A cesarean or even known as a C-section is a surgery to deliver a baby. C-sections can be planned or elective. However, whether a vaginal birth or C-section is decided by the doctor in discussion with the patient once the labor pain has set in.

A C-section might be planned ahead of time if you develop pregnancy complications or you've had a previous C-section and aren't considering vaginal birth after cesarean (VBAC).

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What is Cesarean?

A cesarean or even known as a C-section is a surgery to deliver a baby.

C-sections can be planned or elective, should the pregnancy pose complications or the first child was born via C-section and the mother does not want to consider vaginal birth for the second.

However, whether a vaginal birth or C-section is decided by the doctor in discussion with the patient once the letter pain has set in.

A pregnant woman will be informed by her treating doctor during her regular antenatal visits about the safest method of delivering her baby either by normal vaginal delivery or a cesarean section.  

Conditions leading to Cesarean

Conditions under which the health care practitioner recommends C-section or as in medical terms considered as absolute indications for C- sections.

  • Health concern: It is considered if the mother has an active genital herpes infection when the labor sets in. 

  • It is preferred when the mother has a severe health problem such as a brain or heart ailment. 

  • The problem in the placenta: If the mother has a condition called placenta previa, which means the placenta covers the opening of the cervix which can cause severe bleeding and cause danger to the mother and the baby.

  • Stalled prolonged labor: It is the most common reason for the doctor to recommend C-section. In this type of labor, the cervix does not open enough for the crowning to happen, although the labor contractions are strong over several hours, conducive for the delivery of the baby. 

  • Baby is in distress (fetal distress): If there is an abnormal increase or decrease in the baby’s heartbeat, the doctor may consider a C-section.

  • Abnormally positioned baby: If the baby is positioned buttocks first (breech) or shoulder first (transverse) when the labor starts, the doctor generally prefers a C-section for the safety of the baby.

  • Twins or multiples: A C-section may be considered in the case of twins if the leading baby for delivery is positioned inappropriately. Alternatively, if there are triplets to be born. In addition, in rare cases more than three babies.

  • Prolapsed umbilical cord: If a loop of the umbilical cord escapes ahead of the baby, while the baby is being pushed for delivery, then to avoid this complication the doctor may recommend C-section.

  • Mechanical obstruction: When the birth canal is obstructed by a large fibroid, or the baby is hydrocephalus (a condition where the baby has an unusually large head) or there is a pelvic fracture that is gravely displaced, a C-section is recommended.

  • Previous C-section: This depends on the previous incision and other factors. The doctor will decide if a vaginal delivery can be attempted or a C-section will have to be repeated for safe delivery.

Preparing for Cesarean:

The doctor records the patient’s medical history to evaluate the safety of administering anesthesia. 

Certain blood tests to determine the patient’s blood hemoglobin and blood type may be prescribed to keep blood ready in case blood transfusion is required. 

Even if the doctor is certain about vaginal birth, it is advised to be mentally prepared for a C-section and at least have the doctor discuss the implications and the eventuality should the doctor consider a C-section. 

Understanding the rest and recovery time after a C-section delivery helps plan better. 

Before the procedure:

This preparation is dependent on the condition based on which the C-section is planned and are as follows:

  • Home precautions for a planned C-section: Bath with antiseptic soap may be instructed. The doctor may also instruct not to shave within 24h of C-section as it can potentially cause infection close to the incision site. 

  • Hospital: The abdomen will be thoroughly cleaned. A catheter will be inserted into the urinary bladder to drain urine during the procedure. The intravenous route in one of the veins of the arm is established for administering fluids and medicines. 

  • Anesthesia: Most C-sections are performed under regional anesthesia. The delivering mother will be awake in course of the procedure.

The preferred anesthesia is an epidural block or a spinal block that anesthetizes the lower portion of the body.

The patient does not see or feel anything during the procedure. In an emergency, the doctor may decide to give general anesthesia. 

Cesarean: Procedure

Once the lower portion of the body numbs the doctor makes an incision above and close to the pubic hairline. This is the case of a horizontal incision.

In case of an emergency, the doctor may make a vertical incision. 

This incision exposes the uterus. The doctor then makes a cut in the uterus. The baby is then removed from the uterus. 

Once the baby is out of the uterus, the doctor first clears the fluids from the mouth and nose of the baby, clamps the umbilical cord, and hands it over to the hospital staff. The baby is checked for vitals and prepared to be handed to the mother if she is stable and awake. 

Should the patient express not have further children, before the procedure the doctor has a consent form signed for tubal-ligation (tying the tubes) before stitching the incision. 

The doctor then sutures the uterine and abdominal incisions with mostly dissolvable stitches.

After procedure care: Cesarean

After the surgery, the mother will be on IV fluids until discharge.

Usually, the discharge happens after three days of delivery. This allows the doctor to monitor pain from the surgery and ensure the effectiveness of the anesthesia effectively wears out.

The patient is made to walk as soon as possible after the procedure to avoid the formation of blot clots and constipation due to immobility. 

Other instructions after discharge the patient needs to follow are: 

  • Rest in the following week's post-C-section.

  • Assuming correct posture for effective recovery.

  • Plenty of fluid intakes to replace those lost during surgery.

  • Restrain from sex for at least four to six weeks.

  • Watch for painful breasts, excessive vaginal discharge, discomfort or pain while urinating, and fever. These need to be reported to the doctor immediately.

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