Medical team performing a C-section. Image credit: Flickr
Medical team performing a C-section. Image credit: Flickr

A caesarean section, also called C-section, is a surgical procedure to deliver a human baby. The surgery involves a medical incision of the pregnant woman’s uterus and abdomen, and the baby taken out via the abdomen. Once done, stiches (dissolvable) are used to close the uterus. The skin’s top layer could be sealed with staples or stitches, which typically get removed a few days or a week after surgery. A caesarean section is a longer procedure than vaginal delivery – closing up the belly and uterus being the most time-consuming aspect of a C-section.  

C-sections roughly represent a third of all child deliveries in hospitals. In fact, most C-sections are carried out keeping the well-being of the baby and mother in mind. Typically, the surgeon will not schedule the operation before 39 weeks of pregnancy.

Why a C-Section and Likely Scenarios

Some pregnant woman may require a C-section even prior to labor. The reasons why a C-section is probably inevitable are:

  • Hard and slow labor, or the lack of one.
  • Single or multiple prior C-sections, which increase risks of uterus rupture during a subsequent normal or vaginal delivery.
  • Other type of past invasive uterine surgeries, like a myomectomy (removing fibroids surgically).
  • Twins or multiple-baby pregnancy. Some twins may take a vaginal exit, but it’s extremely rare with a pregnancy involving multiple babies.
  • An overweight or abnormally large baby. This condition is referred to as macrosomia, which is more prevalent among diabetic women or those who have larger-size previous babies.
  • If the baby is positioned transverse (sideways) or in a breech (is not head down).
  • There is a hurdle, like a big fibroid, which makes vaginal delivery impossible or difficult.
  • An abnormal or malformed baby; for instance, a neural tube defect.

An emergency C-section could be carried out if:

  • If the baby’s heart rate is abnormal, which may make it difficult for the baby to withstand extended labor.
  • If the placenta separates from the uterine wall, resulting in the baby not receiving sufficient oxygen if he/she isn’t delivered immediately.
  • A genital herpes flare-up when the water breaks, or during labor. A C-section delivery, in such conditions, will ensure an infection-free baby.

C-Section Risks

A C-section is a common procedure, but it has its fair share of risks. Since it’s slightly complicated than vaginal delivery, the risks are higher.

  • Mothers with C-sections can acquire an infection, experience excessive bleeding, increased post-partum pain, blood clots, undergo an extended hospital stay and a much longer recovery time. Bowel or bladder injuries cannot be ruled out too.
  • Some babies delivered before 39 weeks of pregnancy have a higher vulnerability to breathing issues compared to vaginally-delivered babies.
  • Injuries to the baby and/or death of the mother (extremely rare).

Pre-Caesarean Section

Before a caesarean section delivery, a general anesthesia is rare. A spinal or epidural block is likely to be administered, which would numb the body’s lower half, but leave the mother awake and watchful. Some additional medicines may also be given to ensure complete numbness. However, the mother is likely to experience some tugging sensation during some stage of the surgery. 

A catheter is later inserted inside the urethra to drain out urine during the operation. The top pubic hair section may be shaved too. Antacid medicine could be given before operation as precaution. It helps neutralize stomach acid so that the lung tissues aren’t damaged.

General anesthesia could be administered during an emergency C-section, which keeps the pregnant woman unconscious throughout the procedure. Consequentially, she feels no pain and is unlikely to remember anything. General anesthesia is usually not the norm because it increases the chances of sedation in the mother and baby.

A screen is put up above the pregnant woman’s waist so that she doesn’t see the incisions made. However, some surgeons or hospitals give the mother the option to have her husband or family besides her during the operation and/or place the baby on the mother’s chest right after delivery.

Recovery Stage

Once the operation is done, the new mother is wheeled to the recovery room. The newborn may accompany her if it’s fine. The mother will be given fluids intravenously until she can drink and eat normally. New mothers must stay in the hospital for a few days and take complete bed rest for a day right after surgery.

Mothers may also feel stomach sickness, an itchy or sore stomach region. These are normal reactions to surgery and anesthesia. Women who underwent emergency C-sections could feel confused, scared, chilly, alarmed or sad. Medications usually help subside these feelings.

For some days or even weeks after the operation, the new mom may feel tired, incision soreness, gassy and constipated, and diminished physical strength to move around or even lift the baby. Sudden/acute reactions or movements such as a cough, laugh or sneeze can increase the discomfort or pain. During such times, supporting the incised abdomen region may help.

After a month or two, the uterus heals completely and regular routine shall be up again. However, the actual time-span may vary across patients and doctor advice on the matter is highly advised. The doctor will instruct on when to get back to routine activities, including sex.

Postoperative Care

Early and regular walking, and taking the stairs could help bring down some post-surgery discomfort and pains. This will help mitigate blood clots and keep the bowels moving. These measures must be less intense, with someone around for help. If you already have kids, make sure your family, friends and/or neighbours share your responsibilities.     

Consuming more water could help with breastfeeding-associated pain and also boost milk supply. The increased water content will alleviate constipation troubles too.