Why Fear A C-Section?

Caesarean section (C-section) is a surgical procedure to deliver a baby through incisions made in the mother's abdomen and uterus.

What you need to know about Caesarean section

Delivery by C-section is planned beforehand if you develop complications during your pregnancy, or you've had an earlier delivery through Caesarean section, or are opting for it by choice. However, C-section may also be required as an emergency procedure if complications develop on the day of delivery, and the doctor considers it to be a safer option than a vaginal delivery for you and your baby. Your doctor may recommend Caesarean section to you in one of the following situations:

1. Stalled labour, when your labour isn't progressing despite strong contractions.
2. Your baby's condition: A C-section will be considered if your baby is in an abnormal position with feet positioned towards the birth canal first or is placed sideways, or when you are carrying multiple babies. Changes in your baby's heartbeat or lack of oxygen supply to baby might also prompt a C-section.
3. Your health condition: Your doctor will recommend C-section if you suffer from unstable heart condition, infection that could get transmitted to the baby at time of delivery, or if you've previously had a C-section. A C-section is safer in situations when the placenta detaches itself from your uterus even before labour begins or places itself over the cervix opening, or if the umbilical cord slips through the cervix ahead of the baby.

What are the known complications in Caesarean section?

A Caesarean section is a commonly conducted surgical procedure. It is the most commonly performed surgery in the United States, and one-third of all pregnant women undergo C-section at time of delivery. However, like all major surgeries, there are risks involved.

Risks to you include:

1. Infection and inflammation of uterus lining: Known as endometritis, this can cause fever, uterine pain and foul smelling vaginal discharge.
2. Increased bleeding: More blood is lost during delivery by C-section as compared to vaginal birth.
3. Blood clots: You are at a greater risk of developing blood clots in the pelvic region and legs. The situation can become life threatening if the clot travels to lungs, leading to a condition known as pulmonary embolism. Frequent walking post the surgery can help prevent it.
4. Increased risks in future pregnancies: All subsequent pregnancies carry an increased risk towards uterine rupture, an emergency condition, which is why a repeat Caesarean is offered in all future deliveries. The uterus ruptures along the scar line of previous C-section. You may also face the problem of placenta sticking to the uterus.
5. Reaction to anaesthesia: Reactions to anaesthesia used during epidural or spinal blocks include severe headaches when you sit upright. These may continue for some weeks after the delivery.
6. Surgical injury and wounds: Injuries to nearby organs like the bladder are rare, but can happen. An additional surgery will be required to treat these injuries. It is also possible to develop an infection around the site of incision.

Risks to the baby include:

1. Breathing problems: Babies delivered by C-section are more prone to developing abnormal fast breathing in the first few days after birth.
2. Surgical injury: Accidental nicks may occur on the baby's skin at the time of delivery.

What precautions or steps are necessary to stay healthy and happy post a Caesarean section delivery?

A Caesarean section delivery requires extra care and caution as compared to a vaginal birth. Allow four to six weeks for the C-section incision to heal. Some level of discomfort and fatigue for the mother commonly accompanies the recovery process.

What are the dietary and physical activity requirements during the course of recovery?

Your doctor may prescribe pain medications like ibuprofen and acetaminophen, which are safe for you while you breast feed your baby. Drink lot of fluids to prevent constipation and reduce the risk to urinary tract infections.

What are the concerns over repeat C-sections?

Three caesarean section deliveries are considered safe after your first surgery, but each repeat C-section is also considered to be more complicated than the last, especially if you have internal scars or scar tissues that are adhered to the uterus. Repeat caesarean sections pose the following risks:

1. Heavy bleeding and uterus removal: Though heavy bleeding is associated with any C-section procedure, the risk of losing more blood increases with the number of repeat C-sections. Hysterectomy or the removal of uterus becomes a necessity to prevent further blood loss.
2. Problem with placenta: Every subsequent C-sections exposes you to the risk of developing complications such as a deeper and firmer implantation of placenta or the covering of the cervix opening by the placenta.
3. Weak uterine wall: Every incision into your uterine walls weakens it for future pregnancies.
4. Injury to bladder: The scar tissue from a previous C-section may join the bladder and uterus, making the bladder more prone to injuries in subsequent C-section deliveries.

How can you prevent Caesarean section from taking place?

Learn more about labour and birth during your pregnancy. A C-section may not the better option if your concern is restricted to the size of the baby in ultrasound or fear of labour pains. Avoid epidural analgesia if possible as it delays labour. Inducing labour increases the chances of delivery by C- section. Talk to your health care provider to understand the various aspects of your baby's delivery.

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