A caesarean delivery - also known as a C-section or caesarean section — is the surgical delivery of a baby. It involves one incision in the mother’s abdomen and another in the uterus. Caesarean deliveries are generally avoided before 39 weeks of pregnancy, so the child has proper time to develop in the womb. Sometimes, however, complications arise, and a caesarean delivery is performed prior to 39 weeks.
Why a cesarean delivery is done
A caesarean delivery is typically performed when complications from pregnancy make traditional vaginal birth difficult or put the mother or child at risk. Sometimes caesarean deliveries are planned early in the pregnancy (ELECTIVE CAESAREAN) but they’re most often performed when complications arise during labor (EMERGENCY CAESAREAN).
Reasons for a caesarean delivery include:
- Baby has developmental conditions
- Baby’s head is too big for the birth canal
- The baby is coming out feet first (breech birth)
- Early pregnancy complications
- Mother’s health problems, such as high blood pressure or unstable heart disease
- Mother has active genital herpes that could be transmitted to the baby
- Previous caesarean delivery
- Problems with the placenta, such as placental abruption or placenta previa
- Problems with the umbilical cord
- Reduced oxygen supply to the baby, dip in the fetal heart rate.
- Stalled labor
- The baby is coming out shoulder first (transverse labor)
The Preparation
If you decide that a caesarean delivery is the best option for delivery, then we will give you complete instructions about what you can do to lower your risk of complications and have a successful caesarean delivery. As with any pregnancy, prenatal appointments will involve many check-ups. This will include blood tests and other examinations to determine your health for the possibility of a caesarean delivery.
Your doctor will make sure to record your blood type in case you need a blood transfusion during the surgery. Blood transfusions are rarely needed during a caesarean delivery, but your doctor will be prepared for any complications. Make sure all of your questions are answered, and that you understand what could happen if you need to have an emergency caesarean delivery before your due date. Because a caesarean delivery takes additional time to recover from than normal birth, arranging to have an extra set of hands around the house will be helpful. Not only will you be recovering from surgery, but your new baby will need some attention as well.
How a caesarean delivery is performed?
Plan to stay in the hospital for 2 to 3 days while you recover from your surgery. You would be asked to report to hospital on empty stomach after 8 hours of fast. Before the surgery, your abdomen will be cleaned, and you’ll be prepared for receiving intravenous (IV) fluids into your arm. This allows doctors to administer fluids and any type of medications you may need. You will also have a catheter put in to keep your bladder empty during the surgery.
There are three types of anaesthesia offered to delivering mothers:
- Spinal block: Anaesthesia that’s injected directly into the sac that surrounds your spinal cord, thus numbing the lower part of your body.
- Epidural: A common anaesthesia for both vaginal and caesarean deliveries, which is injected into your lower back outside the sac of the spinal cord.
- General anaesthesia: Anaesthesia that puts you into a painless sleep, and is usually reserved for emergency situations.
When you have been properly medicated and numbed, your doctor will make an incision just above the pubic hairline. This is typically horizontal across the pelvis. In emergency situations, the incision may be vertical. Once the incision into your abdomen has been made and the uterus is exposed, your doctor will make an incision into the uterus. This area will be covered during the procedure, so you won’t be able to see the procedure.
Your new baby will be removed from your uterus after the second incision is made. We will first tend to your baby by clearing their nose and mouth of fluids and clamping and cutting the umbilical cord. Your baby will then be given to paediatrician, and they will make sure your baby is breathing normally and prepare your baby to be put into your arms. If you’re sure you do not want any more children, and have signed the consent, the doctor can tie your tubes (a tubal ligation) at the same time. We will repair your uterus with dissolving stitches and close your abdominal incision with sutures.
Following up after a caesarean delivery
After your caesarean delivery, you and your newborn will stay in the hospital for about 2 to 3 days. Immediately after surgery, you will remain on an IV. This allows for adjusted levels of painkillers to be delivered into your bloodstream while the anaesthesia wears off. We will encourage you to get up and walk around the same day. This can help prevent blood clots and constipation. We can teach you how to position your child for breastfeeding so there’s no additional pain from the caesarean delivery incision area.
We will give you recommendations for home care after the surgery, but you should generally expect to:
- Take it easy and rest, especially for the first few weeks
- Use correct posture to support your abdomen
- Drink plenty of fluids to replace those lost during your caesarean delivery
- Avoid sex for four to six weeks
- Take pain medications as needed
- Seek help if you experience symptoms of postpartum depression, such as severe mood swings or overwhelming fatigue
You can call us if you experience the following symptoms:
- Breast pain accompanied with a fever
- Foul-smelling vaginal discharge or bleeding with large clots
- Pain when urinating
- Signs of infection - for example, fever over 100 °F, redness, swelling, or discharge from the incision