Caesarean section; It is an operative way to deliver your baby through an incision made in the abdomen. Some cesarean sections are planned due to pregnancy-related complications or previous cesarean sections. However, in most cases, the need for a cesarean section does not appear until delivery begins.
Why Caesarean?
In some cases, cesarean section is a safer method than normal delivery. Your doctor may recommend a cesarean section in the following cases;
- If the birth does not progress: Delayed delivery is the most common reason for cesarean section. Despite the contractions you have been experiencing for many hours, your cervix may not be opening enough. Or the baby's head may be too large to pass through the birth canal.
- If the baby's heartbeat requires little oxygen supplementation: If your baby is not getting enough oxygen, or if your doctor is worried about changes in the baby's heartbeat, he may recommend a cesarean section.
- If the baby's position is not normal: if the baby's feet or hips enter the birth canal before the head and the doctor is unable to change the baby's position before labor begins, a cesarean section is necessary to prevent complications.
- If the baby's head is in the wrong position: If the baby enters the birth canal with his chin first, forehead forward or face forward, he may not be able to fit into the pelvis, in which case a cesarean may be required.
- If there is a multiple pregnancy situation: If you are pregnant with more than one baby, it is possible that one or more babies are in an abnormal position. In this case, cesarean section is safer especially for the second baby.
- If there is a problem in the placenta: If the placenta separates from the uterus before the birth begins or if the placenta covers the entrance to the uterus (placenta previa), cesarean section is a safer way to deliver.
- If there is a problem with the umbilical cord: If the cord enters the birth canal in front of the baby or if the cord gets stuck during contractions
- If your baby is too big: Some babies are too big for normal delivery. This is typical if the mother has diabetes.
- If you have a health problem: If you have a health problem such as diabetes, heart disease, liver disease, your doctor may trigger the birth early, if it is not successful, a cesarean section is applied.
- If you have a previous cesarean section: Depending on the nature of the incision and some other factors, you can have a normal delivery after the previous cesarean section. However, in some cases, your doctor may recommend a repeat cesarean section.
In addition, some women may request a cesarean for their first birth to avoid complications that may occur with a vaginal delivery.
Risks: Recovery after cesarean section takes longer than normal delivery. Like all other operations, cesarean section has the risk of causing some complications.
What Are the Risks of Caesarean Section that May Affect the Baby?
Respiratory Problems: Babies born by cesarean section may develop respiratory problems due to abnormally rapid breathing in the first days after birth. C-sections performed before 38 weeks, optionally or without making sure that the baby's lungs are developing, increase the risk of respiratory problems and respiratory distress syndrome.
Fetal Injury: Although very rare, small nicks may occur on the baby's skin during the operation.
What Are the Risks of Cesarean Delivery?
Inflammation and Infection in the Membrane Surrounding the Womb: This condition, known as endometritis, causes fever, chills, backache, smelly vaginal discharge and pain in the uterus. It is usually treated with intravenous antibiotics.
Bleeding: More blood is lost in cesarean section compared to normal delivery. Still, blood transfusions are rarely needed.
Urinary Tract Infection: Urinary tract infection may develop in the urinary bladder or kidneys.
Decreased Bowel Function: Any operation performed on the abdomen can cause decreased bowel activities.
Reaction to Anesthesia: Some women may experience headaches after regional anesthesia.
Blood Clot: The risk of having a clot in the veins in the legs or pelvic organs is 4 times higher than in normal birth. If this clot makes its way to the lungs, the damage can reach life-threatening proportions. You can reduce the possibility of blood clots by walking frequently after the operation.
Wound Infections: Infection may develop and become inflamed at or around the incision site.
Extra Operations: If there is damage to the organs in the immediate vicinity during the cesarean section, extra operations may be needed.
Increased Risks in Future Pregnancies: After cesarean section, there is a higher risk of serious complications such as bleeding, placenta previa, abnormal fetal position, uterine rupture.
If your cesarean section has been determined beforehand, you may want to talk to the anesthesiologist before the operation and share the questions in your mind.
Your doctor may suggest that you have a pre-cesarean blood test. Your blood group will give information about your hemoglobin level.
After the cesarean section, you need to rest for a few weeks. For this reason, it may be good to arrange for someone to help you at home before and after the operation.
How Long Does a Caesarean Take?
An average cesarean section takes between 45 minutes and 1 hour. In most cases, your partner can be present in the operating room with you.
