A cesarean section or "cesarean section" is an operation to remove a baby through surgery. This action is carried out if normal vaginal delivery is not possible, normal delivery risks the life of the mother or baby, if the mother has given birth by cesarean section before, or if the mother prefers this delivery to normal delivery. In some cases, a cesarean section is performed at the request of the mother. If you are planning to have a scheduled cesarean section or want to prepare for an emergency cesarean section, you should learn more about this procedure, undergo the necessary examinations, and develop a treatment plan with your doctor.
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Part 1 of 3: Understanding C-section
Step 1. Understand why a planned cesarean section is performed
Your doctor may recommend a cesarean section based on the condition of your pregnancy, such as if there are health problems affecting the baby. A cesarean section may be recommended as a preventative measure if:
- You have a chronic health problem such as heart disease, diabetes, high blood pressure, or kidney disease.
- You are infected with HIV or active genital herpes.
- Your baby's health is at risk due to a congenital disease or condition. If your baby is too big to pass through the birth canal, your doctor may recommend a cesarean section.
- You are overweight. Obesity can be a risk factor and requires a cesarean section.
- The baby has entered the birth canal, but is in a breech position (legs or buttocks down) and cannot be corrected.
- You have had a cesarean section in a previous pregnancy.
Step 2. Know how the doctor performs the operation
The action plan should be presented by the doctor to you to prepare. In general, most cesarean sections are performed in the same manner.
- At the hospital, the nurse will clean the abdominal area and insert a urine collection catheter. You will have an IV in your arm so you can continue to receive fluids and medications both before and during surgery.
- Most cesarean sections are performed under regional anesthesia which only numbs sensation in the lower part of the body. This means that you will be awake during the operation and will be able to see the baby being removed from the belly. This anesthetic is most often administered through the spine, by injecting the drug into the pouch that surrounds the spine. If you have to have an emergency cesarean, you will be given general anesthesia so you can fall asleep during labour.
- The doctor will cut the abdominal wall near your pubic hairline horizontally. If the baby needs to be delivered quickly as a result of an emergency, the doctor will cut the abdominal wall vertically from just below your belly button to just above your pubic bone.
- Next, the doctor will make an incision in the uterus. About 95% of cesarean sections are performed with a horizontal incision at the bottom of the uterus because the muscle layer in that section is thinner so that blood loss can be minimized. However, if the baby is in an unusual position, or is in the lower part of the uterus, the doctor may make a vertical incision.
- The baby will be removed through an incision in the uterus. The doctor will use a suction device to clean the baby's mouth and nose of the amniotic fluid and then cut the umbilical cord. You may feel a tugging sensation as the doctor removes the baby from the womb.
- Next, the doctor will remove the placenta from the uterus, check the health of the reproductive organs and close the incision with stitches. You will then be reunited with the baby and nurse him on the operating table.
Step 3. Know the risks of a cesarean section
Some mothers decide to give birth by planned cesarean section. In fact, the American Congress of Obstetricians and Gynecologists (ACOG) recommends that mothers and doctors who care for them plan a normal delivery unless a cesarean section is medically necessary. The choice of a planned cesarean section should only be made after serious consultation with the doctor about this procedure and understanding of the potential risks.
- A cesarean section is classified as a major operation and you will likely lose more blood in this procedure than with a normal delivery. The recovery period from a cesarean section is also much longer, which is about 2 to 3 days of hospitalization. A cesarean section is a major abdominal operation with a recovery period of up to 6 weeks. If you have a cesarean section, you will be more susceptible to complications in your next pregnancy. Your doctor may recommend that you undergo another cesarean section in your next pregnancy to prevent uterine rupture, which is the tearing of the uterine wall in the surgical incision during normal delivery. However, some women may try a normal delivery after a cesarean, depending on the place of delivery and the cause of the previous cesarean.
- There are also risks associated with the surgery itself because you are given a regional anesthetic which can trigger an unwanted reaction. You are also more at risk of developing blood clots in your leg veins or pelvic organs as a result of a cesarean section. In addition, the surgical incision may also become infected.
- Cesarean section can also cause health problems in the baby, which include breathing problems such as transient tachypnea (rapid and abnormal breathing in the baby for a few days after birth). In addition, a cesarean section performed too early, at less than 39 weeks of gestation, can increase the risk of respiratory problems in the baby. Babies are also at risk for surgical injuries such as cuts to the skin from a doctor's incision.
