Cesarean Section

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What is a cesarean section?

A cesarean section is an operation in which a physician creates an incision in your abdomen and uterus and your baby is delivered through that incision. This procedure is more commonly known as a C-section.

When is it used?

A C-section may be performed before labor begins if there are medical reasons for not having labor or a vaginal delivery. For example, the health of the mother or the baby may be in danger if the pregnancy continues or vaginal delivery might be impossible or unsafe.

A C-section may also be done when labor begins or during labor if certain problems occur. For example, if at the time of delivery the lowest part of the baby is the face, brow, shoulder, or buttocks (breech), instead of the head, a C-section may be necessary.

For many women in labor, the cervix begins to dilate and then stops before it is fully dilated. Oxytocin may be given to make the contractions stronger. Despite this drug, however, many women do not dilate fully and cannot deliver vaginally. Other women may dilate fully but may not be able to push their babies far enough down the birth canal for a safe vaginal birth. This may happen because the baby is too large for the woman’s birth canal. A C-section may also be performed in these situations.

At any time during labor a baby may develop problems that cause the baby’s heartbeat to slow down. These problems may indicate that the baby cannot tolerate further labor and a C-section may be necessary.

What are the benefits of this procedure?

C-sections can save the lives of newborns and their mothers or prevent the potential complications of a delayed vaginal birth. For example, delivering the baby by C-section may be safer for you and the baby if the baby is having abnormal fetal heart rate patterns or you have severe preeclampsia (high blood pressure caused by pregnancy).

What are the risks associated with this procedure?

As with any procedure, there are risks involved. However, C-sections have been performed for decades and are generally considered safe. If you have any questions about the specific risks associated with a C-section, you should talk with you healthcare provider.

There are some risks when you have general anesthesia. Discuss these risks with your health care provider. A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. However, in most cases regional anesthesia is considered safer than general anesthesia.

• A blood vessel may rupture or be cut and bleed inside the body.
• A piece of blood clot may break off, enter the bloodstream, and damage the lungs.
• The cut in the wall of the uterus may leave a weak area in the wall.
• Any future children may need to be delivered by C-section, depending on how this C-section was done.
• You may develop an infection or bleeding.
• The baby might be injured during the surgery.
• Damage could be done to a vein or artery that could cause serious bleeding and this could require a hysterectomy or blood transfusion.
• The placenta could not come out of the uterus, which could cause serious bleeding and may require a hysterectomy.
• A hole could be made in your bladder that could cause a tract (fistula) between your vagina and bladder.

How do I prepare for a cesarean section?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try finding other people to help you with your day-to-day duties.

Follow instructions provided by your health care provider. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

If you go into labor, call your health care provider.

What happens after the procedure?

Your abdomen will be sore, and you may need help with positioning your baby comfortably for feeding. Walking and standing will be painful for the first few days. Since you will probably be in the hospital for just 2 to 4 days, try to have some help at home for the first week or two.

Avoid heavy lifting for 6 weeks. After those 6 weeks you may begin an exercise program to regain abdominal muscle tone. Ask your health care provider what other steps you should take and when you should come back for a checkup.

The cuts made in the abdomen to deliver the baby are usually horizontal, or across the womb. This allows the muscles in the womb to safely stretch, which makes traditional delivery through the birth canal possible for future pregnancy.

When should I call Greenville OB/GYN?

Call our emergency number at any time if:

• You develop a fever over 100 F (37.8 C).
• You have drainage from your incision, or the incision separates.
• You have heavy bleeding from the vagina.
• You become dizzy or faint.
• You have leg pain, especially if your leg is also swollen and red.
• You have nausea and vomiting.
• You have chest pain.
• You become short of breath.