Cesarean section – everything you need to know about it

Cesarean section – indications

In Poland, it is impractical to perform a cesarean section at the patient’s request. This is an operation for which there are specific reasons that prevent natural childbirth. So what are the indications for a cesarean section? We can divide them into:

• elective (planned),
• emergency,
• urgent

The first group includes. abnormal positioning, anticipated high baby weight, condition after 2 (or more) cesarean sections, or birth disproportion. In addition to obstetric indications for cesarean section, cardiac or psychiatric conditions also stand out. It is worth knowing that a monochorionic twin pregnancy is also an elective indication for delivery by cesarean section.

Sometimes a cesarean section is not planned in advance, but it turns out to be necessary. This happens when the baby is bradycardic and the KTG recording is abnormal. Emergency conditions that require immediate surgery include. Umbilical cord prolapse, eclampsia or placenta prematurely separating from the uterus. In a situation where there is a risk of complications for both the woman and the newborn, such as his hypoxia, it is said that the so-called “newborn baby” is a “newborn baby”. Iodine cut, suggesting doctors’ efforts to get the baby out of the uterine cavity as quickly as possible.

The Polish Gynecological Society distinguishes specific indications for cesarean section and these include:

• Very large size or weight of the fetus,
• Lack of progress in subsequent phases of labor,
• cardiovascular diseases,
• severe preeclampsia,
• Several times the fetus is wrapped around the neck with the umbilical cord,
• serological conflict,
• abnormal positioning of the child,
• placenta detachment,
• preterm labor,
• Tokophobia, which is a psychiatrist-determined panic fear of childbirth.

Caesarean section – preparation

In the case of an elective cesarean section, the most common admission is on the day of surgery, in the morning, while fasting. It happens that in some hospitals the option of admission the day before the scheduled date of the cesarean section is preferred. Usually the mother-to-be is asked to wash with antibacterial soap and shave the area where the scar will be. This reduces the risk of wound infection and impeded healing.

The situation is different, of course, when a cesarean section is performed for emergency indications. In this situation, the preparation stage for the procedure is bypassed to minimize the time until the baby is born.

What does a cesarean section involve?

Before the operation, the mother-to-be usually wears a disposable shirt. Then, already in the operating room, equipment is connected to monitor blood pressure, saturation, and a venflon is inserted. Depending on the situation, an epidural or subarachnoid anesthesia is also connected. In emergency situations, general anesthesia is also necessary.

To administer the anesthesia, the anesthesiologist disinfects and topically anesthetizes the skin of the back, and then injects the drug into the appropriate space. In the case of subarachnoid or epidural anesthesia, the woman giving birth does not feel pain in the lower part of the body. However, he may feel pulling or tugging during the procedure. After the patient is anesthetized, a Foley catheter is inserted into the bladder so that doctors can monitor for damage to urinary structures during the operation. Doctors then disinfect the skin of the woman’s abdomen and spread a sterile covering. They cut more layers to be able to get into the uterine cavity. After carefully incising it, they pull out the newborn and usually hand it over to neonatologists. Later they remove the placenta and stop the resulting bleeding. The tissues are sutured with dissolvable sutures. If the skin is not sutured with self-absorbable sutures, the doctor or midwife pulls them out a few days after the procedure.

After the operation, the woman is taken to the post-operative room, where she is under the observation of a midwife. After a few hours, uprighting takes place and transfer to the maternity ward room.

Types of anesthesia used for cesarean section

Natural childbirth rarely takes place with the help of an anesthesiologist. The situation is different in the case of a cesarean section, which is definitely not one of the most pleasant procedures. For this reason, modern obstetric surgery offers moms-to-be various types of anesthesia to temporarily relieve the pain not only of the labor itself, but also of cutting and sewing. These include:

• General anesthesia – is based on types of substances that put the patient into a state of deep sleep. Nevertheless, it is used only in emergency situations by a number of complications that may follow.
• Subarachnoid an esthesia – this anesthesia uses agents that are injected into the sacs between the spinal column, which contain fluid surrounding the spinal cord and nerves. The specifics work super fast and effectively, which is why they are the most common form of choice.
• Epidural anesthesia – is mainly used in natural childbirth, although, if necessary, the doctor can administer it to a woman giving birth by cesarean section. It involves placing a thin plastic tube (catheter) near the nerves that transmit pain from the uterus and lower half of the body, through which a weak anesthetic is administered continuously.

