Caesarean Delivery – All About C-Section Birth

Caesarean delivery may probably not be the way you envisioned bringing your baby into the world. But remember, when your doctor tells you that you need to have a caesarean delivery, it is because that is exactly what your baby needs. Read this article to educate yourself on caesarean delivery before you consult your doctor with any further questions.

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What Is a C-Section Delivery?

The Merriam-Webster dictionary defines a C-section (Caesarean Section) as:

“A surgical procedure involving incision of the walls of the abdomen and uterus for delivery of offspring.”

This definition holds good today as well. C-sections can broadly be categorised into two categories:

1. Elective C-Section

When the C-section is scheduled in advance, it is called an elective C-section. Many first-time mothers are now opting for C-section deliveries even though they may not have a medical reason to do so. While some opine that it is easier to arrange for leave or support when delivery is planned, others believe that it will help them avoid the pain and complications associated with vaginal deliveries. A doctor may also recommend an emergency C-section if the baby has a medical condition which makes a vaginal delivery risky.

2. Emergency C-Section

When the C-section is done in response to an unexpected circumstance, it is called an emergency C-section. This is mostly necessitated when complications arise after labour has begun.

Read on for a comprehensive overview of the procedure along with information about post-natal care.

What Are the Reasons for a C-Section?

Our mothers and grandmothers have told us that giving birth is the most natural thing on earth, that there are women in villages who stop working in the fields and go behind a tree, deliver their baby, tuck it into a shawl and go right back to work! As easy as that sounds, it is very rarely the case. Most people need a couple of days to recover from a normal delivery. Though a normal delivery (vaginal delivery) is preferred, there are many circumstances when a C-section is decided on.

For example, if you have experienced complications during an earlier pregnancy, or are already facing complications in the current one, you may need to opt for an elective C-section or a ‘planned repeat caesarean’. Here are a few situations in which you may have a planned C-section:

• Your previous delivery was a C-section.
• Your baby is in a breech position (which means he is bottom down).
• Your baby is in a transverse position (on the side), or changes his position frequently (also called an unstable lie).
• You have placenta praevia or a low-lying placenta.
• You have diabetes or a heart condition.
• You have lost a baby during labour or before labour in the past.
• You’re expecting multiples.
• Your baby is not following the expected pattern of growth and development in the womb.
• You have a condition which may make it dangerous to delay birth, such as severe eclampsia or pre-eclampsia.

Some mothers request a caesarean because of an emotionally or physically traumatic experience. A mother may also be apprehensive of labour pains. Most doctors prefer to counsel the mother and encourage her to give birth vaginally in such cases.

Sometimes, if labour does not progress on expected lines, your doctor may choose to deliver your baby by emergency C-section. The speed with which an emergency C-section is executed is determined by the urgency of individual cases.

While an emergency caesarean is performed in response to an urgent need, the reason may not always be life-threatening. Some situations leading to emergency C-sections include:

• Slow progress of labour, either because the neck of your cervix is not dilating rapidly enough when labour commences, or that there is an issue when pushing the baby out of the birth canal.
• The baby may be distressed, or your health may be deteriorating.
• Your baby may be in a breech position, which makes vaginal birth difficult.

A very small proportion of emergency C-sections are carried out urgently as the mother’s or the baby’s life could be in danger. This may be because of one or more of the following reasons:

• The baby’s oxygen levels or heartbeat indicate that he must be delivered immediately.
• You are suffering from severe pre-eclampsia.
• There is placental abruption in which the placenta comes adrift during labour. This may put the baby in danger.
• A prolapse of the cord occurs, which means that the cord slips out of the cervix before the baby. This is a cause for concern, as the baby’s oxygen supply may be cut off if the cord is squashed during the delivery.
• A uterine rupture occurs, which means there is tear in a scar from a previous delivery. This is a rare problem which happens to only 1 in 200 women.
• You experience heavy bleeding during labour.

How Is a Caesarean Delivery Done?

Irrespective of whether the surgery is a last-minute decision or a scheduled surgery, the procedure of a C-section is a simple process with a set pattern. The surgery takes about 10 minutes to deliver the baby, and 30 minutes to stitch the incision. Here’s a quick lowdown about the actual C-section procedure step by step.

