What should a pregnant mother know about c-section or cesarean delivery? There could be instances when mothers who do not plan to undergo cesarean delivery may have an emergency c-section because of different factors. So, it is better to know about cesarean.
I have had a cesarean delivery even if it was not planned. In spite of my preparations to avoid a cesarean section, it did not work, because it is really a time of emergency.
Image from Freepik
After I had a cesarean delivery, my OB-Gyne explained what happened after I regained consciousness. I have undergone an emergency C-section because of the three cord-coil surrounding my unborn baby.
The umbilical cord, 3 cord-coil, twisted around my baby’s neck, arms, and legs. That is why my baby is not going downward and can not be pulled by the doctor out in a normal delivery or vaginal birth.
What is cesarean section delivery?
A cesarean section (C-section) delivery is a type of surgery for giving birth to a baby. Instead of pushing the baby out of the vagina from the uterus through the cervix, a pregnant mother should undergo an operation. The baby will come out from the incision of the belly.
Many cesarean deliveries are well-planned, just like my two consecutive birth giving. However, there are births similar to my first birth with an unexpected C-section because of some complications.
Some reasons to decide to have a cesarean delivery include the following:
- Health problems of a mother or of the baby, such as placenta previa; if a mother has diabetes; or if there is an obstruction like fibroid, that is why it is impossible to have normal delivery; malformation or abnormality of the baby such as an open neural tube defect.
- Multiple births or more than one baby in the uterus (twin, triplets…)
- Size and baby’s position, like macrosomia or a condition where the baby is bigger than normal, or breech or transverse position, where the baby’s feet come first before their head going outward the vagina
- There is no progress during the labor.
- If the mother is HIV-positive and the doctor detects risks of high viral load.
A mother should not undergo a cesarean section delivery earlier than week 39 if there are no medical reasons to give premature or preterm birth.
Because of the rising number of cesarean births in the Philippines, it is important for mommies to understand every information about the C-section. It may come as beneficial or with complications or danger to a mother because it is also similar to any operations.
How does it end with a cesarean delivery?
According to Dr. Maria Theresa Tangkeko Lopez, an OB-GYN in Makati Medical Center, there are many reasons and indications why it is needed to deliver in a C-section procedure, be it emergency or scheduled.
“One of them is really because you were previously cesarean sectioned already. Some would actually asked the trial VBAC but that will be another topic altogether.
But most mom that was once cesarean section wants that they rather have a repeat cesarean section again. The other reason is that when the placenta is the one first before the baby and these are cases that we called placenta previa.
Or even let’s say there is a problem with the baby’s position. For example, the baby is in transverse position o ‘yong nakahalang siya. Or the head is on one side and the butt is on the other side.
Or baby is in the breech position, bale butt first. Especially aside from the butt there’s a foot, may naka-dangle pang foot. Ayan ‘yong mga situations that we would rather deliver through cesarean section.”
For those who have a scheduled cesarean delivery, specifically for those who have a C-section history, your doctor may still recommend to undergone a CS again.
And, if it is an emergency C-section, there are some indications why it would happen to a cesarean delivery, Dr. Lopez further explains.
“Labor is one or nag-rupture ‘yong bag of water mo or sometimes for those patients with comorbids. For patients that are hypertensive, diabetic or even patients that has asthma.
These are things that could trigger your OB to do it earlier. Your blood pressure is uncontrolled. Your sugar is shooting up. Those things can harm your baby and the reasons that can make your OB to decide to do an early o emergency CS.”
If you have decided to deliver your baby in a cesarean section
A consent form will be given and to be signed by the mother and father before undergoing a cesarean delivery operation. If it is an emergency CS, it is possible that the husband or father will sign the consent because the mother may not be able to sign.
An anesthesiologist may explain the different pain-management options for the mother. Today, general anesthesia might be rare, except during dangerous emergency situations. Also, when regional pain relief such as epidural or spinal block might not outstand the pain.
