How Is A Cesarean Delivery Done?

About 30% of all babies in the United States are born through cesarean delivery.
About 30% of all babies in the United States are born through cesarean delivery.

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.

SLIDESHOW

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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