How long does a cesarean section last?

Typically, a cesarean section takes about 30-40 minutes. Much depends on whether a woman has had previous abdominal and pelvic surgery, as well as whether the operation is performed as an emergency or elective procedure. From the skin incision to the removal of the baby usually takes a few minutes. The longest part of the operation is suturing more tissue.

It is worth remembering that a cesarean section can carry complications such as damage to the bladder or ureters. In such a situation, the duration of the treatment may increase. The same is true if a hemorrhage occurs, for example. Typically, the newborn is cared for by neonatologists or kangarooed by a dad or other close friend during this time.

Complications after cesarean section

The course of labor, which is supported by obstetric surgery, carries certain consequences, affecting both the health of the mother’s child and the mother. A toddler may be more predisposed to asthma, allergies and diabetes. In the parent, on the other hand, it is not uncommon to experience severe pain and organ damage Postpartum after cesarean section 

Every woman recovers from childbirth, whether by natural childbirth or cesarean section, at her own pace. This is an individual issue and some moms get back in shape faster, while others take longer to feel the effects of surgery. Very important from the point of view of an imminent return to fitness is timely verticalization after surgery. An important part of improvement is rehabilitation after cesarean section, which takes place in the first three days of confinement. Such treatments include:

• Accelerating the removal of anesthetics;
• Prevention of peritoneal adhesions;
• Improving blood circulation in the treatment field;
• The prevention of thrombophlebitis;
• Prevention of respiratory complications;
• Lactation stimulation.

By book, puerperium lasts 6-8 weeks. During this time, the woman should refrain from sports until she receives permission from the attending physician to begin physical activity. After a cesarean section, specialists recommend giving up long baths and visits to the pool throughout the postpartum period. You should also abstain from intercourse during this time.

Caesarean section – how to take care of the scar?

The aesthetic defect is a scar that often stays with the woman for the rest of her life. It is very important to take care of it, especially when it is fresh, as incorrect treatment can lead to infection. The wound should be washed 3 times a day with a specialized antiseptic designed for this type of injury. In addition, a few days after the procedure, it should be secured with a dressing and protect it from getting wet. After 3 days after the operation, the patient can wash normally, as then the compress is no longer needed. Ba! It is even inadvisable, as it impedes air access to the wound, which in turn can significantly slow down healing.

It is recommended that a newly minted mother wear underwear and clothing that is airy and loose. Tight clothing should therefore be avoided, which can also hinder recovery. It is also worth keeping in mind the material, which should have high permeability.

Cesarean section vs cord blood collection

Many Parents wonder whether a cesarean section delivery is a contraindication to cord blood donation. The recommendations are unequivocal on this issue, stating that both during natural childbirth and Caesarean section it is possible to safely collect the baby’s cord blood. The procedure has no effect on the condition of the mother and the newborn or on the course of the operation. Parents must have an intake kit with them at the hospital on the day of the C-section, and a trained midwife or doctor will take care of everything else.

FAQ:

• What are the indications for cesarean section?

A cesarean section is performed in special situations when the doctor foresees that a natural childbirth may be a threat to the health or even life of the mother and her baby.

• Is general anesthesia used for a cesarean section?

This is the form of anesthesia that is used least often in this case by a number of complications that can occur afterwards.

• Is recovery from a cesarean section hard?

Caesarean section surgery is an invasive procedure, so the rehabilitation and recovery process can be challenging for some newly mothers. However, proper medical attention and trust can yield sensational results.