C-section

What is a Caesarean section?

Caesarean section (C-section or Caesarean birth) refers to the surgical delivery of a baby through a cut made in the mother's abdomen as well as the womb.

The cut made in the skin may be:

• Up-and-down (vertical): This cut extends from the belly button to the pubic hairline.
• Across from side-to-side (horizontal): This cut extends across the pubic hairline. It is utilized frequently because it heals well as well as there is less bleeding.

The incision type utilized relies on the health of the mother as well as the fetus. The incision in the womb may also be either vertical or horizontal.

Need of a C-section

If a woman can't deliver vaginally, C-section permits the foetus to be delivered surgically.

Several conditions make a Caesarean delivery more likely. These comprise:

• Abnormal foetal heart rate
• Abnormal position of the foetus during birth. 
• Issues with labour: 
• Foetus size
• Placenta problems
• Twins or other multiples
• Certain health conditions in the mother, like diabetes.
• Active herpes sores in the mother's cervix
• Prior C-section

Risks linked with a C-section

Some possible complications of a C-section may comprise:

• Reactions to the medications utilized during surgery.
• Bleeding
• Unusual separation of the placenta
• Bladder or bowel injury
• Womb infection
• Difficulty peeing or urinary tract infection.
• Blood clots

Post a C-section, a woman may not be able to give a vaginal birth in a future pregnancy. It will rely on the type of uterine cut utilized. Vertical scars are not sufficiently strong to hold together during labor contractions, therefore a repeat C-section is required.

Preparation for a C-section

• Healthcare provider will explain the procedure to mother.
• Mother will be asked to sign a consent form that gives healthcare provider permission to perform the procedure. 
• In the case where C-section is planned and requires general, spinal, or epidural anaesthesia, the mother will be asked not to ingest food or drink any liquid for 8 hours prior to the procedure.
• Mother may be given drugs to decrease the stomach acid. These also aid dry the secretions in mouth as well as breathing passages.

What happens during a C-section?

A C-section will be done in a special delivery room. In majority of cases, mother will be awake for a C-section. Only in unusual cases will a mother require medication that puts mother into a deep siesta (general anaesthesia). With these, mother will have no feeling from waist down, but mother will be awake as well as able to hear and see baby as soon as he or she is born.

Typically, a C-section follows this process:

1. Mother will be asked to wear a hospital gown.
2. Mother will be positioned on an operating/exam table.
3. A urinary catheter may be inserted in if it was not done prior to arriving to the operating room.
4. An intravenous (IV) line will be commenced in arm/hand.
5. For safety purpose, straps will be placed over legs to hold mother on the table.
6. Hair surrounding the surgical portion may be shaved. The skin will be cleaned with the application of an antiseptic solution.
7. The woman's belly will be covered with sterile material.
8. The anaesthesiologist will continuously monitor heart rate, blood pressure, breathing, as well as blood oxygen level during the procedure.
9. Once the anaesthesia has taken effect, healthcare provider will make a cut above the pubic bone, either transverse or vertical.
10. Healthcare provider will make deeper cuts through the tissues as well as separate the muscles until the wall of uterus is reached. He or she will make a final cut in the womb. This cut is also either horizontal or vertical.
11. Healthcare provider will open the amniotic sac and deliver the baby through the opening. Mother may experience little pressure.
12. He/she will cut the umbilical cord.
13. Mother will get medicine to aid the uterus contract as well as expel the placenta in IV.
14. Healthcare provider will take out placenta and examine the womb for tears or pieces of placenta.
15. He or she will utilize sutures to close the cut in the uterine muscle as well as reposition the uterus in the pelvic cavity.
16. Healthcare provider will close the muscle and tissue layers with sutures. He or she will close the skin cut with sutures or surgical staples.
17. Finally, the healthcare provider will put a sterile bandage.

After a C-section

• In the recovery room of hospital, nurses will monitor blood pressure, breathing, pulse, bleeding, as well as the firmness of womb.
• Usually, mother can be with baby while she is in the recovery area. In certain cases, babies born by Caesarean will first be required to be monitored in the nursery for a short duration.
• After an hour or 2 in the recovery area, the mother will be moved to her allotted room for the rest of the hospital stay.
• As the anaesthesia wears off, the mother may get pain medication as required. This can be either from the nurse or via a device connected to an intravenous (IV) line known as a PCA (Patient Controlled Analgesia) pump. 
• The mother may experience gas pains as the intestinal tract commences working again post-surgery. Moving around and walking aids ease gas pains. 
• The mother may feel uterine contractions known as after-pains for a few days. The womb continues to contract and get smaller over several weeks.
• The urinary catheter is generally removed the day post-surgery.
• The mother may be given liquids to drink a few hours post-surgery. 
• The mother may be given antibiotics in IV while in the hospital as well as a prescription to keep taking the antibiotics at home.

In a nutshell, a Caesarean section is a surgical procedure performed to deliver a baby when vaginal delivery is not possible or safe for the mother or baby. While C-sections are generally safe, they do carry certain potential complications. Recovery from a C-section typically involves monitoring in the hospital, pain management, and gradually resuming routine activities. Ultimately, the goal of a C-section is to make sure the safety as well as well-being of both the mother and the baby during childbirth.