Guide to Cesarean Sectionsby Katlyn Joy | October 1, 2008 12:00 AM
We make our birth plans, pack our hospital bag, and visualize the perfect labor and delivery. While things may not go exactly as planned, for an estimated 30% of American women the baby will be delivered by cesarean section. So while odds are you won't need one, the odds are high enough to make it advisable to learn what you can ahead of time. You want to be ready for whatever kind of labor and birth you have.
Why are cesarean sections necessary?
There are a variety of reasons that a baby must be delivered via cesarean, or c-section:
- One is a breech presentation, where the baby is not presenting head-down. Women who have given birth previously by cesarean have a higher rate of cesareans for later births, although it is possible to have a vaginal birth after cesarean, or VBAC.
- Sometimes the placenta blocks some or all of the birth canal, or becomes detached. These placenta difficulties can precipitate a cesarean.
- While it can be a tricky decision to make, sometimes when labor is just not progressing well a c-section will be performed. What constitutes inadequate progress will be something for the doctor and patient to work out. There is no standard plan or time limit for labor.
- If at some point, there are indicators that the baby is not handling the stress of labor or is in some kind of distress, the decision will be made to go with a cesarean birth. Often this will be connected to the readings the doctor gets from the fetal monitoring. A slowing heart rate during contractions that is persistent, is one example.
- Other reasons include a very large baby, maternal infections, pre-eclampsia or other issues with the mother's health.
Some cesarean births are planned because the issue is known well ahead of time, but many times the decision will be made as labor is underway. Usually the process for a cesarean is pretty much the same whether it is planned or not.
How is a cesarean sections performed?
To perform a cesarean section, typically a nurse will prep you by washing and shaving your abdomen, perhaps giving you some medication, give you an IV, and put a catheter into place.
In most cases, the mother will remain awake and alert during the c-section, but occasionally general anesthesia is used. Otherwise, the choice is between an epidural or spinal block, both of which are delivered via a small tube placed in your back, along your spine. You'll discuss the options with your doctor to decide what options are best in your situation.
The actual operation is when the doctor cuts through the skin of the abdomen, moves the muscle tissue, and then makes a second cut through the wall of the uterus. The baby will then be lifted out and you will be stitched up with either stitches or staples.
Will my partner be allowed to be in the operating room?
Most times, your birth partner will be allowed to remain with you throughout the birth. A curtain will be placed blocking the surgery from view, but doctors typically allow the mom and partner to view the actual birth of the baby. Unless there is some problem, you will also get to hold your baby right away.
What happens after the cesarean section is completed?
Following the cesarean, you will be on IV's for awhile, and given some medication, taking into account whether or not you choose to breastfeed, and instructed on how to take care of yourself following the delivery.
You can expect soreness following the surgery, some cramping, bleeding for several weeks, and of course, fatigue. No matter the method, having a baby is work, after all.
How long will I be in the hospital?
You can expect a hospital stay of a few days, maybe a day or so longer than you would with a vaginal delivery. While you may not feel like it at first, you will be encouraged to start walking around pretty soon after giving birth. It will help your recovery process.
You will be given instructions on what to do at home. For instance you'll be told how to care for your stitches, how long until you can lift things and go up stairs, and when you can have sex again. You'll be returning to the doctor to see how your body is healing probably once a week or so following the birth and then again for a six week check-up.
Take advantage of all offers of help for meals or housework, or other support. You will be glad you did. Eventually, those offers dry up and you'll wish for some help.
What is the recovery time after having a cesarean section?
Recovery time for a cesarean is longer than for a vaginal birth, expect several weeks to get back to feeling full-strength. You'll probably be given some exercises to help get your muscle tone back following the birth. Don't feel rushed or discouraged if it takes awhile to feel or look like yourself again. You will have lots of new responsibilities and less time for yourself but you will recover.Katlyn Joy is a freelance writer, and just graduated with a Master's of Arts in Creative Writing. She is mom to seven children, and lives in Denver, Colorado.
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