CAESAREAN SECTION (CS)

The cesarean section which is also known as “C- Section” is the surgical delivery of a baby that involves making incisions in the mother’s abdominal wall and uterus.  C- Section is mostly performed when a vaginal delivery is not possible or safe for the mother, or when the health of the mother or the baby is at risk. A cesarean section might be planned in advance if a medical reason calls for it, or it might be unplanned and take place during labor if certain problems arise.

Reasons for Cesarean Section

  • Failure of labor to progress: In this condition, the cervix begins to dilate and stops before the woman is fully dilated, or the baby stops moving down the birth canal.
  • Cord compression:  It’s a condition whereby the umbilical cord is looped around the baby’s neck or body, or caught between the baby’s head and the mother’s pelvis.
  • To deliver a baby with developmental conditions.
  • Cesarean section is done in cases of Cephalopelvic disproportion (CPD). This means that the baby’s head or body is too large to pass safely through the mother’s pelvis or the mother’s pelvis is too small to deliver a normal-sized baby.
  • Cesarean section is done in cases of prolapsed cord. Here, the umbilical cord comes out of the cervix before the baby does.
  • Abruptio placentae: when placenta separates from the wall of the uterus before delivery of the baby.
  • To deliver babies in an abnormal position or presentation e.g. breech presentation.
  • Mother with health problems, such as high blood pressure or unstable heart disease.
  • When mother has active genital herpes that could be transmitted to the baby.
  • Previous cesarean delivery.
  • Multiple pregnancies, although twins can often be delivered vaginally, two or more babies might require a cesarean delivery.
  • Fetal distress: During labor, the baby might begin to develop problems that cause an irregular heart rate. When the baby can no longer tolerate labor, cesarean delivery is thereby necessary.
  • Mechanical obstruction: there may be need for cesarean section if the mother has a large fibroid obstructing the birth canal, a severely displaced pelvic fracture or the baby has a condition that can cause the head to be unusually large (hydrocephalus).

The Risks of a Cesarean Delivery

Risks of cesarean delivery to the baby include:

  • Surgical injury: Accidental dents to the baby’s ski8n can occur during surgery.
  • Breathing difficulty: babies born by cesarean section are more likely to develop transient tachypnea. This is a breathing problem marked by abnormally fast breathing during the first few days after birth.

Risks of cesarean delivery to the mother include:

  • Postpartum hemorrhage: Bleeding during and after surgery may occur.
  • Infection: the mother is at risk of developing an infection of the lining of the uterus (endometritis).
  • Blood clots may develop inside a deep vein (deep vein thrombosis).
  • Surgical injury to other organs: this is rare but there can be surgical injuries to the bladder or bowel.
  • Increased risks during future pregnancies: the more C-Sections, the higher the risks of placenta previa and a condition in which the placenta becomes abnormally attached to the wall of the uterus (placenta accreta).

Process of a Cesarean Delivery

  • Make informed consent about the surgical procedure. The patient is also told to plan to stay in the hospital for three to four days while they recover from surgery.
  • Before the surgery, the abdomen is cleaned and the patient is prepared for receiving intravenous (IV) fluids into the arm. This allows physicians to administer fluids and any type of medications that may be needed.
  • A catheter is put in place in order to keep the bladder empty during the surgery.
  • Anesthesia is administered to the mother. There are three types of anesthesia offered to mothers for C- section:
  • Spinal block: Anesthesia that’s injected directly into the sac that surrounds the spinal cord, thus numbing the lower part of the body.
  • Epidural: Common anesthesia for both vaginal and cesarean deliveries, which is injected into the lower back outside the sac of the spinal cord.
  • General anesthesia: Anesthesia that puts the mother into a painless sleep, and is usually reserved for emergency situations.
  • When the mother has been properly medicated and numbed, the 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 the abdomen has been made and the uterus is exposed, the doctor will make an incision into the uterus. This area will be covered during the procedure so the mother won’t be able to see the procedure.
  • The new baby will be removed from the uterus the second after the incision is made.
  • The doctor will first tend to the baby by clearing the nose and mouth of fluids and clamping and cutting the umbilical cord.
  • The baby will then be given to the nurse and they will make sure the baby is breathing normally and prepare the baby into the mother’s arm.
  • The uterus is repaired with dissolving stitches and the abdominal incision is closed with sutures by the surgeon.

Things to Notice Once Undergoing a C-Section

  • After a cesarean delivery, the mother and newborn will stay in the hospital for about three days. Immediately after surgery, the mother will remain on an Intravenous fluid. This permits for adjusted levels of painkillers to be delivered into the blood whereas the physiological state or anesthesia wears off.
  • The mother is encouraged to get up and walk around. After about 24hrs this can help prevent blood clots and constipation.
  • A nurse or doctor can teach you how to position your child for breastfeeding so there’s no additional pain from the cesarean delivery incision area.
  • The mother is advised to take things easy and rest, especially for the first few weeks.
  • Drink plenty of fluids to replace those lost during the cesarean delivery.
  • Avoid sex for four to six weeks.
  • Take pain relief medications as needed and prescribed.
  • Seek help if you experience symptoms of postpartum depression, such as severe mood swings or overwhelming fatigue.

When to Consult a Physician

Consult a doctor if the mother experiences any of the following:

  • Breast pain accompanied by a fever.
  • Foul-smelling vaginal discharge
  • Bleeding with large clots.
  • Pain during urination.
  • Signs of infection which involves fever over 37.50C, redness, swelling, or discharge from the incision site.

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