A caesarean section is a surgical intervention to deliver a baby through the abdomen rather than naturally and is sometimes performed as an emergency when labor and delivery are not straightforward or sometimes it is scheduled ahead of labor when the decision has been made that this is a preferred method of delivery for medical or personal reasons.
What Is a Caesarean Section?
A caesarean section, or C-section, is the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. In certain circumstances, a C-section is scheduled in advance. In others, it’s done in response to an unforeseen complication.
According to the U.S. Center for Disease Control and Prevention, about 33% of American women who gave birth in 2011 had a caesarean delivery. (The rate of caesarean section, in the United States, has risen to nearly 60% since 1996.).
C-section is performed by obstetricians and some family physicians. Although more and more women are choosing midwives to deliver their babies, midwives of any licensing degree cannot perform C-section procedure.
What Is the difference between a planned and an Emergency Caesarean Section?
A planned caesarean section is scheduled to take place before labor begins. Just over 40% of caesarean births in the UK are planned.
An emergency caesarean is unplanned, and can happen if:
- The cervix stops dilating or the baby stops moving down the birth canal and attempts to stimulate contractions haven’t worked.
- The baby’s heart rate gives the practitioner a cause for concern, and he decides that the baby can’t withstand continued labor or induction.
- The umbilical cord slips through the cervix (a prolapsed cord). If that happens, the baby needs to be delivered immediately because a prolapsed cord can cut off his/her oxygen supply.
- The placenta starts to separate from the uterine wall (placental abruption), which means the baby won’t get enough oxygen unless the baby is delivered the right away.
- You have a genital herpes outbreak, delivering the baby by c-section will help the baby avoid infection.
Preparation
Your doctor or midwife should explain why you may need a caesarean, and what will happen during the operation. They will also outline the risks of not having a caesarean, as well as the possible risks of the surgery.
You will be asked for your consent, which you have the right not to give. Before the surgery, you will need to change into a hospital gown, and remove all jewellery. If you have braces you will need to remove it before going into the C-section procedure.
Once in theatre you can expect:
- Various monitors in place to keep an eye on your heart rate, breathing, and blood pressure.
- Your mouth and nose covered with an oxygen mask or a tube placed in the nostrils to provide oxygen.
- A catheter (a thin tube) inserted into bladder through the urethra (which may be uncomfortable when it is placed, but should not be painful).
- An IV in arm or hand.
- Your stomach will be washed and any hair between the bellybutton and pubic bone will be shaved.
- A privacy screen put around your stomach so you cannot see the procedure.
- If you have been given an epidural anaesthetic, and you’re awake, a screen will be placed near the head so you can’t see what is happening. you shouldn’t feel any pain at all during the operation, though you may be aware of some sensations.
- After being given anaesthesia, the surgeon makes an incision on the skin of the abdomen— either vertically or horizontally. The doctor then gently parts the abdominal muscles to get to the uterus, where he will make another incision in the uterus itself. This incision can also be vertical or horizontal.
- The baby will be born very quickly, during the first five minutes, followed by the delivery of the placenta. The obstetrician then closes the uterus with dissolvable stitches, and closes the abdominal incision with stitches or surgical staples that are usually removed, painlessly, a few days later.
What Are the Risks of Having a C-Section?
A C-section is a major abdominal surgery, so it is riskier than a vaginal delivery.
Potential C-section risks include:
- Increased bleeding (that could, though rarely, result in a blood transfusion).
- Infection (antibiotics are usually given to help prevent infection).
- Bladder or bowel injury.
- Reaction to medications.Blood clots.
- Death (very rare).
- Possible injury to the baby.
In the case of emergency C-sections, the benefits usually far outweigh the risks. A C-section could save a mother’s life or the baby’s.
Recovery
Recovery after a C-section takes longer than recovery from a vaginal birth. You can expect to spend around three to four days in the hospital, and at least four to six weeks at home before you feel you are back to normal.
For the first few days and even weeks, you might:
- Feel tired.
- Have soreness around the incision (the doctor can prescribe medications and/or recommend over-the-counter pain relievers that are safe to take if you are breastfeeding).
- Be constipated and gassy.
- Have difficulty walking around and/or lifting the baby.
After all, you have gone through a major surgery to deliver the baby! It might not be the birth experience you have imagined, but you can finally meet your little one that you’ve been nurturing within for the entire gestational period.
