c-section

When we think about giving birth, we tend to picture a woman pushing to get her baby out of the womb rather than having him delivered through a C-section.

Indeed, such a medical procedure, scientifically known as a caesarean section, consists in a surgical incision in the mum's abdomen and uterus that is carried out when the vaginal birth is risky for the mother, the baby or both. It can be planned in advance or done as an immediate response to an unforeseen problem.

If you think that C-sections aren't common, get that idea out of your head. Currently, more than 30% of expectant women undergo this surgery in order to give birth successfully, and the rates keep increasing as time goes by. That's why, at least, you should be prepared for a C-section in case you have to face it. How? Keep reading our quick C-section guide to find out all the details about it.

Why do doctors schedule a C-section?

There are many factors that lead to having a planned C-section. Your practitioner may consider that it's necessary if:

  • You had a previous (or more than one) C-section in the past, especially if it was done with a vertical uterine incision. This would increase the chances for you to experience a uterine rupture when trying a vaginal birth. After a single C-section, though, vaginal birth can still be possible (VBAC).
  • You are carrying multiples.
  • There are placental conditions going on, such as placenta previa,that can partially or totally block the cervix.
  • You have an active genital herpes
  • When the D-day comes, the baby is in a breech or feet-first presentation.
  • You have a very large baby on the way that isn't safe to move through the birth canal.
  • You are HIV-positive.
  • You have serious conditions, such as heart disease, eclampsia or preeclampsia and gestational diabetes.
  • Your baby has congenital problems, like spina bifida or anencephaly, both caused by neural tube defects.

Why would I need to have an emergency C-section? 

Complications may arise during labour, and that can lead the medical staff to change plans and operate on you with an emergency C-section. These are some situations in which it may be required: 

  • Labour is either taking too long or it stops, because you have trouble dilating or the baby doesn't move down, and induction attempts don't work out. The same rule applies to those cases in which labour doesn't even start for more than 20 hours. 
  • When the D-day comes, the baby is in a breech or feet-first presentation.
  • If you end up being too exhausted the doctor suspects that there may be foetal distress.
  • Though it's unusual, C-section is mandatory when the umbilical cord comes out of the womb before the baby, which is known as prolapsed cord. Under this circumstance, the baby can have his oxygen supply cut off, and that's why he needs to be delivered right away with a C-section
  • When your baby's heart rate is a matter of concern.
  • A uterine rupture is another reason for the obstetrician to carry out a C-section.
  • Having a genital herpes outbreak when going into labour or even before, when your water breaks. In such a case, the goal is to keep the baby from getting infected, and thus the C-section.

Can I choose to have a C-section?

You can choose to plan a C-section in advance, rather than opting for vaginal birth, but you will have to discuss it with your obstetrician. For example, there are women who ask for a C-section because they want their children to be born on a specific day, but then they forget that it will take longer for them to recover from the procedure.

Anyway, if your obstetrician doesn't turn down your request, remember that when having a planned C-section, there's a chance for your little one to be born before he's ready (basically, with low birth weight). Calculating a baby’s due date is not entirely exact, since there can occur irregularities in the future mummy’s ovulation at the time of conception. 

 

What are the risks and complications of a C-section?

Without intending to alarm you, a C-section is a very safe way to give birth, but it isn't risk-free. After all, it's considered a major surgical procedure and, as such, it can entail problems, though they aren't that common. For instance, you are at risk of infection, especially if the C-section scar isn't taken care of properly after surgery. Severe blood loss, blood clots, uterine rupture and undesired reactions to anaesthesia are listed as other complications that may arise during and after the incision on the abdomen and the uterus, which will probably cause you more postpartum pain. There's also the unlikely possibility that surrounding organs, like the bladder, get damaged in the process and they require an additional operation.

And what about the newborn? Can a C-section have an impact on the baby? Yes, that is possible. Studies have shown that babies born by C-sections are more likely to suffer from transient tachypnea, a respiratory disorder that occurs shortly after delivery and usually clears up on its own within a day. However, researchers also point out that those children delivered through a C-section before 39 weeks pregnant are at a higher risk of breathing problems, since their lungs may not be fully developed.

How is a C-section done? 

As it happens in a vaginal birth, you'll first be given a routine IV, but the procedure will continue with anaesthesia, by administrating either an epidural or spinal block. This anaesthesia is partial, so you'll be awake but you won't feel the lower part of your body, unless you need an emergency C-section (in that case, you'd be given general anaesthesia). Once you have your abdomen shaved, basically to clear the area, you'll be cleaned with antiseptic solution and you'll have a catheter passed into your bladder, so that the urine can be drained and collected. During this preparation time, you may be encouraged either by your partner, if he's allowed in the room, or a birthing coach.

Unless you refuse it, the medical staff will place a little screen that keeps you from seeing what's going on 'down there'. There are women who skip the part where they get cut, but they do want to catch sight of the baby being delivered (you just have to ask for it!). Once the baby makes his debut into the world, the surgeon will cut his umbilical cord and remove the placenta. He or she will also check the surrounding organs to ensure that no damage has been caused and, if everything's ok, your wound will be stitched up either with stitches or staples. You may be given antibiotics to reduce the risk of infection, along with oxytocin, a hormone that can speed the contraction of the uterus.

The C-section surgery itself doesn't take more than 30 minutes, as long as there are no complications.

Keep in mind that you may not be able to spend much time with your baby in the beginning. Some mums are able to take their babies to the recovery room, while others have to wait until the newborns leave the NICU nursery or until they feel a little bit better after surgery. This can be tough for a 'brand-new' mom, especially if she has en emergency C-section, which isn't expected. As much as you can, try to be mentally prepared for this moment, and remember that you'll just be separated from your munchkin for a little while.

What's the C-section recovery like?

The 'after' is usually the worst part of having a C-section. Not only will you have a painful incision on your abdomen and uterus, but you'll also be groggy due to the effect of the anaesthesia. Normally, it will take you between 4 to 7 days to be able to leave the hospital, but the recovery will continue for a few extra weeks once you are home. You'll need to learn how to take care of the C-section scar, mainly keeping it clean with water and soap and drying it properly without hurting yourself, and avoiding certain activities until the wound is healed. However, and contrary to what you may think, you'll have to be active in order to prevent blood clots and other complications. Here you can read a little bit more about C-section recovery.

Now that you know so much about undergoing a C-section, what do you think about it? As you can see, it has pros and cons. There are women who don't have an option when it comes to giving birth, because of possible risks and certain conditions, but if you do and you still want to consider an elective C-section, take your time to think about it. It may seem an easy and controlled way to deliver, but the resulting recovery is also more difficult. Use your best judgement!