Check out exactly what happens in Cesarean section during childbirth. Learn about the indications of c-section, the time it takes for operation, the scar, recovery time and complication of this surgery.
Childbirth is a process to which the woman’s body is fully adapted. However, sometimes, for one reason or another, natural childbirth may pose a threat to health or even life to both the child and the mother. In such cases, operative delivery is performed which is also known as a Cesarean section.
Indications for Cesarean Section
Cesarean section can be planned and or urgent. The planned Cesarean section is prescribed even during pregnancy according to the indications or at the will of the future mother. The decision on urgent cesarean section is taken if complications occur already during delivery. Sometimes there are dangerous situations that require urgent intervention like acute fetal hypoxia, placental abruption, etc.
Indications for Cesarean section are divided into absolute and relative. Absolute are those on the basis of which the doctor unconditionally appoints the operation, and there is no question of natural delivery. Such indications include the following.
- Narrow Pelvis of the Woman in Childbirth
Due to this, the anatomical features a woman simply allow her to give birth on her own.
If avoided, there will be problems with the child’s passage through the birth canal.
This feature is revealed immediately when registered, and the woman from the very beginning is prepared and set up for operative delivery.
- Mechanical Obstacle
Sometimes there is a mechanical obstacle preventing the fetus from passing naturally. It can be any one of the following.
- Deficiency of pelvic bones.
- Ovarian tumors.
- Placenta previa. The placenta is not located where it should thereby its blocking the fetus path of exit into the cervix.
- Isolated cases of uterine fibroids.
- Uterine Ruptures
At the time there is a probability of uterine ruptures.
This indication for Cesarean section occurs if there are any stitches and scars on the uterus.
For example, after previous operations of Cesarean section and cavitary operations.
- Premature Detachment of Placenta
Pathology is expressed in the fact that the placenta before the onset of labor is separated from the uterus.
This, in turn, is depriving the child of food and access to oxygen.
Relative indications for Cesarean section suggest the possibility of natural delivery. However, this is with a risk for the baby or mother. In such a situation, all individual factors are carefully weighed and considered.
Relative indications are as follows.
- Impaired vision in the mother. This is due to a high load on the eyes when the woman giving birth is pushing.
- Failures in the work of the kidneys.
- Cardiovascular diseases.
- Pathology of the nervous system.
- Oncological diseases, etc.
As you can see, these diseases are not related to pregnancy. However, an intense strain on the mother’s body during childbirth can cause various complications.
In addition, the indication for Cesarean section is gestosis. It’s a violation of the blood and vascular system.
To the indications threatening the health of the child includes various sexual infections in the mother. This is true, as the child can become infected, passing through the birth canal.
As for the urgent cesarean section, it is prescribed in the event that the labor activity is very weak or stopped altogether.
Events in Cesarean Sections
Now that we know about the indication of surgical intervention let’s learn about the whole process. Here we will look into exactly what happens in Cesarean section and even before and after surgery.
- Decision for Cesarean Section
At what time does a mother go for an elective Cesarean section?
The date of the operation is assigned individually and depends on the condition of the woman and the child.
If there are no special indications, then the Cesarean section is prescribed for the day closest to the estimated date of birth.
It also happens that the operation is carried out with the onset of labor.
- Preparation for C-Section
Usually, the expectant mother, who is waiting for the planned cesarean section, is placed in the maternity ward. This is done in advance in order to conduct a survey.
It is done to determine that the baby is full and ready for birth, and to monitor the condition of the woman.
As a rule, the Cesarean section is prescribed for the morning. The last meal and drink is possible no later than 18 hours the night before.
The stomach of the patient should be empty in order to avoid getting its contents into the respiratory tract.
In the morning, on the day of the operation, hygienic procedures are carried out. They make an enema and shave the pubis.
Next, the woman changes into a shirt, and she is taken away or driven on a gurney to the operating theater.