1. Preparation and Anaesthesia

The caesarean section begins with the IV and anaesthesia. This is mostly a spinal block or epidural. This numbs the lower half of the body, but you will remain conscious. Your abdomen will then be shaved and cleaned using an antiseptic solution. A catheter is then inserted into your bladder, and it will stay there for the duration of the surgery.

Your view of your abdomen will be blocked by a short screen. This screen not only keeps the field sterile but also blocks your view of the incision and delivery. While you may feel squeamish about seeing the cut, you are sure to want to see your baby. Ask your doctor to lift the little one up for you to see as soon as your baby is delivered.

In case of an emergency C-section, there is, sometimes, not enough time to numb you, and you may be given general anaesthesia instead. This may leave you feeling nauseous groggy and disoriented, but the discomfort will pass. If an endotracheal tube is inserted during the C-Section surgery, you may also have a sore throat for a while.

2. Incision

Once you’re anaesthetised, a small incision or cut will be made in your lower abdomen, just over the pubic hairline. Don’t worry, if the scar is neatly sutured, it will be almost unnoticeable, and will gradually fade. A second incision will be made in the lower part of the uterus to deliver the baby. The doctor may choose to make two different kinds of incisions. We shall discuss them below.

Types of Uterine Incisions in a C-section Procedure:

• A low-Transverse Incision: Used in most C-sections, this cut is made across the relatively thinner muscle in the lower part of the uterus.
• A vertical cut: If the baby is positioned low in the uterus, or is in an unusual position, the incision is made down the middle of the uterus.

3. The Delivery

After the incisions have been made, the amniotic fluid is suctioned out, and the baby is delivered. You may feel a slight tug when the baby is extracted. The excess mucus in its respiratory tract is then suctioned out, and you will be able to hear your baby cry.

If you’ve been considering C-section for a while, or have been asked to consider, you will most likely have a bunch of questions to know how you can prepare for a C-section if there are risks, and if it is painful, etc. We have addressed most of these concerns below.

Is a C-Section Painful?

As with any surgery, there’s usually some degree of pain and discomfort after a C-section. The recovery period is also a little longer than for vaginal births. Right after the surgery, you may feel slightly nauseous, itchy, and sore; these are all normal reactions to the anaesthesia and surgery, and your doctor might even prescribe medication for these reactions. Coughing and sneezing hurt a bit for a while.

How to Prepare for a C-Section Delivery

Your state of mind is most important during delivery, be it a normal delivery or a C-section. The calmer you are, the easier it is on you and on your baby. These tips can come handy when preparing for a C-section:

1. Create a C-section Wish List

As an expectant mother, you can control various factors surrounded to the surgery, which will help make your experience a positive one. Here are a few options you may consider:

• Music in the operating theatre.
• If you like some support from a friend or a relative, do ask them if they can stay by your side during the C-section.

2. A C-Section Delivery Is Just Another Way of Giving Birth

Prepare for surgery by eating healthy, working out regularly, and maintaining optimum weight. An active lifestyle ensures good health for your baby and increases your chances of having a problem-free surgery and rapid recovery. The fitter you are before a C-section birth, the easier it will be to handle post-surgery recovery. You will find it easier to handle tasks like getting up, walking about, and resuming a normal routine. Moving around after surgery helps lessen any risk of blood clots and helps your digestive system function normally.

3. Take Control

Eat lightly for 12 hours before the surgery if you’re scheduled for a C-section. Food and waste move through your body with the help of a squeezing motion by the intestinal muscles. Because of surgery, the muscles of the intestines slow down considerably making it harder for the food and water to travel through the body. Eat light, easily digestible food which reduces gas build-up, and helps the intestines resume normal function sooner.

4. Choose a Mantra

Even if you have an unplanned C-section, you can still take a moment to recite a simple mantra, a word or verse repeated over and over to help quiet the mind. This helps by calming the mind, engaging breath, reducing stress hormones such as adrenaline and cortisol, and increasing oxygen flow through the body.

Risks of a Caesarean Delivery

There are risks involved with a caesarean delivery as with any major surgical procedure. It is important to know and understand your risks before having a caesarean procedure. A good understanding will help you in your discussions with your health care provider and help you make informed decisions.

Let’s take a look at the probable risks and complications for the mom and the baby.

1. Risks and Complications for the Mom

Do remember that most of the following risks are associated with any type of abdominal surgery.