Step 4. Understand the benefits of a cesarean section
A planned cesarean section allows you to better prepare for delivery, confirm the delivery site, and predict labor and delivery of the baby. Unlike emergency cesarean section, the risk and potential for complications such as infection, negative reaction to anesthesia, or abdominal organ injury during a planned cesarean section are also less. In addition, a cesarean section can also prevent damage to the pelvic floor that can cause digestive problems.
If the baby is very large, the baby has fetal macrosomia, or you are giving birth to twins or more, your doctor may recommend a cesarean section as the safest delivery option. A cesarean section will also reduce the risk of transmitting viral infections from mother to baby
Part 2 of 3: Planning a C-section with the Doctor
Step 1. Take the necessary health checks
Your doctor will likely order certain blood tests to prepare you for a cesarean section. This test will provide your doctor with important information, such as your blood type and hemoglobin level, which he or she will use in case you need a blood transfusion during surgery.
- It's a good idea to tell your doctor what medications you're taking to make sure they don't interfere with surgery.
- The doctor will recommend that you consult with an anesthesiologist to ensure there are no conditions that can increase the risk of complications related to the use of anesthesia.
Step 2. Schedule a cesarean section
Your doctor will recommend the best time to schedule a cesarean section, depending on your medical needs and that of your baby. Some mothers schedule a cesarean section at 39 weeks of pregnancy, based on their doctor's advice. However, if your pregnancy is healthy, your doctor may recommend a time closer to your baby's due date.
After determining the date of the cesarean section, enter that date into the birth plan and fill out the form required by the hospital
Step 3. Know what you will experience the night before the surgery
The doctor should talk about surgery the night before because you shouldn't eat, drink, or smoke after midnight. Also avoid the intake of snacks such as candy, or chewing gum, and do not drink water.
- You should try to get a good night's sleep the night before the surgery. You should also shower before going to the hospital, but don't shave your pubic hair beforehand as this can increase the risk of infection. The nurse may shave the area around your abdomen and/or pubic hair in the hospital if necessary.
- If you have an iron deficiency, your doctor may recommend increasing your intake of iron-rich foods and taking supplements. C-section is classified as a major surgery and you will lose a lot of blood. So, high iron levels will help your body recover.
Step 4. Decide who will accompany you during the operation
When planning a cesarean section, you should tell your partner or partner what will happen before, after, and during the surgery. You should determine whether your partner or companion will be with you during labor or after surgery.
Many hospitals allow an attendant to sit next to you during surgery and take photos during labour. The doctor should allow at least one companion into the operating room with you
Part 3 of 3: Recovering After C-section
Step 1. Stay in the hospital for at least two to three days
As the anesthetic wears off, you will be given a button to adjust the dose of the painkiller through the IV. Your doctor will motivate you to get up and walk around as soon as your cesarean is complete as this can speed up recovery and prevent constipation and blood clots.
The nurse will also monitor the cesarean incision for signs of infection as well as how much fluid you drink, and whether your bladder and digestive tract are functioning. You should start breastfeeding your baby as soon as you feel well enough because contact with the baby's skin and breastfeeding is very important to strengthen the relationship between you and your baby
Step 2. Ask your doctor about pain relievers and home treatments
Before leaving the hospital, your doctor should explain to you which painkillers you can take as well as any preventive treatments you may need, such as vaccinations. Your vaccinations must be updated to protect the health of you and your baby.
- Keep in mind that while breastfeeding you may need to avoid certain medications. Ask your doctor for medicines that are safe for you and your baby.
- The doctor should also explain the process of involution of the uterus which will continue to shrink back to its pre-pregnancy size (lochia). The process of shedding bright red blood which is quite a lot will last up to 6 weeks. You may need to wear highly absorbent pads, which are often provided by hospitals after delivery, and avoid using tampons during recovery.
Step 3. Take care of yourself and your baby during the recovery period at home
The time needed to recover from a cesarean section can be up to two months. So, be patient at home and limit your activity level. Avoid lifting objects that are heavier than the baby, and don't do housework.
- Use the blood loss count to measure your activity level. More blood will come out if you are too active. Over time, the blood that comes out will change color from pale pink or bright red to yellowish or bright. Do not use tampons or vaginal cleaners until the bleeding has stopped. Also, don't have sex until your doctor says it's safe for you to do so.
- Get enough fluids by drinking plenty of water and eating a healthy and balanced diet. This will help the body recover and prevent gas and constipation. Position the crib and equipment close to you so you don't have to stand up often.
- Watch out for a high fever or abdominal pain as they are both signs of infection. If you experience these symptoms, see a doctor immediately.
