A caesarean section may be planned (elective) if there are symptoms that a vaginal birth might be dangerous, or it may be performed unexpectedly (emergency) if complications arise during labour.If your pregnancy and labour are going well, a vaginal delivery is the safest option to deliver your baby. The majority of women give delivery vaginally (about two in every three births).
You have the right to participate in and make decisions regarding your care. A caesarean section can be performed only with your written consent. If you are unable to give a formal approval, your partner or next of kin may.
Reasons for a planned caesarean section
Several reasons exist for you and your doctor to choose a planned (elective) caesarean birth.
These include the following:
You have had a previous caesarean section.
Your baby is born bottom-first or feet-first (breech) and is unable to be turned.
Your cervix (womb opening) is obstructed by the placenta (this is known as Placenta Previa).
Your baby is lying sideways (transverse) and the doctor is unable to turn him or her.
You are pregnant with twins, with the first baby being born bottom or feet first.
You’re expecting three or more children.
Not all women have caesarean sections or are required to have them in certain conditions. The selection will be influenced by your unique circumstances and, in some cases, your preferences.
Reasons for an unplanned caesarean section
Several factors contribute to an unplanned (emergency) caesarean birth, including the following:
During labour, your baby’s head does not descend or ‘fit’ through your pelvis.
Your labour is stalled – your contractions are insufficiently forceful, and your cervix opens too slowly or not at all.
Your infant is in discomfort or their health is being jeopardized.
After your waters have ruptured, the umbilical cord has prolapsed through the cervix and into the vagina, supplying vital nutrients and oxygenated blood to your baby.
A medical condition, such as high blood pressure, makes labour more dangerous for you and your baby.
Several factors contribute to an unplanned (emergency) caesarean birth, including the following:
Things to consider before having a caesarean section:
Your general health, including any health issues, as some factors, may influence your doctor’s surgical and anaesthetic options.
Potential dangers and complications
Any bleeding issues and whether you bruise easily any allergies or medications you are taking tests you need to have – these include blood tests to determine if you are anaemic and to determine your blood type in case you require blood during or after the caesarean section.
Caesarean section anaesthetic
Three types of anaesthetics may be used to ensure that you experience no discomfort throughout your procedure: They include the following:
Spinal anaesthesia — the most frequently used type of anaesthesia for a scheduled caesarean section. A needle will be put between the bones in your spine and a local anaesthetic delivered through it. This will alleviate the pain radiating down from your chest. You will remain conscious and capable of breathing normally. You may experience tugging and pulling feelings during the birth of your baby, but no pain.
Epidural anaesthesia – frequently used to alleviate labour pain. If you have already received an epidural during labour and it is working well, it can be topped up in preparation for an emergency caesarean section. The epidural is a plastic tube that is put into a region surrounding the spine’s lining. Through the tube, a local anaesthetic will be given, which will block any pain sensations from your waist down. You will remain conscious and capable of breathing normally. You may experience tugging and pulling feelings during the birth of your baby, but no pain.
A general anaesthetic may also be used if your baby requires immediate delivery. You will breathe oxygen through a mask and will be given medication via a drip to induce drowsiness and sleep. You will sleep through the delivery of your baby.
Caesarean section types
Caesarean sections are distinguished by the location of the cuts (incisions) done to the uterus. Following your caesarean section, inquire with your physician about the type of incisions made. This knowledge will be beneficial as you make decisions concerning future pregnancies.
When a caesarean section is performed, two types of cuts are possible:
Whenever possible, a lower section incision will be used. This is a horizontal (across) incision through the abdomen (stomach) and a horizontal incision through the lower region of the uterus, which is occasionally referred to as a ‘bikini line’ incision. These cuts heal more quickly, are less noticeable, and are less likely to cause complications in subsequent pregnancies.
A classical incision is a vertical incision made on the uterus. The abdominal cut may be horizontal or vertical. This form of incision is typically reserved for life-threatening crises or under specific circumstances, such as when the placenta is extremely low, the baby is lying sideways, or the baby is quite little. It may raise the risk of complications during subsequent pregnancies and births.
Getting ready for a caesarean section
To prepare for your caesarean section, follow these steps:
You will need to observe a fast. This entails abstaining from meals and liquids, including water, for six hours before a scheduled caesarean section. If you are having an emergency caesarean section, the doctor will inquire as to the last time you ate or drank to determine how to proceed with the procedure.
Blood tests will be performed on you.
Unless there are major issues or you require a general anaesthesia, you may have a support person accompany you. It is often possible for someone to photograph your baby being born, therefore request that your support person bring their camera.
Do not be hesitant to ask questions or to express your concerns to doctors or midwives. If you have any unique preferences, discuss them with your doctor or midwife in advance so they can attempt to accommodate them.
If your doctor believes you are at a higher risk of blood clots, you may be measured for compression stockings to wear throughout the procedure.
