Consultant Obstetrics & Gynecology
Published on 22 August 2022
A caesarean section also known as c-section or 'caesarean' is a surgical procedure in which a baby is delivered through a cut in the abdominal wall and uterus(womb) of the mother. If there are signs that a vaginal birth is unsafe, a caesarean section may be planned (elective) or unplanned (emergency) if problems arise during labour. If you have no serious issues with your pregnancy or labour, a normal birth is the most secure way for your baby to be born .
Why do I need a C-section?
If you are unable to deliver vaginally, the foetus can be delivered surgically via c-section surgery. The caesarean may be planned and scheduled. Also, you may have a c-section if there are any complications during labour. Several conditions make a caesarean delivery more likely. These include:
- Abnormal foetal heart rate: The normal heart rate ranges from 120 to 160 beats per minute. If the foetal heart rate indicates a problem, your doctor will act quickly. This could include supplying oxygen to the mother, increasing intravenous fluids, and changing position. The doctor may perform a caesarean section, if the heart rate does not improve.
- Abnormal position of the foetus: The position of the foetus during birth is head-down normally. Sometimes a foetus is not in the right position. This makes delivery through the birth canal more difficult.
- Problems with labour: Contractions may weaken, the cervix may not dilate sufficiently, or the infant's descent through the birth canal may be irregular.
- Size of the foetus: Your doctor cannot deliver the baby vaginally because the baby is too large.
- Placenta problems: Placenta previa is a condition in which the placenta blocks the cervix.
- Certain maternal conditions, such as diabetes, hypertension, HIV or herpes infection.
- Multiples babies(twins or triplets)
- C-sections in the past deliveries.
Caesarean section Procedure
Before the Procedure
- Gynecologist will discuss the procedure and you are asked to give the consent to do the procedure.
- You will be informed not to eat or drink 8 hours prior to the surgery, if the c-section is scheduled and requires spinal, epidural or general anaesthesia.
- Inform the doctor if you are sensitive or allergic to any drugs.
- Inform the gynaecologist about all of the medications you use.
- If you are having any bleeding disorders or are taking blood-thinners such as aspirin, inform the doctor. You may be instructed to discontinue these medications prior to the procedure.
- Medications may be given to dry up secretions in your mouth and respiratory tracts, as well as to reduce acid secretion in the stomach.
During the Procedure
- C-sections are performed in an operating room under anaesthesia.
- You will most likely be awake during a c-section. Only in exceptional circumstances will a mother require general anaesthesia, which will put her into a deep sleep. The majority of cesarean sections are performed under regional anaesthesia, such as an epidural or spinal. You will not have any feeling in the lower half of the body, but will be awake throughout the procedure.
- You are placed on an operating table. If a urinary catheter was not placed prior to entering the operating room, one may be inserted.
- An intravenous line will be placed in the arm or hand.
- Straps will be placed around the legs to keep you on the table for safety reasons.
- Hair can be shaved and an antiseptic solution will be used to clean the skin around the surgical site and the abdomen will be covered in sterile material.
- Throughout the procedure, the anesthesiologist will monitor the heart rate, blood pressure, breathing, and blood oxygen level.
- After the anaesthesia has taken effect, a transverse or vertical incision is made just above the pubic bone. You may hear the sounds of a machine, which is used to stop bleeding.
- The incisions are deepened to reach the wall of the uterus. This incision in the uterus is either horizontal or vertical.
- Doctor will open the amniotic sac and take out the baby through the opening. The baby's mouth and nose are suctioned, and the umbilical cord is clamped and cut. You might feel some pressure or a pull.
- You will be given medicines through IV to help contractions of the uterus and expel the placenta.
- The doctor will remove the placenta and examine the uterus.
- Then stitches are placed to close the incision in the uterine muscle and reposition the uterus in the pelvic cavity.
- The doctor will close the muscle and tissue layers with sutures. Skin incisions are then closed with sutures or surgical staples.
- Finally a sterile bandage is placed.
After the surgeryIn the hospital
- In the recovery room, vitals (blood pressure, pulse, breathing) are monitored along with bleeding and firmness of the uterus.