Immediately before the operation, anesthesia is performed, a catheter is inserted into the bladder (it will be removed a couple of hours post-operation), the stomach is treated with a disinfectant.
Next, in the chest area, a woman has a small screen installed so that she cannot see the progress of the operation.
- Anesthesia for Operation
Today, 2 types of anesthesia are available namely an epidural and general anesthesia.
Epidural anesthesia involves the introduction of a thin tube through the needle into the exit site of the nerve roots of the spinal cord.
This sounds pretty scary, but in fact, a woman experiences discomfort only a few seconds when the puncture is carried out. Then she ceases to feel pain and tactile sensations in the lower part of her body.
General anesthesia. This type of anesthesia is used in emergency cases when there is no time to wait for the effects of epidural anesthesia.
First, intravenously injected drug so-called preliminary anesthesia. Then through the tube in the trachea comes a mixture of anesthetic gas and oxygen. And the last one is injected with a drug that relaxes the muscles.
- Actual Surgery of Cesarean Section
After anesthesia has worked, surgery begins. How is the Cesarean section performed?
First, a cut is made on the abdominal wall. In the operation, 2 types of incisions are possible namely a longitudinal and transverse.
A longitudinal incision is a vertical from the womb to the navel, done in emergency cases because through it the child is quickly reached. The transverse is above the bosom.
Then the surgeon spreads the muscles, by making the cut on the uterus to open the fetal bladder. After the removal of the child, the placenta is removed.
Then the doctor sews first the uterus with threads, which dissolve after several months. After the tissues have grown together, and then the abdominal wall.
A sterile bandage is applied and the ice is put on the abdomen in order for the uterus to shrink intensively. It is also to reduce blood loss.
Typically, the operation takes from 20 to 40 minutes, while the child is extracted into the light for 10 minutes, and even earlier.
- Postoperative Period
Another day post operation of a cesarean section the woman is in intensive care unit or intensive care. This is so that doctors can observe her condition.
Then the new mother is transferred to a regular room.
To reduce pain, she is prescribed analgesics, drugs for uterine contraction and normalization of the gastrointestinal tract.
Sometimes antibiotics are prescribed, but this is decided on an individual basis. Gradually, the doses of drugs are reduced, and they are completely abandoned.
If the operation has gone without complications, then a woman is allowed getting up for the first time after at least 6 hours.
First, you need to sit on the couch, and after a while stand up. In no case, there can be any strain of the stitches. Experience at least the minimal physical activity, as it threatens with seam divisions.
It is highly desirable to purchase a postoperative bandage in advance. Wearing it will greatly facilitate movement and discomfort in the first days after a Cesarean section. This is especially true when you need to lie down or get out of bed.
- Post-Operative Care, Diet and Stool
As long as the woman is in the hospital, the sutures after cesarean are processed by nurses.
On the first-day post operation, it is recommended to drink only water without gas. You will need to drink a lot to compensate for the loss of fluid.
It will also be necessary to empty the bladder in time. It is believed that a full bladder prevents uterine contractions.
On the second day, liquid food like porridges, broths, etc. is allowed. If everything is in order, then from the third day for the post-operation it is possible to return to the normal diet recommended for lactating women.
However, after delivery, many mothers complain of constipation, and in order to mitigate the situation, it is advisable not to eat solid food for several days.
Also, this problem is solved by enemas, candles and eating foods that have a laxative effect.
Candles used are usually the one with glycerin.When putting such a candle, try to lie down for a while.
- After Discharge
The first and a half months post operation of a cesarean section you cannot take a bath, swim in the pool and ponds. You can wash yourself only in the shower.
Active physical activity should be delayed for at least two months. At this time, the help of relatives and husband is needed. Although, you cannot completely abandon physical activity.
Ideally, the doctor post operation should tell you about exercises that will speed up the recovery of the body. At least you can ask yourself about it.
Renewal of sexual activity is recommended not earlier than one and a half months post operation. Be sure to take care of contraception.
