Caesarean Section when necessary or requested

Caesarean section also called C-section is a non-vaginal delivery of a baby. It is a surgical procedure of delivering a baby through incisions made in the abdomen and uterus of a pregnant woman. Your doctor may decide to perform a C-section if your condition is unsafe to go for a vaginal birth. Most of the times, it may be done when unexpected complications arise during labour however at times pregnant women may prefer C-section rather than normal vaginal delivery. Some of the conditions in which a C-section your obstetrician may recommend caesarean delivery include:

• Twin or multiple pregnancy
• Labour does not progress – The uterine contractions may not be enough to cause dilation of the cervix and allow baby to move into the birth canal
• Foetal complications – Umbilical cord compression or abnormal heart rate
• Placental problems – The placenta may detach from the uterus before delivery, the condition called placenta abruptio
• Large-sized baby – The head of the baby may be large enough and the birth canal may be small comparatively to allow safe normal delivery
• Abnormal presentation – Breech baby or baby is in an abnormal position
• Maternal conditions and infections – Conditions such as maternal diabetes or maternal high blood pressure and maternal infections such as human immunodeficiency virus or herpes

Your doctor may recommend a C-section also if you have had C-section during your previous pregnancy. In conditions such as placenta previa, where your placenta lies too low in the uterus and blocks the birth canal, your doctor may suggest a C-section when it is diagnosed by ultrasound several weeks before delivery.

In the current scenario, C-section delivery is done not only because of medical complications but also some women choose C-section though the medical necessity doesn’t exist. This is elective C-section or parent-choice C-section. Some of the reasons why some women choose C-section include:

• Fear of the delivery pain
• Fear of unpredictable outcomes
• Concern about sexual life in future
• Avoid the uncomfortable experiences of previous vaginal birth
• To avoid the possible medical conditions such as incontinence and perineal damage
• Personal issues such as their family and work place issues

Obstetricians may do counselling and convince the patients for normal vaginal delivery for safe and successfull vaginal deliveries, unless if they anticipate some medical complications.

Preparation for Caesarean Delivery

Once you are moved into surgery room, an intravenous line through which fluids and medications are given during the surgery is placed in a vein of your arm. Anti-infective medicines may be administered to prevent infection. A thin tube or catheter will be placed in the urethra so as to drain the bladder and keep it empty during the procedure. A general anaesthesia, an epidural block or a spinal block will be administered. Then your doctor will make two incisions, one through the skin and the abdominal wall and the second one through the uterus. The abdominal wall incision is made 6 inches in length and the incision passes into the skin, fat and muscles. It can be either a vertical or a horizontal incision. The abdominal muscles are moved apart. After this incision, uterus is opened to remove the baby through another cut made depending on the position of the baby. Once the baby is out, your doctor will clamp and cut the umbilical cord and remove the placenta. Then the uterine incision is closed using absorbable stitches and abdominal incision may be closed with stitches or staples.

If you are awake during delivery you can see your baby soon after the birth. Following C-section, you will be shifted to recovery room. The catheter and IV line will be removed and a nurse or your care takers will help you to get out of bed for some time. You may be prescribed medications to get rid of pain or heating pads may be recommended. You will be asked to stay in the hospital for next 2–4 days after the C-section. You can start breast-feeding and you will be guided by nurse or your obstetrician for the same. After you move home you may experience mild cramps, bleeding and pain at the incision site. Avoid sex or strenuous activities that may impart stress on abdomen for few weeks after delivery to avoid infections and other complications.