3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> Caesarean Section

Caesarean Section

A caesarean section is a major operation involving an incision through the skin and muscles of your abdomen, and into the uterus, in order to deliver your baby. Unless there are medical grounds that make it the safest form of delivery for your baby, electing to have a caesarian section is not a decision you should take lightly. In the majority of cases the recovery time is much longer after a caesarian section.

Types of caesarean section

There are three types of caesarean section, depending on when the decision to perform the operation is made (the surgical procedure itself is the same):

Elective where the decision that a caesarean section is necessary is made before labour. There are many reasons for this decision, for example: a breech position of the baby, a previous caesarean, active herpes in the mother or her pelvis is deemed too small for the baby's head (cephalopelvic disproportion, or CPD).

Emergency where the caesarean is unplanned. In this case, the baby may have started to show signs of distress in early labour, or there has been very little progress. One of the causes for a decision to be made at this stage is when CPD (see above) is discovered once labour has already commenced.

Crash which is a true emergency. If the mother does not already have an epidural in place, she would need a general anaesthetic because the baby needs immediate delivery. Reasons for this include placental abruption, a prolapsed cord or severe signs of distress with the baby's heartbeat.

The operation

The Operation

A caesaraean is no different from any other operation and you should remove any jewellery or nail polish. The top of your pubic hair will be shaved and the midwife will insert a catheter into your bladder just prior to the operation. A needle (a venflon or canulla) will be put into your hand through which fluid will drip in case your blood pressure falls. It takes about 10 minutes from the first incision until the delivery of your baby, and about another 40 minutes for the stitches to be put in the layers of muscle, fat and skin.

The procedure will not hurt but you will be aware of the pushing and pulling inside of you. Some women describe it as'someone washing the dishes inside of their stomach'. The scar is just below the bikini line and will fade in time. anaesthesia

You will usually be given a spinal block or epidural so that you can stay awake during the operation and hold your baby soon afterwards. A general anaesthetic may be advisable if any complications are anticipated, for example, if there is a risk of heavy bleeding, as with placenta praevia.

What happens afterwards?

A caesarean involves major surgery and problems can occur if your do not have enough rest and support afterwards. Being unable to do such a simple task as lifting or holding your baby can be frustrating. However, your midwife can show you different positions that can help, for example, placing a pillow on your lap, lying down or holding your baby under your arm to feed her. It is important to continue your pelvic floor exercises because the muscles may have lost tone during your pregnancy. However, you should avoid other forms of exercise (including driving, lifting and housework) for at least the first 6 weeks. Make the most of any help that is offered as you will need time to recover from the operation as well as having a new baby to look after.

I am going to have a caesarean section, as my baby is breech. My midwife has said that I can have a 'spinal'. Is this different from an epidural?
A spinal block is similar to an epidural but involves injecting the anaesthetic into your back and then removing the needle. With an epidural, a fine plastic catheter is inserted into your back and left so that the drug can be topped up during labour. A spinal is quicker to insert and provides a short but very effective dose of anaesthetic. Because of this, spinals tend to be used for caesarean sections and, if necessary, towards the end of labour or sometimes for a ventouse or forceps delivery.

How much will my partner actually see?
If your partner goes into the operating theatre with you, he will see very little of what is going on. Once everything has been set up and the anaesthetist has put your spinal block in position, a screen will be placed across you so that nothing can be seen from the top of your chest downwards. Your partner will sit next to you, close to your head, so he can only see your head and shoulders. As the baby is lifted out, he will be shown to you and then checked over by the midwife or paediatrician.