There would be a catheter for the urine sample, an IV for fluids, and medicines like antibiotics for an infection. After that, the anesthesiologist will inject anesthesia to your spinal column and will apply antiseptics to the abdominal area with the incision.
Types of cuts or incisions in a cesarean section delivery
There are two major types of incision in a cesarean section. First, is a horizontal incision above the pubic bone or what we call the “bikini cut.” Another is vertical or classical, which may start from the bottom of the belly button through the pubic bone. This is where you might see your linea negra.
My OB-Gyne explained to me that if my cesarean section’s cut is vertical, it will be difficult for me to give birth in a normal delivery in the next pregnancies.
Benefits of a cesarean section delivery
According to Iffath Hoskins, MD, chair of the Department of OB/GYN in New York, cesarean delivery’s advantage is that the pregnant mother and her husband know the birth schedule.
They can plan ahead everything and can expect things to prepare for. In my consecutive deliveries, on the 2nd and 3rd, we chose to give birth to them on the same date, in different months. I gave birth to my three children on the 7th day of each different month. Even the time of their birth is the same (7:38 in the morning) because of having one OB-GYN to help in my delivery.
It might be convenient for some because there is no rush and you may prepare everything, even if you are a working mom while pregnant.
Complications of cesarean section delivery and side effects
Cesarean section delivery is major abdominal surgery. There are many specialists that will take care of you during your birth. But still, a CS has a higher potential of risks because the doctors will incise your skin, abdomen, and muscle, before locating the uterus.
The delivery will take up to 3 to 4 hours. I often feel the doctors settle my organs, before and after they get my baby out.
Like any other ways to give birth, CS may include risks of complications and danger for both the mother and the baby. As older folks said, every mother’s foot is in the pit when giving birth.
As Dr. Lopez adds, one thing to remember and to know when they are having a cesarean surgery is,
“The anesthetic really does give you the cold and shivering. But not all moms would have this experience.
The shivering is part of the side effect of the anesthetic. Plus, the fact na kapag binibigyan kayo ng anesthesia, medyo bumaba ‘yong blood pressure ninyo.
So what we do is to cautioned that drop in blood pressure is to infuse a lot fluids, bibilisan namin ‘yong suwero ninyo. Unfortunately, ‘yong suwerong nilalagay namin sa inyo malamig kaya iyon. Those things contribute to the chill.”
photo: dreamstime (for representation purposes only)
Complications of cesarean section
Many risks and complications are interrelated with CS. These include heavy bleeding, infection, etc. For women who have had 3 children through a cesarean section delivery, there might be a higher chance of danger and complications.
That is why doctors suggest avoiding a cesarean delivery if possible. Except when it is really needed or an emergency.
According to an article from WebMD, there is neglect in educating women regarding vaginal birth or a normal delivery after giving birth through a CS.
The complications of cesarean section delivery include the following:
- post-surgery infection or fever
- too much blood loss
- injury to organs
- emergency hysterectomy
- blood clot
- reaction to medication or anesthesia
- emotional difficulties
- scar tissue and difficulty with future deliveries
- possible death of the mother
- harm to the baby
Side effects of a cesarean delivery
The following are the possible long-term side effects for the baby and mother.
- breathing problems
- effects of anesthesia
- excessive bleeding which might need a blood transfusion
- injury to the bladder
- bowel injury
- deep vein thrombosis
- potential risk in future pregnancies
Things to avoid after having a cesarean delivery
Recovery from a cesarean delivery is not easy. Approximately, you will have 5 days inside the hospital after giving birth in a CS. While a normal delivery has only 2 days in the hospital for the mother and her baby to stay.
After these five days, you will continue your recovery at your home. These are the things to avoid when you had a cesarean delivery to prevent any complications of cesarean section:
- You are not allowed to carry anything heavy.
- It is not advisable to drive in a span of 2 weeks.
- You can not do any exercise routines for four to six weeks.
- Sexual activities are not allowed after 6 weeks recovery from cesarean delivery.
Translated from Filipino by Nathanielle Torre
If you want to read the English version of this article, click here.
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