Cesarean delivery mostly follows this process:
- You will be positioned on an operating table.
- A urinary catheter may be placed before entering the operating room.
- The physician may start an intravenous (IV) line in your arm or hand.
- The physician will shave the hair around the surgical site. They will clean the surgical site with an antiseptic solution.
- The physician may give you local anesthesia, either an epidural or a spinal block to numb you from the waist down.
- Once the anesthesia has taken its effect, the physician makes a cut above the pubic bone, mostly along the bikini line.
- The surgeon makes a deeper cut through the tissues and separates the abdominal and uterine muscles and then enters the uterine cavity.
- The physician will open the amniotic sac to deliver the child through the opening and cut the umbilical cord.
- The physician will give you medicine through the IV line for a contraction of the uterus and ejection of the placenta.
- The physician may watch for remnants of the placenta and tears in the uterus.
- Finally, the physician closes the muscles and tissue layers with sutures or surgical staples.
- The sutures may be removed on day 7.
What is cesarean delivery?
Cesarean delivery is the surgical delivery of a baby by making an incision in the mother’s abdominal wall and uterus. Although cesarean delivery is generally safe, it should be performed during certain circumstances. About 30% of all babies in the United States are born through cesarean delivery.
There are certain disadvantages of cesarean delivery over vaginal delivery. They are as follows:
- Longer recovery period Prolonged hospitalization
- Uterine scarring, making further pregnancies riskier
Why is cesarean delivery needed?
Cesarean delivery might be planned due to a medical reason or performed due to any medical emergency. Cesarean delivery might be recommended in
- Cephalopelvic disproportion (a condition where the baby’s head or body is too large to pass through the mother’s pelvis).
- Previous cesarean birth (attempting vaginal birth may cause the uterus to rupture).
- Multiple pregnancies.
- Placenta previa (a condition where the placenta covers partially or fully the opening of the cervix).
- Transverse lie (the baby lies in a horizontal or sideways position of the uterus).
- Breech presentation (the baby is positioned to deliver feet or bottom first).
- Mothers with underlying medical conditions such as diabetes or high blood pressure.
- Mothers with infections such as human immunodeficiency virus (HIV) or herpes.
An emergency cesarean delivery may be indicated in the following situations:
- Fetal distress (a condition where the fetal brain starts experiencing oxygen shortage)
- Failure of labor to progress
- Placental abruption (the placenta separates from the wall of the uterus)
- Cord compression (the umbilical cord is tangled around the baby’s neck or body)
- Prolapsed cord (the umbilical cord comes first before the baby)
Cesarean delivery should be avoided when
- The mother has a severe pulmonary disease.
- There is a defect in the child that may lead to their death.
What are the complications of cesarean delivery?
Cesarean delivery involves some risks that include:
- Infection
- Bleeding
- Embolism (a blood clot that breaks into the bloodstream)
- Fetal injury
- Injury to the bowel or bladder
- Tear in the uterine wall
- Risks from general anesthesia
- Abnormalities of the placenta in the consequent pregnancy
- Infection in the uterus
- Wound infection
- Trouble urinating or urinary tract infection
- Blood clots
Subsequent pregnancies may have an improper placental position due to a uterine scar from cesarean delivery done at present.
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References
https://my.clevelandclinic.org/health/treatments/7246-cesarean-birth-c-section/risks--benefits
https://www.stanfordchildrens.org/en/topic/default?id=cesarean-delivery-92-P07768
https://www.stanfordchildrens.org/en/topic/default?id=cesarean-delivery-92-P07768
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