Experts advise you to plan the next pregnancy only after 2 years. During this time the body is fully restored and will be able to ensure the full development of the future baby.
Natural Birth After Cesarean Section
Are natural births possible after cesarean? Is one of the most asked questions.
Contrary to popular belief, a woman can itself give birth to a child even if the previous pregnancy ended with a Cesarean section.
If the stitches are healed, there were no complications, the reproductive system was successfully restored and there is no indication for another Cesarean section.
Pros and Cons of Cesarean Section
Operative delivery is possible both for medical reasons and for the woman’s own will. However, usually, doctors oppose such a decision, discouraging the future mother from surgical intervention.
If you also consider the possibility of surgery, provided that normal births are not contraindicated for you. Then you must carefully weigh all the positive and negative aspects of the question.
- Pros of Cesarean Section
- In the operation, trauma to the genital organs such as tears and incisions is not possible.
- Delivery by Cesarean section takes a maximum of 40 minutes. While in natural childbirth a woman is often forced to endure fights within a few hours.
- Cons of Cesarean Section
- The psychological aspect: Moms complain that at first they do not feel connected with the child. They do not have the feeling that they gave birth to it.
- Restriction of physical activity and pain in the place of suturing.
Consequences of Cesarean Delivery
The consequences can be divided into 2 types: for the mother, in connection with the surgical intervention, and for the child, due to unnatural birth.
- Consequences for the Mother
- Pain in the seams, followed by a scar on the abdomen.
- Restrictions on physical activity, inability to take a bath and restore intimate relationships for several months.
- Psychological condition.
- Consequences for the Child
- Psychological: There is an opinion that children who have been born through surgery are less able to adapt to the world around them.
It is worth noting that the opinions of scientists on this issue are diverged, and the experience of moms shows that in most cases, fears of lagging behind children in mental development are contrived, and do not worry about it.
However, it cannot be denied that the child does not go the way prepared for him by nature, and helps to prepare for a new environment of existence.
- The possibility of a residual amniotic fluid in the lungs of a newborn.
- Anesthesia drugs getting into the child’s blood.
- Psychological: There is an opinion that children who have been born through surgery are less able to adapt to the world around them.
Complications After Cesarean Section
If you have a Cesarean section with epidural anesthesia, you need to remember the next moment. Post operation, the catheter with anesthetic is left for a while in the back, and injections are given for analgesia of the sutures. Therefore, post operation is over, a woman may not feel both or one leg, and is unable to move.
There are times when, when shifting a woman to a couch, her legs are turned up, and since the operated does not feel anything, this fact can for a long time remain unnoticed.
Then it threatens? Due to the presence of the limb in an unnatural position, the syndrome of prolonged positional compression develops. In other words, soft tissues are without the blood supply for a long time.
After neutralization of the compression, shock develops, severe edema, impaired movement of the limb and, not always, but often, kidney failure, all accompanied by severe pain that lasts for several months.
Be sure to ask the maternity hospital staff to check if you were properly laid on the couch. Remember that sometimes the squeezing syndrome leads to a fatal outcome.
In addition, anesthesia is often accompanied by headaches and back pain.
Another one of the most common complications is spikes. The loops of the intestine or other organs of the abdominal cavity coalesce with each other. Treatment depends on the individual characteristics of the woman. The case can be limited to conventional physiotherapy procedures or to reach the need for surgical intervention.
Endometritis is an inflammatory process in the uterus. To prevent it and prescribe a course of antibiotics immediately post operation.
Bleeding also refers to complications after cesarean section and, in rare cases, lead to the need for removal of the uterus.
Complications can also occur during the healing of seams, up to their divergence.
So, the operation of cesarean section is a guarantee of life for mother and child in those cases when natural births are impossible or dangerous. Each year this operation is improved, and the number of complications decreases. However, the human factor cannot be ruled out. So if you know about the basic features of surgery and post-operative care, it will help you avoid complications. Now, without further frustration enjoy the pleasures of motherhood.