- You can usually stay with your baby in the recovery area and start breastfeeding. In some cases, babies born by a cesarean section will first need to be monitored separately for a short time.
- As the anaesthesia wears off, you may get pain medications as needed.
- You may experience gas pains as the digestive tract recovers from surgery. The doctor will encourage you to rise from the bed and do walking and moving to relieve gas pains. For a few days, you may experience uterine contractions known as after-pains. Over the course of several weeks, the uterus continues to contract and shrink.
- The urinary catheter will be removed on the second day.
- You will be given liquids to drink a few hours after surgery, later on more solid foods are allowed to consume.
- Use sanitary pads till you stop bleeding. Cramps and vaginal bleeding are normal for several days after birth. Over time, the vaginal discharge may change from dark red or brown to a lighter colour.
- Do not douche, use tampons, or have sex until the doctor says it's okay. Avoid engaging in strenuous activities, driving, or heavy lifting.
- Take pain killers as prescribed by the doctor. Aspirin and other pain relievers may increase bleeding. So, only take medications that have been prescribed to you.
- Visit the doctor for follow up. This is usually 2 to 3 weeks after the surgery.
Benefits of C-section delivery
- Women can plan when they want to give birth and can control the pain as experienced during normal delivery.
- Injury to vagina can be avoided.
- Women who have caesarean sections are less likely to have urinary incontinence (loss of bladder control).
- Babies are less likely to have birth trauma.
- HIV positive mothers are less likely to pass on the virus to their babies.
Risks of c-section delivery
Some of the possible complications of a c-section are:
- Drugs reactions during surgery.
- Abnormal placental separation, particularly in women who have had a previous caesarean section.
- Injury to the urinary bladder or bowel
- A uterine infection
- Infection of the wound
- Urinary tract infection or difficulty urinating
- Return of bowel function is delayed.
- Blood clots
A woman who had a caesarean section may be unable to have a vaginal birth in the future. The type of uterine incision used will determine the outcome. Because the uterine scars are too weak to hold together at the time of labour contractions.
C- section delivery at Medicover
At Medicover Hospitals, we have the most trusted team of gynaecologists and obstetricians working together to provide quality care to our patients. We provide different types of treatment customised to every single person using the most advanced technologies and world-class cutting edge infrastructure bringing the best results for our patients while remaining cost-effective. Our gynaecologists and obstetrician have performed many deliveries with successful outcomes.
Frequently Asked Questions:
Women carrying twins, triplets, or more may require a c-section. This is especially true if the labour begins too soon or the babies are not in a head-down position. A c-section is recommended for delivery if the placenta covers the opening of the cervix.
Vaginal birth (normal delivery) is much safer than a c-section for most women.
C-section has lower risk of urinary incontinence and sexual dysfunction after childbirth. It reduces the possibility of insufficient supply of oxygen to the baby during delivery. Reduces the risk of the baby experiencing trauma while passing through the birth canal.
The more c-sections performed, the greater the risk of obstruction of the cervix with placenta and a condition in which the placenta is attached to the uterine wall (placenta accreta). A c-section also increases the risk of the uterus tear along the scar line (uterine rupture) in women who later attempt vaginal delivery.
You will not feel any pain during the c-section, but you may feel pulling and pressure. During a caesarean section, most women are awake and simply numbed along the lower half of the body with regional anaesthesia such as epidural or spinal block. They will be awake to see and hear their baby being born.
After the baby is delivered, the uterus is closed with a double layer of stitches. Four of the remaining five layers are stitched with a single layer, but one layer is not restitched because it heals better without restitching, with no buckling and a lower chance of scar tissue developing.
You should not bathe until your incisions are healed and no longer bleeding and you should not lift anything heavier than your baby. Do not use the staircase repeatedly.
Whole grains, especially oatmeal, dark leafy greens, fennel, garlic, chickpeas, nuts, seeds, ginger and papaya.
You should not exercise until at least 6weeks postpartum.
It is important to get out of bed and walk around within 24 hours after surgery. This can help ease gas pains, help you have easy movements of bowel and prevent blood clots.
Belly breathing, seated kegels, wall sit, scar massage and leg slides.