What you need to know about cesarean

Know About Cesarean Section

Dr Ayesha Sajeela Gill (Consultant Gynaecologist) 

In cases where vaginal delivery is not possible, surgical procedure involving cutting the abdomen and womb to remove the baby is called cesarean .

Although cesarean surgery, which is seen as an alternative to normal birth, has some risks for mother and baby, it is also a fact that cesarean is a life-saving operation when birth does not progress naturally.

We have compiled what you need to know about cesarean from the guideline “Delivering with Confidence” prepared by Lamaze, a serious authority in the field of birth for 50 years with the trainings and researches it has organized:

Is it possible to have vaginal birth after cesarean?

Some physicians argue that cesarean is safer for mother and baby in terms of perineum damage. However, systematic and current research shows that vaginal delivery is much healthier for mother and baby than cesarean.

If forceps, vacuum or episiotomy will not be used, there is very little risk of perineal damage during vaginal delivery.

Cesarean surgery also increases the following risks in the short term: blood clotting, stroke, surgical injury, infection, pain, separation from the baby, physiological trauma, hospital stay longer, emergency uterus surgery and removal of the uterus and death. Problems that cesarean may cause in the long term are: increased pelvic pain, intestinal knotting, infertility and some problems that may be encountered in future pregnancy. (Such as ectopic pregnancy, placenta previa, uterine rupture…)

Cesarean surgery also increases the risk of surgical injury for your baby. It can cause breathing problems and sucking difficulties. It is also risky for your next possible pregnancy, problems such as stillbirth, very low birth weight, preterm delivery and central nervous system injury.

If you have already had a cesarean delivery, the possibility of opening a cesarean wound is very low for your next birth. This possibility may increase if your birth is initiated by intervention or if your cesarean wound is above and horizontal.

General anesthesia or epidural anesthesia in cesarean delivery?

  • When you may need a cesarean section:
  • If you have bleeding.
  • If your baby cannot get oxygen.
  • If Placenta previa has been diagnosed
  • If the baby stands transverse (laterally or crosswise) in the birth canal
  • If you have an uncontrollable diabetes or pregnancy-induced high blood pressure.
  • If your doctor does not take care of vaginal delivery (SSVD) after cesarean or if the hospital does not have a 24-hour ready anesthesia team.
  • If your birth is not progressing and the baby is also in good condition.
  • If the baby is in an inverted position and your doctor is inexperienced with breech deliveries.
  • If your baby's heartbeat slows down and it doesn't improve even though you change your position and drink more water, get oxygen or reduce artificial pain.
  • If you have more than one baby, if one of the babies is in a transverse position or your doctor is inexperienced with vaginal multiple births.

To avoid unnecessary intervention:

  • If there are no clear health issues to start or accelerate birth, let your birth start and progress spontaneously.
  • Check with your doctor if you will need fetal imaging continuously.
  • Plan for a perfect birth support.
  • Remember that your body knows how to give birth very well.
  • Act during the birth and change positions frequently.
  • Stay at home as much as you can, do not go to the hospital until the pain is tight.
  • Actively meet your contractions.
  • Keep your energy high by eating and drinking liquids.
  • Before deciding on epidural, try methods of dealing with non-drug pain.
  • If you have received an epidural, ask for it to be removed at the strain stage.
  • Even if you have had a cesarean surgery before, be sure to discuss the possibility of vaginal delivery (SSVD) after cesarean with your doctor.
  • If your baby is in breech arrival position, stands upside down, discuss manual interventions to keep the baby's head down.

To make birth as natural as possible, even in a cesarean section:

  • Make sure your partner and birth supporter are with you in the operating room.
  • Take your baby on your lap as soon as possible after birth and get skin-to-skin contact.
  • Breastfeed again as soon as possible.
  • Be sure to stay with your baby in the hospital.
  • Get support from your family and friends while in the hospital.
  • Be patient until your baby learns to suck nipples.
  • If your baby is not breastfeeding immediately or if you are having other breastfeeding problems, ask the hospital staff to help you. Milk your first milk (colostrum) and try to feed your baby from a small bottle or dropper.
  • In order not to worsen breastfeeding problems, warn hospital staff not to give your baby food, feeding bottles and pacifiers.

This is informative base article if you have any problem go to your consult doctor for further necessary action.