A C-section or Cesarean section is a surgery in which a baby can be delivered through the abdomen and uterus. It can be planned or be performed as needed. On-the-fly C-sections result from unforeseen complications in which either the baby or the mother are at risk. While many mothers want to have a seamless vaginal birth, around one-third of births in the US are C-sections.
Unfortunately, C-sections come with more risks than vaginal births and entail a more prolonged recovery in the hospital than a vaginal birth. In terms of what a C-section entails, a doctor, family physician, or obstetrician will make an incision in the mother’s abdomen and uterus, and the baby will be pulled out.
Why is a C-section performed?
There are some situations where your doctor will know ahead of time that a vaginal birth will be dangerous. These situations are:
The baby is in breech or transverse. Ideally, your baby will be in a position in your womb where they will be headfirst when it comes time for delivery. If your baby is breech, this means their feet or bottom are first. If your baby is transverse, that means that they are sideways. You can use specific techniques to get your baby out of breech before delivery instead of a C-section.
Congenital disabilities. Specific congenital disabilities like severe hydrocephalus, a build-up of fluids in the brain, might mandate a C-section.
Problems with the placenta. If the placenta sits so low that it covers the opening of the cervix, you will need to have a C-section.
Multiple pregnancies. A C-section may be necessary if you are carrying twins or multiple babies. In these cases, sometimes one or multiple babies are in breech in the womb.
Previous C-section. Sometimes, if the mother has previously had a C-section surgery on her uterus, it means that her subsequent deliveries must be via C-section. However, this is not true for all cases.
Sometimes a C-section will need to be done due to complications during the birth. Some of these complications may be:
- The timing of labor is not progressing, and medicines do not help
- Placental abruption (when the placenta separates from the uterine wall too quickly)
- Pinched umbilical cord
- The baby is in fetal distress with an elevated heart rate
- The baby’s head or body is too large to fit through the birthing canal
Every birth and C-section is different. Even if your doctor says you need a C-section, you can usually ask for a second opinion. Unfortunately, in an emergency, that is not always possible, and you are at the mercy of your doctor.
How is a C-Section performed?
Before the procedure begins, you will be given some sort of anesthesia so you don’t feel the pain during the process. While you are being given anesthesia, your anesthesiologist will talk you through their pain management strategy.
Other preparations that may take place are:
- Monitors all around you to examine your heart rate, breathing, and blood pressure
- Oxygen mask or tube in your mouth or nose to give you extra oxygen
- A catheter inserted into your bladder
- IV in your arm or hand
- Wash your belly
- Shave your belly
After you receive anesthesia, your doctor will cut horizontally into your abdomen. They will then pull apart your abdominal muscles to get to the uterus. Sometimes, they will make another cut either vertically or horizontally. Usually, horizontally heals faster and also allows for vaginal births in the future.
Once your doctor cuts into the uterus, they will gently pull the baby out and suction their mouth and nose. Then, they will cut the umbilical cord. You will then be able to see your baby. After, the baby will be handed to the medical professional responsible for making sure your baby is okay. The final stage of a C-section is when the obstetrician takes the placenta away from the uterus and stitches your abdomen and uterus.
You should not be able to feel any pain during your C-section due to the anesthesia. Most women are also able to be fully conscious so they can witness their baby during birth. However, some conditions dictate general anesthesia so the mother would be unconscious.
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What are the risks of C-sections?
C-sections are quite safe in this day and age. However, there are always risks involved with surgeries. Some of the main dangers to look out for during a C-section are:
- Intensified bleeding
- Bladder injuries
- Reactions to medication
- Blood clotting
- Injury to the baby
Additionally, recovery is generally a bit longer for C-sections than it is for vaginal births. You will likely have to stay in the hospital for about three to four days. You may feel itchy, sore, and nauseous immediately after your C-section. These are natural symptoms and will go away.
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American Academy of Pediatrics: “Delivery by Cesarean Section.”
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