C-section 101

By Published On: April 30th, 2010

If a good ol’ fashioned vaginal delivery is in your […]

If a good ol’ fashioned vaginal delivery is in your birth plan, you may be asking yourself why it’s important to get schooled on C-sections. And you’re not alone: Most moms-to-be go into labor with the intention of delivering by way of the birth canal. However, for many first-time mommies, the L&D scenario they imagine is quite different than their actual experience. Unforeseen risks, complications and health factors can toss a wrench in even the best laid plans. Whatever your personal birthing intentions may be, preparing yourself for an assortment of situations—including an unexpected C-section—will serve you well in the delivery room.
c-sectionWhen it’s right for you
For many expecting moms, the need for a C-section may not become apparent until labor is already under way. But there’s also a laundry list of factors that could result in your doctor recommending a pre-planned Cesarean delivery. If any of these conditions arise before or during labor, your medical provider will likely consider delivery via Cesarean the safest option.

  • Fetal distress. Your baby isn’t getting enough oxygen, experiences significant changes in heart rate, or is too big to fit through the birth canal.
  • Stalled labor. The delivery is too difficult on mom or babyorisn’t progressing as it should.
  • Placental problems. Your placenta is low in your uterus, covering or nearly covering your cervix (placenta previa),or your placenta begins to partially or completely break away from your uterus (placental abruption).
  • Umbilical cord problems. The cord cuts off oxygen to your baby during labor or passes through your cervix before baby does.
  • Abnormal positioning. Baby is breech or horizontal-lying, or his head is ill-positioned to fit smoothly past your pelvis.
  • Health problems for baby. Spina bifida, hydrocephalus, or other defects or developmental issues.
  • Health problems for mom. Heart or lung disease, diabetes, active STDs, AIDS or other passable infection.
  • Previous delivery via C-section. While vaginal birth after Cesarean (VBAC)is sometimes an option, your doctor may recommend a repeat C-section.

Delivery 411
Most parents know what a Cesarean section is, but the details surrounding the actual surgery can be a bit foggy. Here’s what to really expect.
Pre-op: The operation itself can be extremely quick, especially when it’s unplanned. If there’s time, you’ll be asked to sign general consent forms allowing the medical staff to perform the operation, and then you’ll be prepared for surgery. Your abdomen will be shaved to the pubic line, a catheter will be inserted, and an enema may be administered. In most cases, your partner will be given hospital scrubs to wear, and he’ll have the option to sit or stand with you near the head of the bed. A curtain will be hung between the two of you and the surgical team to block the actual procedure from both your views. You’ll then be given appropriate anesthesia (just a numbing agent—you’ll only be put completely to sleep in very rare circumstances), and the procedure will begin.
During the procedure: The initial “bikini cut” will be made through your skin to the muscle. Your abdominal muscles will then be manually pulled out of the way to reveal the uterine wall, which will be cut to remove your baby. The doctor will first deliver your baby and then deliver the remainder of the uterine lining.
Post-op: You and your partner will likely be allowed to see your baby before the medical staff takes her off to be cleaned, tested and weighed. For the next 30 minutes or so, you may feel a light tugging as your doctor stitches or staples each incision. This should be the only sensation you’ll be able to notice.
You may be groggy, feel nauseated,or have gas pains in the hours following surgery, but these side effects will slowly subside. If you’re planning to breastfeed, a nurse or lactation consultant can help you find the most comfortable position to prevent putting stress on your abdomen. After about 12 hours, your catheter will be removed and you’ll be able to eat light, bland foods. You’ll be spending the next three to five days in the hospital, where the staff will ensure you’re healing appropriately and able to breastfeed (if that’s your desire). Before you leave, they will also make sure you understand your pain medication procedures and the extent of your physical abilities. At the end of your stay, your doctor will remove your sutures and you’ll be cleared to head home with your new bundle of joy.
The road to recovery
C-sections are considered major abdominal surgery, and thus you should give yourself lots of time to recover. Having help is key—it’s really important to have your partner, a handful of family members, friends and sitters on call. You may even consider inviting someone to move in for a couple weeks to help as you recuperate. This may sound over the top, but remember that while you’re healing, you’ll be unable to partake in most physical activities—including cooking, cleaning and lifting anything heavier than your infant.
During the next several weeks, focus on bonding with your little one, drinking lots of fluids, and slowly increasing your movement—walking can help prevent blood clots and promote healing (just be sure not to overdo it). At six weeks you can talk to your doctor about resuming sexual activity, and at eight weeks you should be able to begin moderate exercise. By this time, you’ll probably be feeling great and healing well, which means you can get on with life as you knew it (plus baby!).