A Caesarean Section is a major surgical operation to remove the baby from the uterus through an incision in the mother’s uterus. A Caesarean Section is required when birthing through the vagina is not possible or when a vaginal birth would pose a danger to either the mother or baby. A planned Ceaserean is an elective operation. Sometimes the surgery can be performed as an emergency (unplanned), when complications arise during labour. The rate of Caesarean births is around 25% in Australia and steadily rising (The Royal Australian and New Zealand College of Obstetricians & Gynaecologists) – RANZCOG.
Here are some reasons why Caesarean’s may be performed.
* The baby appears to be too large to pass through the pelvis.
* Part of the placenta is covering or partially covering the opening of the cervix, this is called placenta praevia.
* Previous Caesarean birth (although some women are capable of having a VBAC – vaginal birth after caesarean), this must be discussed with medical staff as each woman and her previous history are different.
* Breech presentation (bottom down instead of head down). Some doctors may attempt a vaginal breech birth, however most hospitals would be likely to insist on a planned elective caesarean.
* Concern for the baby’s condition. Babies can become stressed during labour.
* Labour is not progressing as expected – remember you will be put onto a very strict timeline once you are admitted to hospital. So stay at home as long as possible to avoid interventions.
* The mother has active vaginal herpes which could potentially infect the baby during a vaginal birth.
* The mother has a medical condition such as pre-eclampsia where her blood pressure is very high.
* The placenta partially separates from the wall of the uterus – placental abruption.
Most Casearean births are performed under an epidural/spinal block. You will be fully awake during the entire operation, however you will not feel pain. You will however feel pulling and tugging sensations. Some emergency operations may be performed under general anaesthesia, this luckily doesn’t happen very often as you are totally unconcious and unable to bond with your baby for some time. Almost all Casearean Section incisions will be a horizontal bikini cut. If for some reason you have previously had a verticle (classical) incision you will not be able to try for a VBAC birth.
Dissolvable stitches will be used to close the wound. You will be sore for quite a while after the surgery, but it is very important to be up out of bed and walking around within about 12 hours of your surgery. Prolonged resting in bed can result in blood clots developing in the legs, and you could get a chest infection or pneumonia. Regular analgesia will be offered to enable you to be up and about without too much discomfort.
As with all surgery there are risks involved and your doctor and anaesthetist will discuss specific risks with you, so that you fully understand and are able to give your informed consent for the surgery to go ahead.
The outcome that all medical and midwifery staff are wanting to achieve is a healthy mother and a healthy baby.