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Labor and Birth 27

Cesarean Section

A cesarean section is a surgical procedure in which an incision is made in a woman ’ s abdomen and uterus to deliver her baby . Cesareans can save lives in the event of life-threatening complications during labor . However , a cesarean section is major abdominal surgery , and carries the same risks as any surgery for the mother and additional risks to the baby . It is best reserved for only those situations in which there is true medical necessity . Cesareans may be “ elective ” or planned in advance , they may occur during labor with time to discuss your situation and ask questions , or they may be performed rapidly in an emergency . Usually , the mother is awake and her partner is present for surgery .
Possible Reasons for Cesareans ( Planned ) What to Expect
• Malpresentation : breech , transverse or other
• Regional ( spinal or epidural ) anesthesia is used
• Placenta previa : placenta is covering the cervix most often . General anesthesia is used if time is
• Sexually transmitted disease , such as HIV or an limited or there is a medical condition that does active herpes outbreak not allow for spinal or epidural anesthesia .
• Multiple gestation : twins , triplets or more
• An IV and bladder catheter will be placed .
• Medical complications in baby or mother
• A drape will be placed in front of you to keep the


surgical field sterile . Some facilities offer a clear
Possible Reasons for Cesareans ( Unplanned ) drape to allow parents to see the birth .
• Usually one person may accompany you .
• Prolonged first or second stage ( the limit on the
• The safest and most commonly used incision is low length of time varies greatly among providers ); also transverse , a horizontal cut along the bikini line . called “ failure to progress ” or labor arrest
Other incisions used more rarely include classical
• Fetal distress ( a vertical cut ) or T-shaped .
• CPD ( cephalopelvic disproportion ): baby ’ s head
• After baby and placenta are born , the incision in won ’ t fit through mother ’ s pelvis the uterus will be closed using sutures , then your
• Sudden medical complications in mother or baby , skin will be sutured or stapled . such as placental abruption ( placenta separates
• After repairs are done , you will be taken to a from the uterine wall prematurely ), umbilical cord recovery room , where your blood pressure , heart prolapse ( cord is being compressed beneath baby ’ s rate , and respiration will be monitored . head ) or other emergencies
• Usually within 6-8 hours after birth , you will be encouraged to get up and walk .
• Be sure to notify your provider right away if you If a cesarean becomes necessary , consider how to experience any signs of infection , sharp or sudden make the experience as joyful and memorable as possible , such as having your partner with you , taking pain at your incision , or tenderness , pain , redness photos or video , having someone describe what is or swelling in your leg ( s ). happening , playing music , and having your partner announce the baby ’ s sex . You can also request skinto-skin contact with the baby in the operating room or as soon as possible and delay newborn procedures until after bonding and breastfeeding .
If you were hoping for a vaginal birth and your labor results in a cesarean , it is important that you allow yourself to grieve the loss of the experience you wanted . If it becomes difficult for you postpartum , consider talking to a trusted friend , counselor , or seeking help from a support group .
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