HEALTHPLAN MAGAZINE

A caesarean section, also known as a C-section, is used to deliver a baby by cutting across the tummy and womb. It is only used when it is considered the safest way to deliver the baby. If vaginal birth is considered too risky, a caesarean section may be planned or employed in an emergency.

There are many reasons why a caesarean section may be carried out, such as the baby being in a feet-first breech position or if the baby isn't getting enough oxygen or if the individual has pregnancy related high blood pressure. Some women often ask for a caesarean section, which may be permitted after weighing up the risks and benefits with your nominated healthcare professional.

Preparing for a Caesarean Section

If a caesarean is planned, a blood test will be arranged in advance. The blood test is designed to highlight anaemia, which means you may need to have a blood transfusion if you lose a lot of blood during the operation.

A caesarean is usually performed with regional anaesthesia, where you can't feel anything from the waist down but are awake during the procedure.

If there is an issue with the delivery or any problem with the baby, then a caesarean will be carried out immediately. It is likely you will be put under general anaesthetic, which will mean you are asleep throughout the operation.

For a caesarean to take place it requires consent; this is usually a written agreement where you understand the risks and benefits. In an emergency situation, the consent will be verbal as it may not be possible for you to sign a form.

Procedure

With a C-Section, a screen is placed across the body, so you cannot see what is happening, but the surgical team will explain the process to you. Once the anaesthetic is working, your abdomen will be cleaned with antiseptic. A cut is made in the lower part of your stomach and womb; this is usually less than 20cm long. The baby will then be carefully delivered and will be handed to you.

The incision will then be sewn up with dissolvable or regular stitches and the wound covered with a dressing. If regular stitches are used, you may have to have them taken out after 7-10 days.

To deliver the placenta, your surgeon may inject you with a synthetic oxytocin, which will make your womb contract for placenta delivery.

To make you more comfortable, you may be offered music in the room as well as planning how and when you'd like your baby handed to you. You may also be given a catheter to ensure your bladder is empty.

Aftercare

Once the surgery is over you will be moved from the operating theatre to a recovery room where you will begin to recover from the anaesthetic. Painkillers will be administered when needed, and medical staff will continue to observe you to ensure that you are well.

You may be given compression stockings and blood-thinning medication to reduce the risk of blood clots, and you can eat and drink whenever you feel hungry or thirsty. After around 12 hours, once you are able to walk, your catheter will be removed.

The dressing for the wound will have to stay on for at least 24 hours, and it is normal to remain in the hospital for a few days after delivery. This is to ensure a strong recovery and to make sure there are no signs of a fever or infection. If you make a speedy recovery and have plenty of care and support at home, you may be able to leave sooner.

During this period in the hospital you can receive support with breastfeeding as well as ask any questions about your caesarean and if there are any consequences after the procedure.

Recovery

As well as painkillers administered in aftercare, you'll be advised on what medication to use once you are at home. For infections, you may be given antibiotics, which you may need to take when you leave, medical staff will advise you before your departure.

Your wound may still be sore, to speed up the healing process, clean the wound daily as per the instructions of the healthcare professional and loose, comfortable cotton clothing is advisable. It is important to keep an eye on your wound, in case of infection. Once it is healed, the wound will form a scar, which will fade over time.

It can take time to recover, so avoid doing strenuous exercise until you feel ready to do so. Gentle exercise is encouraged but if you feel uncomfortable in any activity then stop and rest.

You will receive a six-week postnatal check-up from a healthcare professional; this is the ideal time to ask any questions and make sure you are recovering well.

Risks

A caesarean section is a common procedure and is largely a very safe procedure. As with all medical procedures, a C-section can lead to complications in a small number of patients. If a caesarean is planned, your medical professional will discuss all the risks involved beforehand, so you are completely aware.

A temporary risk is the side effects after the procedure surrounding the pain and discomfort from the incision and the healing and scarring of the wound. If the wound is well cared for, it should heal properly, but infections can occur so make sure to look for any abnormalities, discharge, swelling or abnormal pain with the wound.

While most caesareans are free of complications, some possible issues regarding the procedure include excessive bleeding, blood clots, infections to the womb or wound and a reaction to the anaesthetic. Complications can vary and will be different to every single person, based on your medical record; your doctor will be able to advise you on the risks that may apply to you.

For the baby, risks are rare. There may be a laceration, whereby the surgeon accidentally cuts the skin when opening the wound, but this is usually minor and heals with ease. Another risk is the possibility of breathing difficulties which typically occurs in babies born before 39 weeks if this does happen, it will usually improve after a few days and doctors will ensure your baby is closely monitored.

In rare cases a caesarean may affect a future pregnancy, however, most women who have a caesarean can safely deliver their next baby either through vaginal birth or another C-section.