Cesarean Section:

A cesarean section is a surgical procedure for delivering a baby through incisions in the abdomen and uterus. It assists pregnant women at risk during natural childbirth, and in some emergency cases, it can be a life-saving delivery method.

Who Performs Cesarean Sections:

Cesarean sections are performed by obstetricians and gynecologists, as well as some family physicians. Midwives are generally not authorized to perform cesarean sections. The timing of the delivery is often scheduled in advance by the doctor, but in emergency cases, a cesarean section may be necessary to save the life of the mother or baby.

Why Cesarean Sections Are Needed:Who Performs Cesarean Sections:

Many women opt for cesarean sections to alleviate the pain of natural childbirth. However, there are cases where a cesarean section is necessary due to the risks associated with vaginal birth, such as:
1- Abnormal fetal positioning, such as breech or transverse presentation, where the baby’s position in the uterus poses risks.
2- Fetal congenital abnormalities, such as severe hydrocephalus.
3- Maternal infections, such as HIV/AIDS or active genital herpes, which could pose a risk of transmission to the baby during vaginal birth.
4- Multiple pregnancies.
5Previous uterine surgeries, like a prior cesarean section, even though vaginal birth after cesarean section (VBAC) is possible in some cases.

Additionally, there are emergency situations that necessitate an unplanned cesarean section, including:

– Arrested labor or fetal distress despite medical interventions.
– Premature placental separation.
– Fetal distress, where there are significant changes in the fetal heart rate and inadequate oxygen supply.
– Failure of the fetus to progress through the birth canal due to its size.
It’s essential to take measurements of the woman’s pelvis before delivery to determine the possibility of vaginal birth.

What happens during a cesarean section:

Anesthesia: Regional anesthesia is used in a cesarean section, such as an epidural or spinal block. Discuss with your anesthesiologist the different pain relief options available to you. In some emergency cases, general anesthesia may be chosen by the doctor.
You should arrive at the hospital two hours before the scheduled cesarean section for some routine pre-delivery tests, including:
1- Vital signs assessment, such as heart rate, respiration, and blood pressure.
2- Placement of an oxygen mask or nasal cannula to provide oxygen during the procedure.
3- Placement of a urinary catheter to empty the bladder during and shortly after the surgery (this may cause some discomfort).
4- Placement of an intravenous catheter for rapid administration of medications if needed.
5- Cleansing and sterilization of the surgical site, including shaving the area between the navel and pubic bone.
6- Special drapes are placed around the abdomen, leaving only the surgical site exposed.
Initially, after anesthesia, the skin above the pubic hairline is cut, and then the doctor makes incisions through the layers of the abdominal wall and then performs a surgical incision in the uterus. The baby’s head is suctioned and delivered, followed by the umbilical cord being clamped and cut. Finally, the placenta is delivered, and the uterus is closed with dissolvable stitches, while the abdomen is closed with surgical sutures that will be removed later.
You can see your baby immediately after the procedure, and then they will be taken by the nursing staff for special care.

Can your partner be present during the procedure:

Your partner or a close family member can be present during the cesarean section and stay by your side throughout the delivery. They will need to wear a surgical gown and mask to be in the operating room. In some emergency cases, the doctor may recommend not having anyone with you. Discuss this with your doctor before the procedure.

Can I see my baby immediately after a cesarean section:

With regional anesthesia (above the waist or below the spider web), you can remain awake during the procedure and not feel any pain. Although there is a drape in place to prevent you from seeing the full procedure, you can still see your baby.

Risks of a cesarean section:

The risks of a cesarean section are very rare in modern times. However, some complications can occur, including:
1- Bleeding.
2- Infection.
3- Injury to the bladder or intestines.
4- Blood clots.
5- Injury to the baby.
6- Death (very rare).
7- Allergic reactions to medications.
8- Low blood pressure in the mother due to anesthesia.
9- A mother who has had a cesarean section may require future cesarean deliveries, especially if the uterine incision is vertical rather than horizontal. The risk of placenta problems in future pregnancies also increases.

Post-surgery recovery:

– You may need to stay in the hospital for 3-4 days after surgery. There is usually some discomfort and pain after the surgery, and you will need a longer recovery period compared to a natural delivery.
– It is normal to feel nausea, vomiting, or itching after surgery as a natural effect of the anesthesia. You may also experience fear, panic, confusion, or coldness. Inform the doctor about any painful or distressing feelings.
– After the surgery for two weeks or more, you may experience:
1- Persistent fatigue.
2- Tiredness and constipation.
3- Pain around the surgical incision.
4- Difficulty lifting the baby or walking.
These feelings are all normal. The doctor will prescribe several medications to relieve pain as much as possible. You should not take medications randomly, especially if you are breastfeeding.

Some instructions to follow after a cesarean section:

1- Support your abdomen near the incision when sneezing, coughing, or laughing, as these movements may be painful.
2- Avoid driving or lifting heavy weights.
3- Do not apply pressure to your wound.
4- You should not engage in sexual activity until you ask the doctor and ensure that the uterus has recovered. Usually, it takes about 6 weeks before you can resume sexual activity.
5- Early and frequent walking helps alleviate some of the discomfort of a cesarean section, reduces swelling and bloating of the abdomen, and helps prevent blood clots.
6- Get help with household chores as you may not be able to perform routine activities and return to normal activity for 6-8 weeks.
7- Drink plenty of fluids to promote milk production and avoid constipation.
8- Use a side-lying position while breastfeeding to relieve pressure on the abdomen.

Contact the doctor immediately if you do not feel better within a few weeks or if you have:

1- High fever.
2- Severe and sudden pain in the surgical incision area.
3- Vaginal discharge with a very foul odor.
4- Severe vaginal bleeding.
5- Severe leg pain, swelling, or redness.
6- Chest pain or difficulty breathing.
7- Pain in one of the breasts.
8- Severe depression with thoughts of harming the baby or yourself.