Sometimes there are complications during the birthing process. There are many reasons that prevent a mother from undergoing normal delivery. When normal vaginal delivery is not possible, a surgical approach like Cesarean or C-Section is opted by the doctors to deliver the baby through an incision in the abdomen and uterus. Besides, there may be some more reasons of the surgical approach for C-Section delivery which is safe for the health and survival of the mother or the baby or for the both sometime. Know about C-section, the surgery, procedure, risk, complications and recovery.
When is C-Section Considered?
Here are some of the obvious causes for choosing C-section surgery for delivery:
- If the size of the fetus's head is found too large to fit and pass through the birth canal or pelvis (Cephalo pelvic Disproportion or CPD)
- If the umbilical cord is wrapped around the baby's neck
- If the position of the fetus is abnormal like breech presentation (buttocks or feet first), with chances of getting stuck into the birth canal.
- If the birth canal is found obstructed abnormally by the umbilical cord or the placenta
- If the mother's pelvic structure may not allow adequate passage for birth then the doctor may opt for C-section
- If the oxygen level is low in the fetus
- If the heartbeat of fetus is found below average then again the doctor may opt for C-section
- If labor is absent or not progressing (dystocia) as expected within the due time of delivery
- If there are weak or infrequent contractions at the time of labor
- If the umbilical cord gets pushed into the vagina ahead of the baby and becomes compressed casing reduced blood flow through the placenta to the fetus
Apart from the reason shown above there may be some other reason that can compel to opt for C-Section:
- Mother is suffering from obesity or maternal diabetes or both
- Mother had hypertension or high blood pressure related to pregnancy
- Genital herpes is present
- Malignancies of the genital tract
- General health condition of the mother is so poor
- Multiple births and increased maternal age
- Previous history of C-Section
- Mother is carrying multiple fetus that is twins, triplets etc.
C-Section Procedure: How is it Done?
In a C-section, the following procedures are considered.
In case of regional anesthesia the mother, remains awake during the surgery. It allows mother to have her baby earlier than that of general anesthesia. Regional anesthesia also bears a lower risk in case of the mother suffering from some indicative heart, lungs or kidneys problems. So, it is the most preferred and dependable method of pain relief during a C-section. Regional anesthesia may be either spinal or epidural. On the other hand, some mother might experience a drop in blood pressure when a regional anesthetic is administered. This is dealt with administered fluids, medication, or both.
- Spinal Method - Spinal anesthesia involves inserting a needle into a region between the vertebrae of the lower back and injecting numbing medications.
- Epidural Method - An epidural is similar to a spinal except that a catheter is inserted so that numbing medications may be administered continuously
This method is generally opted in case of an emergency in C-section. When regional anesthesia is considered a risk for the mother with a history of coagulation disorder that would be complicated by a drop in blood pressure, general anesthesia is deemed the best alternative. But the most adverse side of this method is it carries certain risks such as pulmonary aspiration and failed intubation.
C-Section Surgery - Procedure
The procedure for C-section is performed in the following manner
- Opening the abdomen and the uterus is the two consecutive procedure of C-section.
- A horizontal incision is taken in the skin and the abdominal wall usually along the bikini line. A vertical incision may sometimes be taken, depending on the case.
- Thereafter, incision is made in the uterus.
- A transverse incision is mostly preferred because it heals well and keep the chances for a vaginal delivery for the mother in future.
- Once the uterus is opened, the amniotic sac is ruptured and the baby is delivered.
- Under this procedure, the umbilical cord is clamped and cut, and the baby is evaluated carefully.
- Then the placenta, which is attached to the uterus is removed.
After all the contents of the uterus are removed, the uterus is repaired, and the rest of the layers of the abdominal wall are closed. The uterus and abdomen are stitched closed. Often, the surgical staples are used instead in closing the outermost layer of the abdominal incision for a quicker healing. This entire surgical procedure may be performed in less than one hour if there are no other complications.
Possible Risks and Complications of C-Section
Here are some of the risks and complications of C-section
- Post-operative inflammation and infection of the membrane lining the uterus
- The risk of developing a blood clot inside a vein
- Heavy blood loss known as postpartum hemorrhage
- A blood clot in the legs or lungs.
- Nausea, vomiting, and severe headache after the delivery
- Bowel problems, such as constipation
- Injury to another organ like bladder during surgery
- Breaking open of the incision scar during a later pregnancy or uterine rupture
- Formation of scar tissues inside pelvic region. This is called Adhesions. It leads to future pregnancy complications
- Injury of the baby during alienation procedure
Some conditions may increase the chances of risks during C-section. Hence a more careful approach is needed for such high risk cases.
- Placenta Previa, it is the growth of the placenta low in the uterus, blocking the cervix
- In case of premature delivery, immature lungs and breathing problems may be observed in babies delivered before 39 weeks of gestation
- Low birth weight for premature delivery
- High blood pressure in mother
C-Section Recovery and Care
After a C-section, a woman may spend two to four days in the hospital depending upon her health condition. Some may be required to stay a little longer. The overall recovery and care period following a C-section is up to six weeks. The area around abdomen may be sore from the surgery and the skin and nerves in this area need some time to heal. Using common pain killer medications to take the edge off any post-surgery pain found most helpful. Medication usually to be continued for about two weeks after the surgery. Mothers are also advised to not have sex for a few weeks after her C-section to avoid strenuous activities.
Most mothers who follow medical advice, proper diet and activities, as suggested following a C-section, usually recover well within the time. Those who had complications and who need additional treatment, may take more time.
Special Care Tips for Quick Recovery Following C-Section
- Clean the incision daily
- Do not rub
- Allow the area to dry completely
- Do not soak in water
- Keep it dry during the day
- Avoid lifting anything heavier than the new born for at least 6 weeks
- Use comfortable abdominal binder
- Wear loose fitting clothes in the beginning
For any changes in the wound or any complaints, it is best to seek medical opinion without delay.