Cesarean Section: An Overview
Cesarean section (also called a c-section) is the most common major surgery done today. It is performed about 1 million times a year in the United States. In most cases, a cesarean section is a safe method of delivering a baby.
There are different reasons why a woman may have a cesarean section. When the procedure is scheduled ahead of time rather than performed in an emergency situation, it is similar to having a scheduled surgery. Usually, cesarean sections are scheduled around the time you are
39 weeks pregnant, or when the baby is ready for life outside the womb. It may be done earlier if you have a scar on the upper part of your uterus from a previous cesarean section.
Your uterus, also called your "womb," is a pear-shaped organ that rests above the vagina, or birth canal.
After you become pregnant, your uterus stretches and expands, along with the growing baby. Your baby grows inside your uterus in a balloon-like sac called the amniotic sac. This sac is filled with amniotic fluid, which is mostly water.
The placenta, which is also known as the "afterbirth," is a sponge-like layer between the amniotic sac and the inside of the uterus. It contains 2 sets of blood vessels: one set from the mother and one from the growing baby. These vessels are close enough that food and oxygen from the mother's blood can easily move to the baby's blood and provide essential nutrients for the baby to grow. The nutrients travel from the placenta to the baby through a blood vessel in the umbilical cord, which enters the baby's navel.
As the baby grows, waste products that are naturally made need to be cleared from the baby's blood. These waste products travel through the baby's blood vessels to the placenta and are then transferred to the mother's blood. The waste products are then eliminated from the mother's body.
Preparing for a Cesarean Section: Signs of Labor
Even though you may be planning to have a cesarean section, it is still important for you to know the
signs of labor in case your labor starts before your scheduled c-section.
One of the first signs of labor is intense
contractions of your uterus that come at regular intervals. Another sign is when your cervix starts to dilate and the protective
mucus plug loosens and falls out. It is also possible for your water to break at this point. When your water breaks, this means that the amniotic sac in your uterus has burst and released the amniotic fluid. Usually, contractions will get stronger after your water breaks. If you have these signs, you should call your doctor or the birthing center to determine if you actually are in labor.
Once you are there, a medical professional should check to make sure that you are actually in labor. If you are not, he or she may want to observe you for awhile and then suggest that you go home with instructions about what to watch for. If you are in labor, the medical professional will prepare you for your cesarean section.
The Cesarean Section Surgery
Before your cesarean section surgery, you will be given anesthesia, and a catheter (plastic tube) will be placed in your bladder to drain your urine during the procedure. Once you are asleep, your doctor will then make a 6- to 8-inch incision in your abdomen, directly over your uterus. If you've had a cesarean section before, your surgeon will usually try to go through the previous scar. Once the surgeon is inside, another incision will be made through the uterus.
Your baby is then delivered through this opening. The umbilical cord is cut, and your baby is handed to a healthcare provider, who will take him or her to a small, warmly lit plastic crib, called a warmer. Then your baby is cleaned and dried, and eventually checked by a pediatrician.
Your placenta will then be carefully removed from your uterus. At this time, you may also receive Pitocin®, which is a drug that causes the uterus to contract and helps prevent serious bleeding. Your doctor will then close the incision on your uterus, and the incisions in your skin will be closed with surgical staples or stitches that will later dissolve on their own.
Complications Associated With Cesarean Section
As with any surgery, there are possible complications with cesarean section; however, these complications are generally rare.
Complications with a c-section can include, but are not limited to:
- Infections in the mother or baby
- Minor bleeding
- Separation of a scar on the uterus from a previous cesarean delivery
- Hemorrhoids
- Constipation
- Urinary tract infection (UTI)
- Ileus, or a temporary stoppage of bowel activity
- Abnormal or painful scar
- Allergic skin reaction.
The risk for complications is higher for women who are overweight or who use alcohol, tobacco products, or other drugs, such as cocaine. Also, a woman is more likely to have complications if she has
diabetes,
seizure disorders, sexually transmitted diseases, or hepatitis.
There is also the risk of certain complications for the baby, although these rarely happen. These can include, but are not limited to:
- Fractures of the skull or long bones
- Scratches or cuts
- Serious brain or nerve damage.
Depending on your health, if there is a complication, you may need to stay in the hospital longer than planned. You may need to have a blood transfusion or another surgery, such as a hysterectomy, or get a temporary or permanent colostomy. Other complications may mean you have a permanent disability or lose your life. Your age and other medical problems may be factors in whether you have complications. Talk with your doctor if you have any questions or concerns about possible complications associated with your cesarean section.
Recovering From a Cesarean Section
Be sure to rest as much as possible after your cesarean section. It can take from 4 to 6 weeks to recover fully. Your doctor will plan a post-operative checkup after delivery to see how well you are healing.
Your incision may make it difficult to lift things for a while. You might want to plan for some help caring for your child, especially if you have other children. Your healthcare providers may have some suggestions about short-term help for you and your baby following the cesarean section.
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