Caesarean delivery, scheduled or urgent. How does it work and what are the risks?

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Caesarean section

Il Caesarean section It is a surgery that is used to deliver a baby and involves an incision on the lower part of the belly, just below the bikini line. It should be practiced only in cases of urgency or when a natural birth puts the health of the baby or mother at risk, instead in the country it is carried out almost in the 40% of cases and it is often considered as "the easy birth", for those women who do not want to suffer and expressly ask for the cut. In this guide to caesarean delivery let's find out together what it is, when and how it is performed.

In this article

  • Etymology
  • Scheduled
  • Urgency
  • Experiences
  • How it happens
  • Anesthesia
  • How long does it last
  • risks
  • postpartum
  • Caesarean section or natural birth
  • Vbac

Caesarean section, etymology

Popular tradition has it that this name was coined at the birth of Julius Caesar, who is read to have been born from a cut in his mother's belly. In reality, the word caesarean itself is not referable to Caesar, but rather to "cut down"past participle of the Latin verb" caedere "ie cut. And in fact, the birth takes place through a cut on the maternal abdomen.

Video: Caesarean section explained by the gynecologist

In this video, a gynecologist and obstetrician talks about the planned and urgent caesarean section. How it takes place, what are the risks for the mother and the unborn child. And she explains what the baby feels when she is born with a caesarean section and what is the difference compared to a natural birth.

Scheduled caesarean delivery

It is the only case in which it is possible to predict the date of birth of your baby. Simply assessed the situation and the maternal-fetal well-being, the gynecologist decides that spontaneous labor cannot be expected and that this child must be born with a caesarean section. Usually the date is fixed around the 37-38 week, that is two or three weeks before the term, of the presumed date of delivery. This is because the surgeons who will perform the surgery will be faced with a less reactive uterus (i.e. less prepared to contract as for a spontaneous labor) and a smaller baby so the incision may be smaller.

The choice to run a scheduled cesarean delivery it may be due to various factors, although there are few real absolute indications for caesarean delivery. Let's see them together.

Read also: What happens after childbirth

When is it best to have a caesarean section?

There are not many absolute indications for which a Caesarean section, but those that are recognized as such are very important. Absolute indications for the execution of a planned caesarean section are:

  • breech child: positions of the child different from the canonical cephalic "upside down" position;
  • problems of the child such as malformations or serious pathologies that do not allow him to safely face labor;
  • anomalies of the maternal pelvis for which despite being in the correct position the child could not pass;
  • very large size of the baby (macrosomia) which would surely cause it to be stuck in the maternal bone basin;
  • twin and multi-twin pregnancy;
  • placenta positioned "like a plug" on the cervix, a situation that would expose you to serious risk of bleeding if a spontaneous birth were to occur;
  • important maternal pathologies that prevent the efforts of spontaneous labor such as heart disease and serious respiratory problems;
  • and finally maternal HIV infections, although not all studies agree on this last indication because mother-child transmission does not appear to be greater in spontaneous delivery.

Emergency caesarean delivery

Clearly all these indications are for planned cesarean delivery, if instead there should be alterations in the baby's heartbeat, difficulty in its progression towards birth or any other problem (even during spontaneous labor) we intervene with a emergency caesarean section. Lately, it is quite fashionable to recommend a caesarean section for "maternal anxiety", that is, in those mothers who are particularly terrified of spontaneous childbirth. Experts are not in favor of this choice because perhaps it would be better to provide support to face the fear to this mother and once you see that this terror does not pass, think about the caesarean section.

Video Story of an Emergency Caesarean Birth

After the attempted induced birth: the testimony of Cecilia who first experienced the induction and then the emergency cesarean section with total anesthesia because the spinal was not working.

Caesarean section experiences

Among our planets there have been several cases of emergency caesarean deliveries but also of caesarean deliveries after labor or scheduled.

  • The story of our lawyer made us relive her emotions and fears. A difficult birth in the 41st week that is initially induced due to reduction of the amniotic fluid and soon turns into a nightmare and the need to quickly resort to an emergency cut.
  • The story of a difficult birth of a mother who went through all the labor and then got to have to do the cesarean
  • Michi's ugly cesarean: who gave birth to her first daughter with a scheduled cesarean and the second, despite an attempt at a natural birth, came to light with the cut.
  • An emergency cesarean with suspected megalosomy: the story of one of our users who explains to us how her little Giulia, her third daughter, came into the world thanks to an emergency cesarean and gives advice to all mothers about to give birth

How does a caesarean section happen

Unlike spontaneous birth caesarean delivery it's a real surgery. In fact, you are hospitalized to be able to do it and you stay there 3-4 days after the surgery. It is basically an incision of the abdominal wall first and then of the uterus to go to extract the baby not from the vaginal canal but from the hole made in the uterus. It is absolutely safe and can be performed with different techniques, at different gestational periods and for different reasons.

