A Caesarean section is the surgery that is done to deliver a baby either because a vaginal delivery will be harmful to the mother or the baby, or because you have chosen not to have a vaginal delivery.
Most of the time, it is done as a planned surgery (called an elective Caesarean section), which means that during the antenatal period, your doctor has identified some factor(s) that indicate the need for a C-section, which may include:
• Previous Caesarean section or uterine surgery
• A small pelvis
• Presence of large uterine fibroids obstructing the cervix
• Low lying placenta
• A large baby (more than 4kg)
• Abnormal position of the baby e.g. breech, transverse lie
• Pre-eclampsia in the mother
In other cases, the C-section is performed as an emergency, after a woman has already gone into labor, but the vaginal delivery has to be abandoned to save the life of the mother and/or the baby. Some of the causes are as follows:
• Prolonged labor or failure to progress in labour
• Fetal distress
• Cord prolapse
• Failed induction of labour
Whatever the cause for a Caeserean section, and whether or not it is done as an emergency, it is important that you understand the reason(s) why it is being done, and you get clarification from your doctor on any aspect that is unclear to you.
Before the surgery, some tests will be done to check your blood level, heart and kidney functions, and blood clotting function. For an elective surgery, a date will be fixed for a time that the baby is mature enough to be delivered, usually from 37 weeks of gestation. If there is a need to deliver before the baby is old enough, you might be placed on an injection to mature to the baby’s lungs earlier.
For this surgery, you will have the choice of either being put to sleep (general anaesthesia), or being numbed from the waist down (spinal anaesthesia), as long as there are no other medical contraindications involved. Most times, people choose to be awake, so that they can witness the moment the baby is born.
A cut is made on the lower abdomen; below the bikini line, to expose the uterus. The uterus is opened up by making another cut on its lower part, and the surgeon carefully brings the baby out. Immediately the baby is delivered, the umbilical cord is cut and baby is taken aside to be cleaned and resuscitated if necessary. The placenta is then separated from the uterus, and the uterus repaired, before closing up the skin.
A Caesarean section lasts for an average of 45 minutes, and after the surgery, you might experience some pain and abdominal discomfort. There are no contraindications to carrying or breastfeeding your baby because of the Caesarean section alone, and you will be discharged home after four days on admission.
After a Caesarean section, it is advisable to wait for at least six months for the uterus to heal fully before you get pregnant again, so you will need to discuss contraception with your doctor.