Preparation: An official from the medical team cleans the abdomen before cesarean section. A catheter is placed in the bladder to collect urine. A serum is attached to your hand or arm to provide fluid or medication. An antacid to prevent heartburn may also be given during the procedure.
Anesthesia: Regional anesthesia is generally applied in cesarean section. One type of regional anesthesia is spinal block. In this, the drug is administered directly into the sac surrounding the spinal cord. Another type of anesthesia is epidural anesthesia. In epidural anesthesia, the drug is administered just outside the sac surrounding the spinal cord.
If there is a need to start the procedure as soon as possible, spinal anesthesia is used more often because it acts more quickly than epidural anesthesia.
If regional anesthesia has been administered, you will be awake during the procedure; You can hear and see the baby after birth.
In an emergency, general anesthesia may also be used. This type of anesthesia is given through an intravenous line in the arm or from the gas you breathe through a mask. With general anesthesia, you cannot see, hear and feel.
Abdominal Incision: Your doctor makes an incision through the abdominal wall. Generally, a horizontal incision is made near the groin area. If a larger incision is needed or the baby needs to be delivered quickly, your doctor may also make a vertical incision just below the navel and just above the pubic bone.
Uterine Incision: After the abdominal incision, an incision is made in the uterus. The uterine incision is usually made horizontally from the lower part of the uterus. Other types of uterine incisions can be made according to the position of the baby and the risk of complications.
Birth: If epidural or spinal anesthesia was given, you will not feel pain while the doctor may feel some movements as the baby is removed from the womb. The doctor cleans the baby's mouth and nose from fluids, cuts the umbilical cord. The placenta is removed from the uterus and finally the incisions are sutured. Even if you can't hold your baby right away, you can see it right away.
What should you pay attention to in the hospital after cesarean section?
After cesarean section, many mothers and their babies stay in the hospital for about 2-3 days. As the effect of the anesthesia decreases, you can adjust the painkillers given intravenously with the help of a pump to control the pain.
You will be encouraged to get up and walk for the first 24 hours after your C-section. Moving speeds up your recovery and prevents constipation and blood clots. The catheter and vascular access are removed within 12 - 24 hours.
While in the hospital, your doctor will monitor the incision site for infection. They will also monitor your appetite, how much fluid you consume, and your urinary and bowel activities.
Before you leave the hospital, talk to your doctor about preventive measures and vaccinations. For your own health and for your baby's health, it's a good idea to make sure you've been vaccinated.
Breastfeeding: The incision in the vascular access and cesarean section can make breastfeeding a bit of a strange feeling. After the procedure, you will begin to breastfeed, albeit with assistance. Ask your nurse to teach you breastfeeding positions and how to make the baby comfortable. Breastfeeding while you are in pain makes the situation worse. Your doctor will recommend you medication for your post-operative pain, considering that you will be breastfeeding.
What to Consider at Home After Caesarean
When You Go Home Cesarean section heals within 4 to 6 weeks. Fatigue and discomfort are normal. While you heal, take care of the following:
Take care of yourself: Take time to relax. Keep everything you and your baby may need close by. Do not lift anything heavier than your baby for the first 2 weeks.
Pay attention to your stomach: Pay attention to the posture of your body when you stand up and walk. Hold your stomach in sudden movements such as coughing, sneezing, laughing. Use extra reinforcements like a pillow while breastfeeding.
Drink plenty of fluids: You need to drink plenty of fluids to replenish the fluids lost during childbirth and breastfeeding and to prevent constipation. Remember to urinate frequently to avoid urinary tract infections.
Avoid sexual intercourse: Most doctors recommend not having sexual intercourse for 6 weeks after giving birth, but intimacy should not be abandoned.
Take medicine when you need it: Your doctor may recommend painkillers. If you have constipation or have painful bowel movements, your doctor may prescribe a necessary medicine for this condition.
Know when to contact your doctor: Call your doctor if you have a fever higher than 38 degrees, severe abdominal pain, redness, swelling, discharge from the incision, or chest pain that accompanies the flu. Contact your doctor if you have rash, hives, smelly vaginal discharge, burning when urinating, blood in the urine, excessive bleeding, swollen, red and painful areas on the legs.
Postpartum depression is also a possible condition. If your mood is not very good, if you feel depressed, seek help as soon as possible.
If you feel bad because you had a cesarean instead of a normal delivery, remind yourself that your baby and your own health are more important than the delivery method. Although the recovery period is longer in cesarean than in normal birth, the result is the same in both, you return home with your baby, and this feeling overshadows everything.
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