To minimise the danger of infection, the theatre team will wipe your abdomen with antiseptic and cover it with sterile cloths. In many hospitals, the hair surrounding the region to be shaved is shaved to make cleaning easier. A catheter (plastic tube) will be put into your bladder to keep it empty during the operation.
The actual caesarean section procedure typically lasts between 30 and 60 minutes. It will include the following:
A cut will be made in your abdomen and uterus by the doctor (both about 10 cm long).
Your baby will be extracted via the cut. Occasionally, the doctor will use forceps to assist in lifting your baby’s head out.
Your infant will be thoroughly examined.
You will soon be able to hold your kid. Skin-to-skin contact can help to enhance your infant’s early attachment and make breastfeeding simpler.
If you are unable to hold your baby in the operation room, your support person will most likely be able to.
The umbilical cord will be severed and the placenta will be extracted.
Typically, an injection will be administered to compress your uterus and minimize bleeding.
Antibiotics will be administered to help prevent infection.
Muscle, fat, and skin layers will be sewn back together and a dressing put to the wound.
Following a cesarean section
Following a cesarean section, several things will occur, including the following:
You will remain in the recovery room until you are ready to be transferred to the ward.
If you have been given a general anaesthetic, you will almost certainly awaken in the recovery room. Once you are awake, you should be able to see your kid.
Breastfeeding will be encouraged. Breastfeeding is likely to be easier for both you and your baby if you begin early. Having a caesarean section can make nursing more difficult to initiate, so seek all necessary assistance. Breastfeeding is the optimal food for your baby’s health and development, and the midwives are here to assist you. Certain hospitals encourage moms to nurse their infants in the recovery room with the assistance of a midwife.
You may require a drip for the first 24 hours or so to ensure proper recovery from the anaesthesia.
Notify your midwife or doctor if you are experiencing discomfort so they can administer medication to alleviate it. Pain medicine may cause drowsiness.
After any nausea has passed, you may begin drinking.
When you can resume eating, the midwife or doctor will advise you.
Your catheter will remain in place until the anaesthetic wears off and you regain sufficient sensation in your legs to safely walk to the toilet. This may not occur until the following day.
Walking can aid with recuperation. Additionally, it can help prevent blood clots and swelling in your legs. When you initially get out of bed, a midwife will assist you.
Additionally, you may receive an injectable to prevent blood clots.
Antibiotics may be required following the procedure.
For a brief period following the operation, you may experience difficulty with bowel motions. It should be beneficial to drink plenty of water and eat foods high in fibre. Your doctor or midwife can provide more guidance.
Following the removal of your dressing, you will be urged to keep the wound clean and dry. This will aid in the healing process and decrease the chance of infection.
After a caesarean procedure, your baby will require special care.
Following a caesarean section, your baby is more likely to experience respiratory difficulties and will require admission to the special care nursery for some time (although they are usually ready to go home when you are). Around 35 kids out of every 1,000 experience breathing difficulties following a caesarean birth (compared with five in 1,000 babies following a vaginal birth).
If your baby is preterm or ill, he or she may need to be admitted to the special care nursery as well. Generally, your partner or support person can accompany the infant. When you are sufficiently healthy and as soon as possible, the midwife or nurse will assist you in viewing your baby. Midwives and nurses are available to assist you in expressing breastmilk for your baby.
Caesarean section risks and complications
Although caesarean sections are a regular and reasonably safe surgical operation in Australia, they are nevertheless considered significant surgery. As is the case with any medical operation, there are dangers associated with it for both you and your baby.
Several of the more frequent hazards and problems include the following:
Blood loss that is greater than typical
Clots of blood in the legs
Infection of the uterine lining a prolonged hospital stay (three to five days, or 72 to 120 hours, on average)
The ache in the area of the wound (you will be given pain relief)
Difficulties with future vaginal birth attempts
A necessity for a caesarean section in the future due to anesthetic-related problems.
Certain women experience major complications following a caesarean operation. Always speak with your midwife or doctor about any concerns you have, so they can determine whether or not the issue is significant and offer you the necessary therapy.
Several issues to keep an eye out for include the following:
Abdominal pain or a wound that is deteriorating and does not heal after you take pain medication
-relieving medication for ongoing or new back pain, particularly in the area where the epidural or spinal injection was administered (muscular aches and pains are normal)
Leaking pee constipation inability to pass wind or bowel motions pain or burning when passing urine or inability to pass urine
Increased vaginal blood loss or foul-smelling discharge from the vagina coughing or shortness of breath calf (lower leg) swelling or pain wound edges coming apart or seeming infected
Six weeks following caesarean section
Women often stay in the hospital for around three to five days following a caesarean surgery. This may differ between hospitals or if you experience complications after your recovery. In some hospitals, you can elect to be discharged early and get follow-up care at your residence. Inquire with the nurse or midwife about the services available at your hospital.