Everything you need to know about C-sections
Everything you need to know if your baby doesn’t come au naturel
Friday, September 12, 2008
You may think a Cesarean won't happen to you, but with the rising rates of Cesarean birth no one can be totally sure. In many places Cesarean rates account for between 30-35 percent of births.
"I think it should be a discussion that's had as a part of prenatal care. I think people have a fear that if they bring it up it's going to happen," says Dr. Perpetua Goodall, an obstetrician/gynecologist at the University of Chicago Medical Center.
Sandy Clark, mother of four children all born Cesarean, admits she and her husband barely looked at the film about the C-section in the prenatal classes. So while she was surprised to find herself in the middle of a Cesarean, she says it didn't seem like a terrible idea after many hours of labor.
"If you need an escape hatch, whatever you have to do to relieve my pain is OK," she says. "You just want to know that your baby is OK."
Why Cesareans happen
Planned Cesareans can be a result of things like previous Cesarean births, a low-lying placenta that covers the cervix (placenta previa), breech presentation or an active infection such as herpes, Goodall says. Unplanned Cesareans happen when the baby isn't tolerating labor, failure to progress in dilation or hemorrhage. A C-section will be performed anytime there is a serious risk to mother or infant.
"If it's an emergency situation things may happen very quickly. You really don't have a chance to mull it over," Goodall says.
What's the experience of a Cesarean?
The mother will be given medication to make her numb, but she will stay awake through the procedure. Depending on a particular women's situation, the cut will either be made classical (vertically through the abdomen) or traverse (horizontally at the bikini line.)
The surgery will last anywhere from 30 minutes to an hour depending on the surgeon and whether or not there is scar tissue from previous abdominal surgery to cut through.
After the surgery is complete the mother is wheeled away to a recovery room where she will sleep, usually until her medication begins to wane.
Recovery in the hospital
For the first 24 hours the pain is controlled with opiate derivatives given through an IV. If you choose to breastfeed, your baby will be brought to you for feeding and you'll need help getting into a comfortable position.
"Breastfeeding (causes) the uterus to contract. That's an added ouch," Clark says.
A Cesarean may dampen your desire to breastfeed, but it does not disturb the flow of the milk, so if you choose to you still can.
The average patient stays in the hospital for two to three days after surgery. Of great concern will be your first bowel movement and passing gas because the bowel can be very sluggish after surgery, especially if it was moved out of the way, Goodall says. You'll be given stool softeners in the hospital (and often to take home with you) because the pain medications also make many women constipated.
Recovery at home
When you go home your doctor will tell you to avoid driving, putting anything in the vagina (tampons or douche), all intercourse, heavy stair climbing or other exercise and not to lift anything over 10 pounds. If your Cesarean was caused by an oversized baby you'll be allowed to pick the baby up, but carefully.
If your incision was closed with stitches you'll need to see your doctor between three and seven days after surgery to have them removed, which for most people is painless and quick.
The most important thing-aside from taking care of your bundle of joy-is to take care of yourself. That means resting, following doctor's orders and staying on top of the pain. The medications are safe for breastfeeding mothers, Goodall says.
Remember that you'll need help once you're home. If your bedroom and the baby's room are on different floors, have your caregiver move everything into one room on the same floor so that you have less moving to do. Most importantly, let people help if they offer.
Some women also experience a brief depression over not being able to deliver vaginally.
"I think they feel a sense of loss, like they are missing out on something," says Goodall. "When you're growing up as a woman and you think about what your delivery will be like you do not think about having a C-section."
Within six to 12 weeks you will be completely healed and able to resume all functions though you may have bouts with scar tissue, numbness or deciding how to approach subsequent births.