What to Expect in a C-Section.
Let's start by defining a C-section. A vaginal delivery occurs when the baby is delivered through the vagina by natural means. In a C-section the baby does not go through the birth canal, but rather is pulled out through an incision made in the mother's abdomen and uterus. Unlike a Vaginal delivery,a C-section involves a surgical procedure and is performed in an operating room under sterile conditions.
In the United States, approximately one in four babies is delivered by C-section, according to the American College of Obstetricians and Gynecologists. In developing countries maternal and fetal morbidities are found due to lack of caesarian delivery.
When to Perform a C-Section
It's important to note that, in most cases, doctors will opt for a vaginal delivery over a C-section. The reason is that a vaginal delivery is almost always considered to be safer for the mother and baby unless extreme health conditions warrant otherwise. C-sections may be scheduled in advance if certain conditions are present and both the mother and doctor agree that it is necessary.
Often, however, C-sections are performed in emergency circumstances because conditions indicate that the mother or baby is at risk for a potential problem. If the mother's or baby's health is at risk, then a c-section might become the immediate alternative for saving lives. So, you may go into the delivery room anticipating a "normal" delivery and suddenly find that you're going to have a C-section. It's impossible to tell when this will occur, but your doctor will explain why you need to go through C-section.
Fortunately, with the advent of antibiotics and improvements in surgical techniques, it is a relatively normal procedure that is performed routinely and successfully every day around the world.
Preference of anesthesia is a subject many have less knowledge, Spinal anesthesia is preferred generally in obstetrics so the mother will have numbness from her navel downwards, and the anesthetic drug does not go to the baby’s circulation. Due to improved Anesthesia this procedure is very safe and some people believe that it is even safer than vaginal delivery. In countries like Brazil more than 60% go this procedure for safety measures and also for their sexuality. The muscles of vagina are not cut and therefore these women can still continue enjoying their intercourse. In normal delivery usually pelvic floor muscles are cut by a procedure called episiotomy and therefore sensitivity of the perineum is interfered with and many women do suffer. This is a bit exaggerated but it is true
General anesthesia is used in anxious mothers and emergency caesarian sections where mother is having other maternal complications.
How many caesarean can a woman have
They used to say ' once a caesarean always a Caesarean' and also once they have had three caesareans a woman should be sterilized. These two jargons are no longer true. It is still possible for a woman to deliver vaginally under good observation provided the reason for the first caesarean was not due to pelvic contraction. Also provided an elective caesarean procedure is performed before labour starts one can have as many as 10. Dr Sali has had a patient who he carried out the 8th caesarean procedure. Provided labour has not started, and with good Hospital proximity and communication women should be encouraged to complete their families without being threatened by we obstetricians
After theater the recovery area patient is taken back to the ward and kept 8 to 10 hours flat on the bed without a pillow for the spinal anesthesia patient. (Patient is instructed not to lift her head) This will prevent the spinal headache which everyone is talking about. The spinal needle is very small nowadays, so there is not so much CSF leak, and post-operative complaints are very minimal.
After 8 hours the patient is asked to sit on the bad, because it is common to feel dizzy, have some black tea with sugar. Then after wards can have some soft food for the first day. Then slowly the mother is asked to stand up and walk, she can be encouraged to go to the toilet urinate on her own after the catheter is removed, she can clean herself and normally we use water proof band aid the normal routine things becomes easy.
In normal situations the obstetrician does not touch the bowels, so there is no necessary to wait for flatus to pass. Early ambulation makes the recovery quicker and it minimizes the hospital stay to maximum of two nights.
Actually in many settings the incision is cosmetic and minimal handling will give you a good scar, so nowadays there is no suture removal, the skin is done by absorbable sutures. The Band-Aid will be removed on the 6th or 7thday.
After that the mother has no worries, can wash and shower etc, It is very important for abdominal support, so there are post caesarian abdominal support belts in the market, can help to keep the belly fat away.( many women complain about a belly fat after caesarian section, with abdominal support the mother gets her body back to normal .She can even get back to her normal exercises after 6 weeks.
Don't forget to make a follow-up appointment with the OB who delivered your baby. Make the appointment within four to six weeks after the delivery (that means you'll have to always make an appointment at discharge from the hospital). If you have any questions regarding your recovery, however, always call your doctor ASAP.
In conclusion, as we have seen from above, C-Section delivery needs team work, the medical team as well as the family support. At Sali international hospital we have modern facility with appropriatepersonal to do the procedure and help you through the recovery period.
Dr.Vindhya Pathirana -OBGY.