Cesarean Birth (C-Section)

What to Expect Prior to ProcedureC-section is often unplanned and only occurs when a problem is encountered. Anesthesia You will have general or regional anesthesia (eg epidural or spinal block). Many women prefer regional anesthesia so they are conscious and can see their new baby immediately. During ProcedureYour abdomen will be washed and shaved before the surgeryA catheter (tube) will be placed in your bladder to empty itA small tube will be placed in a vein of your arm or hand to provide fluids and medication during surgery Description of the ProcedureThe doctor will make incisions in the abdomen and uterus and deliver the baby.There are two different types of skin incisions: vertical or horizontal There are three different types of incisions for the uterus: Low transverse incisionsmost common type, usually bleed less, form stronger scars, and present less danger of rupture during future laborsClassical incisions (high vertical incisions)associated with the highest risk of bleeding and future rupture of the uterus, used only in emergency situationsLow vertical incisionsused to deliver a baby in an awkward position or if the incision may need to become a classical incisionThe uterus will be closed with stitches that later dissolve on their own. Stitches or staples will be used to close the abdomen.

After ProcedureThe baby is immediately examined by medical personnel. Depending on the condition of you and your baby, you may be allowed to hold the baby. How Long Will It Take?45-60 minutes Will It Hurt?Anesthesia prevents pain during the surgery. You may feel some pressure and tugging as the uterus is opened and the baby and placenta are removed. You will receive pain medications after to manage pain. Average Hospital Stay2-4 days Postoperative CareYou may require antinausea and pain medicationsFor several days after surgery, you may need to eat a lighter, blander diet than usualYou may be given special compression stockings to decrease the possibility of blood clots forming in your leg.For lung health, you may be asked to use an incentive spirometer to breathe deeply and cough frequentlyYou'll be encouraged to walk very soon after surgeryYou will experience heavy vaginal bleeding, as after any delivery, and will need to use an absorbent sanitary napkinAvoid lifting anything heavier than your baby for the first weeks after surgeryDelay having sexual intercourse until you've had your 6-week check-upBreastfeeding is encouraged Risks Cesarean birth is major surgery and risks are involved. The estimated risk of a woman dying after a cesarean birth is less than one in 2,500 (the risk of death after a vaginal birth is less than one in 10,000). Other risks include:

Infection uterus or nearby pelvic organs, such as the bladder or kidneys, can become infected Increased blood lossthe average loss is about twice as much with cesarean birth as with vaginal birth Decreased bowel functionthe bowel sometimes slows down for several days after surgery, resulting in distention, bloating, and discomfort Respiratory complicationsgeneral anesthesia can sometimes lead to pneumoniaLonger hospital stay and recovery timecesarean stay is 3-5 days in the hospital, less than 1-3 days for a vaginal birthReactions to anesthesiathe mother's health could be endangered by unexpected responses to anesthesia or other medications Risk of additional surgeriesmay include hysterectomy or bladder repair OutcomeYou should heal quickly and completely after a C-section. Talk with your surgeon about the type of incision used and its effect on future births. You may need some help learning breastfeeding positions so that you won't put pressure on your incision. You may also notice some uterine cramping, pain, and an increase in vaginal bleeding at the beginning of nursing. Call Your Doctor If Any of the Following Occurs If you have just had a cesarean section, call the doctor immediately if you:

Develop a feverBecome dizzy or faintExperience nausea and vomitingBecome short of breathHave pain, swelling, and redness at the incision site RESOURCES: American College of Obstetricians and Gynecologistshttp://www.acog.org/ March of Dimes Birth Defects Foundationwww.marchofdimes.com/ CANADIAN RESOURCES: The Society of Obstetricians and Gynaecologists of Canadahttp://sogc.medical.org/ Women's Health Mattershttp://www.womenshealthmatters.ca/ References: Cesarean Fact Sheet. International Cesarean Awareness Network website. Available at: http://www.ican-online.org/pregnancy/cesarean-fact-sheet. Accessed June 10, 2008. Cesarean section. Childbirth.org website. Available at: http://www.childbirth.org/section/section.html. Accessed June 10, 2008. Cesarean section. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/cesareansection.html. Accessed June 10, 2008. Last reviewed January 2008 by Jeff Andrews, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.