nose and mouth of fluids and clamping and cutting the umbilical cord. The hospital staff will make sure the baby is breathing normally. The doctor will repair the uterus with dissolving stitches and close the abdominal incision with sutures.

After a cesarean delivery

Immediately after surgery, mother will remain on an IV. This allows for adjusted levels of painkillers to be delivered into the bloodstream while the anesthesia wears off. After the cesarean delivery, both mother and child typically have to stay in the hospital for about three days.  Doctor will provide home care recommendations before discharge. Patient should generally follow these instructions:

  • Take enough rest, especially for the first few weeks
  • Use correct posture to support the abdomen
  • Drink plenty of fluids to replace those lost during the cesarean delivery
  • Avoid sex for four to six weeks
  • Take pain medications as needed

Consult the doctor if case of following symptoms:

  • Consult the doctor if symptoms of postpartum depression, such as severe mood swings or overwhelming fatigue
  • Breast pain accompanied with a fever
  • Foul-smelling vaginal discharge or bleeding with large clots
  • Pain during urinating
  • Signs of infection e.g. fever over 100 °C, redness, swelling, or discharge from the incision

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