Cesarean Section by Gynecologist

Cesarean Section

What is a Cesarean delivery?

C-section or Cesarean delivery is a type of surgery used for delivering a baby. According to National Center for Health Statistics, about 1 in 3 babies in the United States is delivered by a C-section. If you have a C-section, you will be given anesthesia so that you won’t feel pain. During a C-section, the doctor makes an incision in the belly and then the uterus. The baby is taken out through that incision.

Will I know in advance if I need a C-section?

You may. The most common reasons for a cesarean delivery before onset of labor are:

  • The mother delivered a baby by cesarean in the past.
  • The baby is not coming out head first.
  • The baby is very large.
  • The mother has an infection, such as herpes or HIV. Which can infect the baby during a vaginal birth.
  • The mother has a condition called “placenta previa.” The placenta is the organ that brings the baby nutrients and oxygen and carries away waste. If placenta blocks the way to the vagina, the baby can’t get out on its own, its called a placenta previa.
  • The baby has a problem, and the doctor believes labor and vaginal delivery might not be safe.

Some women choose to have cesareans even if they don’t need to. You should talk to your doctor if you think you want to have your baby this way. Surgery brings real risks.

When should planned C-sections happen?

In most cases, you should wait until the 39th week of pregnancy or later. (A normal pregnancy lasts about 40 weeks.)

Why do some women end up having C-sections after labor begins?

A common reason is that labor doesn’t move along like it should. This can happen if:

  • Contractions (the tightening of the uterus that happens during labor) are not strong enough to get the baby out.
  • The baby is too big.
  • The mother’s pelvis is too small (the pelvis is the set of bones around your hips and vagina).
  • The baby is in an unusual position, such as chin-first or sideways.

Other reasons that C-sections are done are:

  • The baby’s life is in danger; for example, because its heart rate is too slow.
  • The mother’s life is in danger; for example, because she is bleeding too much.

If my labor is moving slowly, will I need to have a C-section?

Not necessarily. First, your doctor or nurse might offer a medicine called oxytocin . The medicine should make your contractions stronger. If that doesn’t help within a few hours, your doctor might suggest a C-section.

How is a C-section done?Cesarean Section

Here are the main steps:

  • First, you will get anesthesia to keep you from feeling what happens during the surgery. There are two kinds of anesthesia. With regional anesthesia (epidural or spinal) , you stay awake. Under general anesthesia, you are asleep.
  • Next, the doctor will make an incision on your lower belly. There are two ways of making the incision:
    • Most of the time, the incision goes across your belly, from 1 side to the other, an inch or 2 above your pubic hair.
    • If you are bleeding a lot or your baby is in danger, the incision might go up and down. This kind of incision is sometimes the fastest way to get the baby out.
  • After opening your belly, the doctor will make an opening in your uterus and remove the baby. Then the doctor will cut the umbilical cord and take out the placenta.
  • Finally, the doctor will close your uterus and belly with stitches and possibly staples.

How long does it take to get better after the surgery?

Within a few hours, you will be able to move around, and eat and drink. Most women go home after 3 days, but will have some pain. It can take up to 6 weeks to heal completely. Women who have a job can usually go back to work after this time.

Are there risks of having a C-section?

Yes. Although most mothers and babies do well after a C-section, there are risks. Compared with a vaginal delivery, C-sections are more likely to cause:

  • Harm to the bladder, blood vessels, intestines, and other nearby organs.
  • Infection.
  • Blood clots that can block blood vessels and cause trouble breathing.
  • Lost bonding time between mother and baby.
  • A longer time for the mother to heal after the birth.
  • Problems with the placenta and uterus in later pregnancies.
  • Trouble breathing for the newborn. This usually lasts for just a short time.

Your doctor can help you decide if the risks of surgery are worth taking for you.

What symptoms will I have while I’m getting better?

For the first few weeks, it is common to have:

  • Mild cramps in your belly.
  • Light bleeding and yellowish fluids coming out of your vagina.
  • Pain where the incision was made.

See your doctor if:

  • You have a fever higher than 100.4°F (38°C).
  • Your pain gets worse.
  • Your vaginal bleeding gets heavier.
  • The incision in your belly gets more sore or red, or is bleeding or leaking fluid.

If I have a C-section, will all of my future deliveries have to be C-sections?

After first cesarean, a trial of labor can be given on next pregnancy. However births are more likely to be by a cesarean section. You should consider the size of the family you want because the risks increase with the number of cesarean sections you have. Two cesarean sections do not appear to have a higher complication rate, but three or more carry serious risks. Ask your doctor if a trial of labor is possible for you.