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Giving birth by cesarean section

Giving birth by cesarean section
September 09
10:12 2014

Every woman wants a normal vaginal delivery, but sometimes due to certain complications in the delivery, it is just not possible to give a vaginal birth. In such instances, cesarean section or C-section is used to deliver a baby.

C-section is basically categorized in to two types: elective cesarean and emergency cesarean. Let’s try to know more about the two, so if at all your doctor recommends cesarean for you, then you know why he or she is suggesting and what to expect from the same.

What is an elective cesarean:

Cesarean that is performed before the labor starts is termed as elective cesarean. When choosing elective cesarean, you will know exactly when the C-section will take place; you can discuss all your queries, doubts etc. with your doctor beforehand.

Some of the reasons for elective caesarean are:
  • Your previous delivery was a caesarian and it is felt that C-section would be safer this time too.
    Multiple pregnancy- you are carrying twins or triplets or more
    Your pelvis too small or your baby too big for a successful vaginal birth
  • Breech presentation: Inside your womb, your baby is upturned. When your baby would be born, first his/her legs will come out of your vagina instead of head. However, giving birth to breech baby is possible vaginally, an extremely hard birth may need C-section.
  • Transverse presentation: your baby’s position is such that, first his or her shoulder will enter the birth canal. This can make delivering a baby vaginally very complicated.
  • Severe medical situation like high blood pressure or diabetes, can increase the risk during the vaginal delivery
  • Placenta praevia: it is a condition in which placenta covers part or all of your uterus and is blocking the exit path of the baby.
  • Placenta dysfunction: Proper oxygen and nutrients are no longer reaching to your baby, that he or she requires. Therefore, depending on how many weeks you are pregnant, he or she may be better delivered than inside your womb.
  • Antepartum hemorrhage: During your pregnancy you have been bleeding excessively
    Past vaginal tear: if during your previous labor, you tore severely, C-section would be suggested, as it would be safe for you.
  • When having infectious diseases like herpes and HIV, C-section is the better way to deliver a baby.
    Severe pre-eclampsia: If the situation is so severe, that yours and your baby’s health is at risk, then delivering quickly might be required.
What is an emergency caesarean:

When there are complications during labor, emergency caesarean can be done. However, this doesn’t essentially mean that all of a sudden you will be taken to an operation theatre with emergency alarms.

Depending on the conditions, you may have ample of time to consider advantages and disadvantages of c-section and continue with vaginal delivery.

Some of the reasons for emergency caesarean are:

Your baby is in pain and not managing well and requires to be quickly delivered

Your labor is progressing slowly or is not progressing at all. Sometimes your cervix can take quite a long time to dilate for your baby to be delivered. This delay can be draining for both the mother and the baby.

Placenta abruption: The placenta starts to shed away from the wall of your uterus. This is very risky because of the threat of hemorrhage (excessive bleeding) and other problems.

A failed assisted delivery using ventouse or forceps

Your baby has not entered into the birth canal. There can be two reasons for the same, either your pelvis is too small or your baby is too big to give birth vaginally.

What happens at the time of caesarean:

Caesareans are done in operating theatre. A whole team of doctors, surgeons, anesthetist, pediatrician, nurses and assistants are present at the time of caesarean. The operation is generally carried out after an epidural or spinal anesthetic.

A catheter is inserted in to your bladder and a drip is put in to your arm or hand so you get enough fluids or additional pain relief. The surgeon makes one cut of about 20 cm in your lower abdomen and another cut in your womb. The baby is then lifted out through the skin. The womb is opened easily and the whole procedure from the cut to the baby’s birth takes only a few minutes.

Your baby will be then checked quickly by pediatrician in order to find how he or she is doing and if he or she is doing perfectly well, then he or she will be handed to you or your partner. But, if there will be any concerns then he or she may be immediately moved to the baby’s special care unit. Meanwhile, surgeon will deliver the placenta and seal the incision by stitches. Dissolving stitches are used.

If everything is normal, then the whole procedure will generally take around half an hour or less. You will be then moved to a ward where you may have to spend a day or two. Once you have your baby with you, and if you want to breastfeed, then go ahead. Or if you have any doubts then you can discuss the same with your doctor.

How you will feel during a caesarean:

In some cases, a caesarean is conducted under general anesthetic, so you won’t find out much about what’s happening. But, in most circumstances, you will either have an epidural or spinal anesthetic, so you should feel nearly insensitive from your chest and downwards.

However, you won’t experience any pain, but you will definitely feel some strain as the operation goes on and your baby is delivered.

Pros and cons of C-section:

A C-section is considered as quick and easy way to deliver a baby. But, it’s a major surgery with risks included. The vital risks are that you might bleed greatly during or after surgery, your wound can get infected or you can develop a blood clot in the veins of your legs.

According to the NICE (National Institute for Health and Clinical Excellence) there are certain risks involved in C-section as compared to vaginal birth. Here are some of the involved risk factors:

  • Pain in the abdomen
  • Bladder injury
  • Injury to the ureter (the tube that connects your bladder to your kidney)
  • Need of another surgery
  • Hysterectomy
  • Admission to an ICU
  • Developing a blood clot
  • Have to be hospitalized for longer time
  • Readmission to hospital
  • No more children

Demise of the mother in severe conditions

This all sounds scary. But, every case of delivery is different and therefore, these risks don’t apply to all the pregnant ladies, it completely depends on you and the circumstances. Your doctor or surgeon will discuss everything with you and they also try to take all the apt measures to lessen the risk and complications.

In addition, according to NICE, as compared to vaginal birth, there are possibilities of you to suffer from:

  • Hemorrhage
  • Infection of the lining of the womb or the wound
  • Injuries to genital organs or the womb
  • Bowel incontinence
  • Postnatal depression
  • Back pain
  • Pain at the time of intercourse
  • There are lesser probabilities of you experiencing:
  • Pain in the perineum
  • Bladder incontinence 3 months after the delivery
  • Womb prolapse

Coming to your baby’s health, as compared to vaginal birth, there is no increased or decreased risk of uncommon risks like nerve injury in the arms and neck, bleeding inside the skull and cerebral palsy or death.

Furthermore, C- section do augment the chance of your baby having breathing problems at birth.

Depending on the complications in your pregnancy your doctor will advise you the most appropriate way to deliver baby. However, you can discuss your concerns with him or her freely.

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