• Infection: The incision site, pelvic organs such as the bladder and the uterus are susceptible to infection.
• Haemorrhage or Increased Blood Loss: A blood transfusion may be necessitated by excessive blood loss during caesarean delivery.
• Injury to Organs: There is a possibility of injury to organs such as the bladder or the bowel.
• Adhesions: The formation of scar tissue inside the pelvic region may cause pain and blockage. Complications like placental abruption or placenta previa may be caused in future pregnancies by adhesions or scar tissue.
• Extended Recovery Time: A C-section requires an extended recovery ranging from a few weeks to several months.
• Reactions to Medications: There can be a negative reaction to pain medications or the anaesthesia administered after or during surgery.
• Risk of Additional Surgeries: A C-section may lead to additional surgeries such as bladder repair, hysterectomy or another caesarean.
• Maternal Mortality: The rate of maternal mortality C-section birth is higher than that of vaginal births.
• Emotional Reactions: Some women may struggle to bond with a baby delivered via C-section as they feel dissatisfied with their birthing experience.

2. Risks and Complications for the Baby

• Premature Birth: A baby delivered by a planned C-section could have low birth weight because of being delivered too early if the gestational age was not accurately calculated.
• Breathing Problems: A baby delivered by C-section is more likely to have respiratory problems as indicated by some studies.
• Foetal Injury: In rare cases, the baby may be injured during the incision made for the C-section surgery.

Mother Care After a C-Section Delivery

The mother needs a little extra care after a C-section. Remember these points, and it will be easier to recover sooner than expected.

1. Recovery

It is natural to want to start taking care of your newborn, but it is important to remember that the time needed for emotional and physical recovery after a C-section is more than what requires after vaginal birth. Make sure you get adequate post caesarean care so that you recover swiftly. You will need to spend three to four days in the hospital and another four to six weeks resting at home before you go back to your normal life.

Your doctor will ask you to rest and limit your movements so that you don’t put undue stress on the incision. Make sure you take the advice as ignoring it will lead to an extended recovery time.

2. Be Careful

Your scar will be sore for several weeks. Make sure you refrain from carrying and holding anything except the baby. When nursing or cuddling, use a nursing pillow, or a normal pillow placed over your incision to lay the baby on.

3. Take It Easy

While it is important to take care of the new baby, it is equally important for you to take care of yourself. Don’t be shy about asking for help. Ask others to hand the baby to you instead of getting up every time. Do whatever it takes to make your life easier, and do it guilt-free.

4. Keep a Keen Eye on Your Incision

Watch out for any post-caesarean wound infection and seek immediate medical attention. You can accelerate your incision’s healing process by adopting a few easy practices, such as keeping the wound clean and wearing loose clothes that don’t irritate your belly.

Numbness, pulling and itching around the incision are normal and will fade. Call your doctor if you are in pain, suffering from a fever, or if the wound is oozy or red. These may be symptoms of an infection. While some clear fluid discharge is normal, it is advisable to talk to your doctor about it anyway.

5. Take Off the Pressure

Avoid foods or drinks that may make you gassy, as the build-up of gas can cause discomfort. Not only does it put pressure on the incision, but it can also be a sign of indigestion, which is caused as the anaesthesia slows your bowel activity down. If you do have indigestion, try drawing up your knees and taking deep breaths while lying on your left side or your back. Make sure you hold your incision site for support and to avoid injury.

6. Stay Regular

Constipation is a common problem many women face after pregnancy. Make sure you relax and avoid straining when you are on the toilet. Eating fibre-rich foods like vegetables and fruits and drinking plenty of fluids is one of the precautions you should take after a C-section. Your doctor may advise a mild laxative or stool softener if you face any problems.

7. Nourish Yourself

Your diet after a C-section is important; healthy food and lots of water are essential to maintain your strength and energy.

8. Get Moving

You’ll have to wait until your incision heals before you resume a regular workout schedule, but it is easy to exercise and facilitate recovery even when your movements are restricted. Boost circulation and muscle tone by stretching the calf muscles, flexing your feet, and wiggling your legs as much as you can comfortably. As your stamina increases, walk slowly around the house, resting frequently. This helps improve your digestion, too. Walking around helps build stamina, and soon enough, you will feel well enough to venture out for a stroll with your little one.

Although it may be a challenge to resist taking charge of your little one and your home, remember that you must be fit enough to do justice to the task.

Also Read: Benefits & Risks of C-section