Are you considering a c-section? Prenatal preparation for a Caesarean delivery is very important and will help make your caesarean birth a more positive, empowering experience. By knowing what to expect and having a game plan of action, you can reduce your stress levels and get the most out of your birth experience.
What Is Caesarean Delivery
Caesarean delivery is a surgical procedure that involves making an incision in a woman's abdomen and uterus to extract the baby. It is also known as c-section or caesarean section.
Caesarean delivery is used when vaginal birth puts both the mother and baby at risk. The decision to have a caesarean delivery is usually made by doctors and midwives after considering factors such as the baby's size, how far along in pregnancy the mother is, whether labour has begun naturally or been induced, and any complications that might arise during labour or delivery.
Caesarean delivery aims to safely deliver a baby while preserving maternal health and avoiding harm to either mother or baby.
Indications for Caesarean Section
In birth, there are many indications for a Caesarean Section. It is necessary to determine the safest and most effective manner of birth for both mother and baby. The following are some of the indications for a C-section:
Maternal Health
- The mum has had a previous caesarean section
- There is an active genital herpes infection
- Or there is active chorioamnionitis (infection of the membranes surrounding the fetus)
- Another is acute abdomen, such as appendicitis or ruptured ectopic pregnancy
- There is a chronic illness that could worsen with vaginal delivery, such as heart disease or lung disease
Fetal Health
The most common reason for a C-section is fetal distress. This can include the following signs:
- Length of the umbilical cord (the longer it is, the more likely the baby will need to be delivered via C-section)
- Fetal heart rate (the heart rate should be above 100 beats per minute)
- Position of the fetus (some babies are positioned so they cannot be born vaginally).
Placental Health
The placenta's health can indicate whether or not a baby will be born via a C-section. A healthy placenta has smooth edges and has been attached to the wall of the uterus since conception.
Placentas with rough edges may indicate an infection, which could cause fetal distress, necessitating a C-section.
The placenta provides nutrients and oxygen to the fetus, so any abnormalities in its development or function may lead to complications during childbirth.
For example, suppose there is too much amniotic fluid in the uterus (polyhydramnios). This could cause complications such as preterm labour, hypertension (high blood pressure) and preeclampsia (pregnancy-induced high blood pressure).
Breech Presentation
Breech presentation is a common reason for a caesarean section. A breech presentation occurs when the baby's buttocks or feet are presented first, rather than the head.
When the baby is in breech presentation, it can be difficult for him or her to pass through the birth canal. The risk of complications, such as difficulty breathing and injury to organs and blood vessels in the birth canal, increases with each additional week of gestational age.
In some cases, doctors recommend that you have a caesarean section because they believe your baby has an increased risk of stillbirth if he or she is born vaginally.
For example, if you have had one or more previous cesarean deliveries or babies who were born prematurely, your doctor may recommend a caesarean delivery for your current pregnancy.
Types of Caesarean Section
Caesarean Section is a surgery in which the surgeon makes an incision in the abdomen and uterus to deliver a baby.
There are three types of Caesarean sections:
Elective Caesarean Section
This type of C-section is scheduled for the convenience of the parents, for example, when the baby is thought to be too big to pass through the birth canal or if there are other complications such as preterm labour or placenta previa (the placenta lies over the cervix).
Emergency Caesarean Section
This type of C-section is needed when complications during labour require immediate medical attention. Common reasons for an emergency C-section include:
- Prolonged Labour: When labor takes longer than expected due to factors like slow cervical dilation, effacement, large baby, or emotional stress.
- Non-Reassuring Fetal Status: If the fetus shows signs of distress, which can result from irregular heartbeat, low oxygen levels, or other conditions.
- Perinatal Asphyxia: Inadequate oxygen supply to the baby before, during, or after delivery, leading to complications like hypoxemia and acidosis.
- Shoulder Dystocia: The head is delivered, but the shoulders remain stuck, often affecting first-time mothers.
- Postpartum Hemorrhage: Excessive bleeding after delivery, usually due to weak uterine contractions, clotting disorders, or placental problems.
- Malposition of the Baby: Babies in unusual positions, such as breech or facing upwards, may require assistance for safe delivery.
- Umbilical Cord Issues: Cord around the neck, compression, or early emergence may necessitate immediate intervention.
- Placenta Previa: The placenta covers the cervix, leading to bleeding during the third trimester, often requiring a cesarean delivery.
- Cephalopelvic Disproportion (CPD): Baby's head is too large to fit through the mother's pelvis, often necessitating a cesarean delivery.
- Uterine Rupture: Scar from previous cesarean delivery may tear during labour, posing risks to both mother and baby.
Elective Repeat Caesarean Section
This type of C-section is planned before labour begins so that it can be scheduled during a time when the mother and baby will be healthy enough to undergo surgery safely.
Type of Caesarean Section Incision
A caesarean section is performed in delivering a baby through an incision in the mother's abdomen and uterus. The incision is made transversely or horizontally. There are two main types of caesarean sections, determined by where on the uterus the incision is made:
High Vertical Incision
This type of incision is done in the upper abdomen. It doesn't go all the way through the skin like a traditional C-section, but it does go all the way through your abdominal muscles and fascia.
This type of incision can cause less scarring than other types because it doesn't go through as much tissue.
However, this method makes it easier for bacteria or germs from your bowel to get into your abdominal cavity and cause an infection or inflammation after surgery.
Low Vertical Incision
The low vertical incision is made at the top of your pubic hair, just above your belly button. It's the most common type of C-section because it's easier to perform and heals faster than a classical incision. It also has fewer complications, like infection and adhesions (when tissue sticks together).
