Cesarean Section

What Is a Cesarean Section?

The cesarean section, also known as C-section or Cesarean birth, is a surgical procedure used to deliver a baby when a vaginal delivery is not considered safe or when the health of the baby or the mother is at risk. It is done by making a cut in the abdomen and uterus to deliver a baby. A C-section might be planned before the patient develops pregnancy complications, or the patient has had a previous C-section and is not considering vaginal birth after a cesarean. However, the need for a first-time C-section does not become obvious until labor is underway.

Depending on the health of the mother and the fetus, the type of incision is decided. The abdominal incision made in the skin may be:

• Vertical (Up-and-Down) - This incision is made from the belly button to the pubic hairline.

• Horizontal (Across From Side-to-Side) - This incision is made across the pubic hairline. A horizontal incision is commonly used because it heals well and produces less bleeding.

Why Is Cesarean Section Carried Out?

Cesarean delivery is planned if any of the following conditions exist:

• Cephalopelvic Disproportion (CPD) - CPD means the mother's pelvis is very small to deliver a normal-sized baby, or the baby's body or head is large to pass safely through the mother's pelvis.

• Previous Cesarean Birth - Even though vaginal birth after an earlier Cesarean is possible, it is not an option for all mothers. Depending on the type of cut made in the uterine and the risk of uterine rupture, the health care provider might recommend a repeat C-section.

• Abnormal Baby Positions - In some cases, if the baby is in an abnormal position, a C-section might be the safest way to deliver the baby. If the baby's buttocks or feet enter the birth canal first, also called a breech, or the baby is positioned side or shoulder preferably, also called transverse, and the baby cannot be turned through abdominal manipulation, a cesarean delivery is recommended.

• Multiple Pregnancies - Cesarean might be needed in the case of twins, the leading baby is in an abnormal position, or the case with triplets or more babies.

• Placenta Previa - It is a condition where the placenta is attached too low in the uterine wall and covers the opening of your cervix by blocking the baby's exit through the cervix.

• Cord Compression - If the umbilical cord is twisted around the baby's neck or body or looped between the baby's head and the mother's pelvis, an immediate C-section is recommended.

• Stalled Labor - This is the most common reason for cesarean section. In this condition, the cervix might not open enough despite strong contractions over several hours, or the baby may stop moving down the birth canal.

• Fetal Distress - The baby might develop problems that cause an irregular heart rate during labor. So, the doctor might decide on cesarean delivery.

• Prolapsed Cord - If a loop of umbilical cord comes out of the cervix before the baby, a C-section is preferred.

• Mother's Health Concern - If the mother has a severe health problem, a C-section might be recommended, such as a brain or heart condition or any infectious disease like genital herpes at the time of labor.

• Mechanical Obstruction - In cases with a large fibroid obstructing the birth canal, baby’s head is huge, or a severely displaced pelvic fracture, a C-section is recommended.

What Are the Risks of Having a C-Section?

Cesarean section is becoming a more common delivery type; it is still a major surgery that can cause risks for both mother and child. Vaginal birth is always preferred because of its low risk of complications.

The risks of a C-section include the following:

• Bleeding.

• Abnormal separation of the placenta, especially in women with previous Cesarean delivery.

• Injury to the bladder or bowel.

• Infection in the uterus.

• Reactions to the drugs used during surgery.

• An embolism occurs if a blood clot breaks off and enters the bloodstream.

• Risks from general anesthesia.

• Trouble during urination or urinary tract infection.

• Delayed return of bowel function.

• Blood clots.

• Longer recovery time compared with vaginal birth.

• Complications of abdominal surgery like adhesions, and hernia.

How Is a C-Section Performed?

Before the surgery, the abdomen will be cleaned, and intravenous (IV) fluids and any medications needed are administered into the arms. A catheter will also be placed to keep the bladder empty during the surgery. Three types of anesthesia are administered to delivering mothers, depending on the requirement. They are spinal block, epidural, and general anesthesia.

After anesthesia, the doctor will make a horizontal or vertical incision above the pubic hairline. A vertical incision is given during emergencies. After creating an incision into the abdomen, the uterus is exposed, and the doctor will make an incision on the uterus. The baby will be removed from the uterus after the second incision. The baby's nose and mouth are cleaned to remove the fluid, and the umbilical cord is cut off. The baby is then handed to the hospital staff, and they will make sure the baby is breathing normally and prepare the baby to be put into the mother's arms. If the patient is confident of no more children, the doctor ties the tubes (a tubal ligation) simultaneously. Finally, the doctor will repair the uterus with dissolving stitches and close the abdominal incision with sutures.

What Should Be Followed After the Cesarean Delivery?

After cesarean delivery, the newborn and the mother will stay in the hospital for about three days. After the anesthesia wears off, the painkillers will be delivered into the bloodstream through intravenous (IV) lines.

Standing up and walking around is advised to prevent constipation and blood clot. The doctors will recommend home care after the surgery, which are

• Take enough rest, especially for the first few weeks.

• To support your abdomen, use the correct posture.

• Drink plenty of fluids.

• Take pain medications as needed.

• Avoid sex for four to six weeks.

If the mother is experiencing symptoms of postpartum depression, consult a doctor.

If the mother is experiencing any of the following, immediately call a doctor,

• Severe breast pain accompanied by a fever.

• Bleeding with large clots or foul-smelling vaginal discharge.

• Pain and discomfort while urinating.

• Signs of infection like a fever over 100 degrees Fahrenheit, swelling, redness, or discharge from the incision.

Conclusion:

Cesarean section is a surgery done to deliver a baby if vaginal delivery is not possible. Nowadays, C-section is becoming common among everyone; it has added complications compared to vaginal birth like bleeding, infections, injury to bowel and uterus, etc. However, proper surgical procedures and home care can reduce the complications of c-section.