Cesarean birth

Most women prefer to give birth without undergoing surgery, but in some cases it can’t be avoided. It’s possible in some cases to know ahead of time that you will be going to have a cesarean delivery, especially if you’ve had complications that warrant it. It may also be necessary to perform a cesarean if such issues arise during labor that will make vaginal delivery unsafe for you or your baby.

Reasons for a cesarean birth include: a labor that does not progress in a way it should, signs of premature labor, placenta previa (the placenta is covering part of your cervix), breech presentation of baby, or presence of infection in mother that could spread to her baby (such as Hep C or HIV).

During a cesarean surgery an incision is made through your belly and uterus to allow the doctor to take out your baby. It’s estimated that 25% of women in the UK and 32% of women in the US, give birth this way.

If you know in advance that you will be having a cesarean birth, then you’re going to be somewhat more prepared, but if it has to done as an emergency it can be a bit scary. Usually you will be given an epidural or a spinal anesthetic, a method safer than giving general anesthesia. Another benefit of this method is that you will be able to see your baby right after birth.

Babies delivered by cesarean birth do not have the squishy appearance that babies born vaginally do. Usually your partner will be allowed to remain in the operating room and share the experience of birth of your child.

The issue of cesarean delivery on maternal request (elective cesarean) remains extremely controversial, especially when there is no medical indication at all. Fortunately, more and more obstetrician are willing to listen to a women’s request - even if there is no medical indication. Important is that you find out about the pros and cons of a cesarean delivery in advance.

The argument that a scheduled cesarean delivery is more dangerous is unjustified. Excluding emergency cesarean sections, there's no good evidence to show this.

The benefits of an elective cesarean delivery are that you avoid the uncertainty of labor and delivery. There’s generally less chance of fetal distress, fetal injury, pelvic floor injury and uterine rupture. A cesarean delivery eliminates a lot of risk to the fetus, as your baby doesn't have to go through the stress of birth.

If you have a cesarean delivery, you will need to spend a few days at the hospital to recover.

Recovering from cesarean delivery is similar to any major abdominal surgery; the only difference is that instead of losing an organ such as a gall bladder or an appendix, you gain a baby.

Except for an intact perineum, you will also experience all the postpartum discomforts of a vaginal delivery such as after pains, lochia, breast engorgement, hair loss, fatigue, increased perspiration, post partum blues, exhaustion and fatigue.

Expect the following in the hospital recovery room:

Your doctor will monitor you carefully until the effects of the anesthesia wear off. Your memory may be fuzzy if you had a general anaesthesia. Effects of spinal or an epidural block generally takes longer to wear off than general anesthesia.

Once the effects of anesthesia wears off, the incision starts hurting. Its intensity depends on many factors, including your pain threshold and your previous history of cesarean birth, as subsequent recoveries are less uncomfortable than the first one. You will be given pain medication to control the pain.

You may experience some nausea, for which the doctor may prescribe you an antiemetic (a drug that is effective against vomiting and nausea).

A nurse will regularly evaluate you. She will record your vital signs (temperature, blood pressure, pulse, respiration). She will also check your urinary output and vaginal discharge, the dressing of the incision, the firmness and location of your uterus and the IV and urinary catheter.

If your condition is stable you will be shifted to the hospital room within 24 hours of delivery. Expect the following in the hospital room:

Evaluation of your vital signs, dressing, urinary output and vaginal discharge, as well as the IV and urinary catheter happens regularly.

If you are able to urinate on your own, then your urinary catheter may be removed after 24 hours of surgery.

You may experience after pains similar to a woman who has had a vaginal delivery. They happen after about 12 to 24 hours after delivery. They are the contractions of uterus which helps to bring it back to its pre pregnancy shape.

Your IV will be discontinued and you will be allowed to take fluids by mouth about 24 hours after surgery (that is the time when your bowels begin to show signs of activity by moving or passing gas). Gradually you will be allowed to return to your normal diet over the next couple of days. Breastfeeding moms should take plenty of fluids.

You may get a referred shoulder pain which happens as a result of irritation of the diaphragm from air in the abdomen following surgery. This may last up to a few hours, and helped by an analgesic.

You may be advised to wear elastic stockings to improve circulation and to prevent formation of blood clots in the legs due to inactivity post surgery.

You may expect to get your stitches (if they are not absorbable) or clips removed four to six days after delivery.

And finally if everything goes well and there are no complications you may expect to go home about four to seven days after delivery.