But sometimes, a low vertical incision isn't possible. For example, if you have a large baby or are delivering twins, your doctor may have to make a classical incision instead—this is when they cut through your lower abdomen to deliver the baby.
A classical incision takes longer to heal than a low vertical incision and has more potential complications like adhesions and scarring.
Low Transverse Caesarean Section
The low transverse incision is one of the most common types of Caesarean incision, and it's also known as a "bikini cut" because it's located in the low abdomen.
This type of incision can be made horizontally or vertically. Because the skin is not opened completely in this type of surgery, it heals quickly.
The scar is generally less visible than other types of scars and can easily camouflage by clothing, but it may not be possible to breastfeed after having this type of surgery.
Preparing Yourself for a C-Section
Getting ready for a cesarean section (C-section) involves a few important steps to ensure a smooth experience for both you and your baby. Before the actual day of the procedure, there are some things you can do to prepare. Make sure to follow your doctor's instructions, attend prenatal visits, and ask any questions you may have about the procedure.
You might need to fast for at least six hours before the surgery and take medicine to prevent stomach acid reflux. Your pubic hair will be shaved, and a urinary catheter will be inserted to drain urine before the surgery. On the day of the C-section, you can opt for regional anaesthesia (spinal or epidural) to be awake during the operation, or general anaesthesia if necessary.
At the hospital, you can expect a few more steps before and after the C-section. The most common skin incision is a horizontal cut near the pubic hairline, and the tummy is opened in layers to reach the uterus. The baby is delivered, the umbilical cord is cut, and the placenta is removed.
How long does a caesarean section take?
The duration of a C-section can vary depending on several factors, including the complexity of the procedure, the specific circumstances of the mother and baby, and the surgical team's experience.
On average, a C-section typically takes around 45 minutes to an hour from the time the surgical incision is made to the delivery of the baby. However, the entire process, including preparation and recovery, may take a few hours.
Depending on your condition, you may be allowed to drink fluids a few hours after the operation, and breastfeeding can usually begin as soon as you are awake and back in the ward. Pain relief will be provided, and you might experience cramps and bleeding from the vagina. Gradual leg movements are recommended to prevent blood clots.
Mothers usually stay in the hospital for about 2 to 3 days after a C-section.
Caesarean Delivery Side Effects
If you've had a caesarean delivery, you may be experiencing some of the following side effects:
- Pain in your abdomen or pelvic area. You may also feel pain in your back or legs. This is because you have a wound that needs time to heal and will be sore for some time.
- Bleeding, especially if it's heavy. Your doctor may give you medication to help stop the bleeding and encourage your wound healing.
- Trouble urinating or having a bowel movement. Most women find these issues improve after about six weeks after delivery. If they do not improve, talk with your doctor about possible treatment options such as manual expression of urine (or catheterization) or constipation remedies like fibre supplements or a bowel stimulant drug called senna).
- Swelling in the legs (oedema) results from fluid retention from lack of activity after delivery. Your doctor may prescribe drugs to reduce oedema if it continues for more than two weeks after delivery.
Complications of Caesarean Section
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Bleeding
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Infection
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Sepsis
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Stitches come loose
Caesarean Section - Risks to the Baby
The risks to the baby during a C-section are generally fewer compared to those for the mother. Here are some potential risks that your baby might face during a C-section delivery:
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Breathing Issues
Babies delivered by C-section may have a higher likelihood of developing breathing problems, especially if the procedure is performed before 39 weeks of pregnancy. This is because vaginal birth helps clear fluid from the baby's lungs, while C-section babies might retain some fluid.
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Respiratory Distress
Babies born via C-section before labour begins could experience temporary fluid retention in their lungs, potentially leading to respiratory distress. However, this usually resolves within a day or two.
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Injury
Although rare, there is a small risk of accidental nicks or scrapes to the baby during the C-section procedure.
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Anesthesia Reaction
While uncommon, there is a slight chance that the baby might have a negative reaction to the anaesthesia used during the C-section
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C-Section Recovery Period
After leaving the hospital, the recovery process continues at home. It's important to take it easy and rest as much as possible during the first few weeks. Activities that involve lifting heavy objects or exerting too much strain on the body should be avoided. It's generally recommended not to lift more than 25 pounds during this period.
For pain relief and incision soreness, healthcare providers may recommend safe medications such as ibuprofen or acetaminophen. They might also suggest using a heating pad for comfort.
Certain activities should be postponed during the recovery period. Sexual intercourse is usually advised to be avoided for at least six weeks after the C-section to prevent infection. Similarly, driving should be postponed, especially if narcotic pain medications are being used, until one feels comfortable applying brakes and checking blind spots.
It's important to monitor the C-section incision for signs of infection, such as redness, swelling, or discharge. If any of these symptoms are observed, or if there's fever, heavy bleeding, or worsening pain, the healthcare provider should be contacted.
Emotional well-being is also crucial during the recovery period. Postpartum depression is a possibility, and if symptoms like severe mood swings, loss of appetite, overwhelming fatigue, and lack of joy in life occur, it's important to seek medical help.
The American College of Obstetricians and Gynecologists recommends ongoing postpartum care, including a follow-up appointment within three weeks after delivery for emotional and physical evaluation.
When considering whether a caesarean delivery is the right choice for you, it's crucial to engage in a thoughtful and informed discussion with your healthcare provider. Both natural vaginal delivery and elective C-section have their own set of advantages, disadvantages, and potential risks.
Ultimately, the decision should be based on a thorough understanding of the options, guided by the expertise of your healthcare team, and aligned with your long-term health and family planning goals.
Here at theAsianparent Singapore, it's important for us to give information that is correct, significant, and timely. But this doesn't serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.