Cesarean
From ChildWiki.com
The cesarean is the birth of a child through a surgical intervention onto the mother's uterus.
Sometimes, the doctors won’t perform a cesarean until well after labor sets in, but this doesn't mean it is an urgent procedure. In most situations, it is something that the doctors cannot anticipate until labor begins.
Women can have a cesarean birth for various reasons, amongst which are: the frequency of fetal heartbeats are irregular, which means that the baby may not be able to survive a vaginal birth; the umbilical cord is coiled around the baby's neck, which can pose a risk during a vaginal birth; the umbilical cord prolapses or is slipping through the cervix before the baby, which can lead to compression of the cord during birth and to stopping the fetal oxygen; placenta abruptio can also call for a cesarean on occasion; placenta previa, when the cervix is blocked completely; the baby is in a breach or butt first position and not placed head down towards the birth canal; the cervix stopped dilating for some reason, the woman is unable to have substantial contractions, or cases in which a cesarean might be preferred to a forceps assisted vaginal birth.
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[edit] When Is a Cesarean Scheduled?
There are cases in which it is clear that a woman will need a cesarean even before labor begins. Part of the conditions that require a scheduled cesarean are:
- The baby is in a difficult position (breach or transverse)
- The fetus has a condition or abnormality already known
- The mother is expecting multiple babies (three or more, twins can be delivered vaginally)
- The mother has genital herpes that can be transmitted to the baby in a vaginal birth (this can cause fetal blindness)
- The mother has placenta previa (the placenta is covering the cervix)
- The mother has placenta abruptio (the placenta is separated from the uterine walls and the fetus is in danger)
- Preeclampsia, which often escalates quickly making waiting for birth to come naturally very dangerous for both mother and child
- The mother has a medical history of invasive uterine interventions or multiple cesareans
[edit] What to Expect During a Cesarean
Even if the cesarean is a surgical intervention, the father of the newborn is often allowed to remain in the operating room, unless the cesarean is a true medical emergency or complications arise during a routine procedure.
The first thing that a woman readying to undergo a cesarean should expect is an examination and interview with the anesthesiologist. This will familiarize her with the options she has to eliminate the pain. Modern cesareans are no longer performed using total anesthesia. An epidural or spinal injection will be inserted in the spaces between the vertebrae in order to numb the lower half of the body.
During the procedure, a urethral catheter is installed to drain urine, as well as an IV in case drugs are urgently administrated. The medical personnel will install a cloth shield so the woman cannot see the incision site and the details of the procedure.
Once anesthesia sets in, the doctor makes a small horizontal incision in the skin above the pubic bone (known as the bikini incision) and then creates a second incision onto the inferior part of the uterus. The baby will be born via the incision site. The doctor facilitates its exit, and raises him above the shield for a short time so that the mother can see him. Then, a neonatal doctor will visually examine the newborn, while the surgeon removes the placenta.
After examination, the newborn, if he is healthy, is given to the father or maternal support person while the incision is closed. This can take up to 30 minutes, because every layer of organ, muscle and skin has to be closed individually.
Once the surgery is complete, the woman will be moved to a recovery room where she can begin to breastfeed the newborn if possible.
[edit] Can Cesarean Birth Chances Be Reduced?
Not all C-sections can or should be prevented, but there are a number of ways a women can reduce the cesarean risk, amongst which are: remaining healthy during pregnancy, a healthy pregnancy diet, exercising, and lots of resting once labor starts.
Also, remaining active while in labor helps. Walking and climbing stairs can speed up labor, by making contractions stronger, longer and more efficient.
Women that need to remain immobile (those with epidurals or physical handicaps) can significantly reduce labor duration by keeping properly hydrated through the use of an intravenous saline drip or by eating ice chips. A fast and efficient labor usually leads to a natural birth, thus the cesarean risk is out of the picture.
[edit] Vaginal Birth After a Cesarean
VBAC is possible for most women that gave birth through a cesarean. A cesarean birth does not mean that the next child has to be born the same way. More than 70% of women that try the vaginal birth after a cesarean succeed, and the lower uterine vertical and horizontal incisions pose a low risk of uterine rupture.
