A CAESAREAN SECTION MAY BE SUGGESTED IF THERE IS A POTENTIAL BENEFIT TO YOUR OWN OR YOUR BABY’S HEALTH, OR SOMETIMES BOTH.
A Caesarean section is the delivery of your baby by means of a cut in the abdomen. A Caesarean rate of around 10-15 % is thought to be reasonable, although in most western countries the rate has risen above 20%. almost a 3rd of all babies in Australia are now delivered by Caesarean.
TYPES OF CAESAREAN
Caesareans are either emergency or planned procedures. The doctor assesses urgency with a grading scheme. A Grade 1 Caesarean is one that is carried out if there is an immediate threat to the baby’s or mother’s life. A Grade 2 Caesarean is one where there is concern for the baby’s or mother’s wellbeing, but no immediate threat to life. A Grade 3 Caesarean is done when there is no immediate concern for the mother or the baby, perhaps because of a condition in the mother or baby. A Grade 4 Caesarean is an elective delivery planned to suit the woman and hospital.
CONSENT
The doctor will always get your consent prior to carrying out a Caesarean. She will tell you why the procedure is being proposed, and what its benefits and risks are. Ideally, you should have plenty of time to decide whether you want the operation or not, although with an emergency Caesarean, the time to think things over may be limited.
YOUR ANAESTHETIC
The anaesthetist will make sure that you have no pain during your operation, and will help you with pain control afterwards. Most women are awake during a Caesarean. An injection of medication into the spinal fluid in you back, called a spinal block, numbs any sensation of pain. Or, if you’ve been using an epidural for pain relief in labour, this can be used for the operation. After your anaesthetic has been given, the anaesthetist will check that it is working properly. Being awake usually means that your birthing partner can stay with you and it’s also a little safer for you and for your baby than a general anaesthetic. Very occasionally a general anaesthetic is needed.
THE OPERATION
Once the anaesthetist is happy that you’re pain free, your tummy will be cleaned with an antiseptic solution and sterile drapes will be placed over you, which also stop you and your partner seeing the operations.
During the operation, a long incision will be made on the tummy wall, across the bikini line, although occasionally an up-and-down cut below the belly button is done. Your bladder will be pushed down and the front of the uterus is opened so that the doctor can assess the baby. If your waters haven’t already broken, this will be done now before the baby and placenta are delivered. The surgeon will release the head from the pelvic brim and lift the baby out. Sometimes another member of the team needs to put pressure on the uterus to assist this. You’ll be able to see your baby when the cord has been cut, and once initial checks have been done on your baby, you or your partner should be able to hold your baby and have skin-to-skin contact while the operation is complete. You’ll have an injection of syntometrine to help deliver the placenta. To finish the Caesarean, the uterus will be closed up with one or two layers of stitches, the the tummy wall will be stitched in seperate layers.
RECOVERY
You will be encouraged by the midwives and obstetrician to get out of bed the following day, and by the day after this you may be well enough to do most things for yourself, with help.
POSSIBLE COMPLICATIONS
There are several common, but minor problems associated with Caesareans. These include bleeding during the operation, or a day or so later; needing a blood transfusion; or getting a minor infection in the bladder or in the wound. A major infection is far less common and having to have a second operation because of a life-threatening wound infection is rare.
MOST COMMON QUESTIONS AFTER CAESAREAN SECTION:
When can I drive?
6 weeks after a c-section is the recommended wait time before you can drive a car. It is important that you also speak with your car insurance to check what is stated in their T&C’s.
When can I exercise?
After a c-section you will need to wait until your 6 week check with your obstetrician before starting a strenuous program. Starting with low-impact exercises, such as walking and pilates.
When can I pick up my other child?
If your other children are 10kg + it is important that you avoid picking them up, as mentioned above in ‘When can I exercise’ you will need to wait a minimum of 6 weeks before being able to do any heavy lifting or strenuous work that can impact your abdominal muscles.
How do I take care of my Caesarean section wound?
(for all of Dr Suzana’s current pregnancy patients you can find this information in the USB we provide to you after your 10week appointment)
Your Caesarean incision may have been closed with staples which are usually removed within 3-7 days of delivery.
However the most common way that the incision is closed is with stitches, and are usually reabsorbable sutures, meaning they are absorbed by the body and do not need to be removed. Keep your wound clean and dry. Wear loose clothing and look for signs of infection (such as redness, pain, swelling of the wound or bad-smelling discharge). You will need to go see your obstetrician or midwife.
The incision will heal over the next few weeks. During this time, there may be mild cramping, light bleeding or vaginal discharge, as well as pain and numbness in the skin around the incision.
Most women will feel well by 6 weeks postpartum, but numbness around the incision and occasional aches and pains can last for several months.
Can I have a Vaginal Birth After a Caesarean (VBAC)?
ANSWER COMING IN OUR NEXT BLOG! 👉