Anesthesia for caesarean section

In reality we are not talking about a real anesthesia, in the sense that the skin sensitivity is partially preserved. What happens is that it is used a spinal analgesia. That is, by inserting a catheter in the space between the spinal meninges (in the lumbar part of the back) a drug is injected which it takes away the pain sensation to the lower part of the body. So the lower part is not completely asleep, women often report feeling touching and pulling at the level of the abdomen but they do not feel pain. It is the method of safer analgesia because it is easily reversible but also easily controlled in case of problems, as well as being more tolerable by the mother in terms of the quantity of drugs injected. Clearly having only the lower body means that mom is Wake-up calls for the entire duration of the intervention. She won't see what happens but she will be able to see her newborn baby.

Surgical technique of caesarean section

Until recently the traditional technique practiced for the caesarean section, it involved the incision of the maternal abdomen in the longitudinal direction from the navel towards the pubis, therefore with a considerable aesthetic impact. Today, however, the most common execution technique is the Stark method, Reed chiamato sweet cesarean mostly for the best aesthetics and speed of recovery compared to the traditional technique.

The Stark method

The Stark technique cuts the skin very close to the pubic bone, below the bikini line, and horizontally, with a aesthetic impact noticeably different. But it is not only for this reason that we are oriented towards this technique.

After having incised the skin and subcutis, the technique does not involve cutting, but digitally removing the abdominal muscles, preserving their almost total integrity; to incise the uterus but to enlarge the incision digitally.

So a large cut is not made in the uterus to let the baby out, but a small hole which is enlarged by tearing (forgive the image a little sharp but to be clear) the muscle fibers with the fingers of the two surgeons. It seems paradoxical but this contributes to a better and faster wound healing and a more resistant scar than those made with a scalpel or scissors.

How long does a caesarean delivery last?

The whole procedure of caesarean section usually lasts between 40 and 50 minutes. The mother, as we said, is subjected to spinal anesthesia and then the doctor will make the incision to extract the baby. After that, while the baby is being checked and bathed, the doctor will sew up and stitches.

Caesarean delivery video

Below is a two interesting link to a video showing:

  1. the animated representation of the indications and the intervention of the caesarean; VIDEO

Caesarean section, the risks

Like all surgical interventions, the caesarean is not without risks, mainly related to adverse reactions to analgesia, or the risk of bleeding. However, it must be said that the incidence of these events is very, very rare indeed. Cesarean delivery has now become a routine operation, all hospitals have surgeons able to perform it both in programmed and urgent conditions.

Post-caesarean delivery

Being a surgery it takes a few days to recover. Surely the first day after the operation they will make you stay in bed, still with the drip and the catheter. But once the IV therapy is finished, the catheter will be removed and you will be asked to get up. It is important to start moving right away because scientific evidence tells us that immobility helps the formation of clots that can give rise to deep vein thrombosis, a rather dangerous cardiac and circulatory complication that would imply a longer hospital stay and more aggressive post-partum therapies.

Convalescence of caesarean section

La convalescence it is that of any other surgery. Generally, however, the new mother is invited to get up, take a walk in the room, sit on the armchair already the day after the birth and in most cases, I will be able to go home later two or three days. The stitches will be removed (or reabsorbed) within a couple of weeks and all women who have given birth via a caesarean section report that they have felt much better after removing the stitches (which, however, can pull a little and annoy).

Caesarean section, scar

The internal stitches will reabsorb on their own while the external ones will have to be removed manually as soon as the scar is healed, and this usually happens in about ten days. You will then find yourself with a beautiful scar that is first pink and then definitively white. The skin around it will begin to regain sensitivity, and the scar will shrink to 4-5 centimeters in length. At this point the doctors recommend trying to crush it, to manipulate it: you should feel nothing, no lumps, no bumps. If your scar is so done you can rest assured that the suture has been well done. If, on the other hand, you feel irregularities, points that pull more than others or small bumps you can make what is called harmonization of the scar, aimed precisely at regularizing it and making it as smooth as possible.

Belly after caesarean section

After the cesarean the belly will appear a little flaccida and the skin will be sagging and relaxed. Immediately after the operation, gynecologists recommend the use of the pancera, which serves both to feel less pain in the wound, and to help the abdominal muscle band - affected by the cesarean - to heal more quickly.

It is good to know that it also takes a year before the body recovers its pre-pregnancy shape and that it is necessary to wait six months after caesarean section before doing exercises and gymnastics on the abdominals.

Post cesarean pain after months

Do some new mothers complain of abdominal pain even months after cesarean delivery? Is this normal or should you worry? The two main types of persistent post cesarean pain are nerve pain and muscle pain.

  • Il muscular pain it can occur spontaneously but can also be triggered by trauma (such as childbirth) even more if associated with post-pregnancy hormonal changes, stress and lack of sleep. In this case, therefore, the muscles - especially the abdominal ones and in the pelvic area - contract and cause pain by compressing the nerves.
  • Il pain related to the nerves it can be caused by trauma involving small nerves that leave a feeling of numbness, loss of sensation and sometimes pain.

Both conditions should be reported to the doctor.

Caesarean section or natural birth

And so the question arises: is natural birth better or a caesarean section? Having removed all that we have said about emergencies and the absolute indications where certainly not only is it better, but a caesarean is absolutely necessary, we believe that everyone must make their own choices by evaluating the pros and cons of each type of birth.

  • On the one hand, spontaneous birth certainly implies a greater effort before birth, but a faster recovery after childbirth.
  • On the other hand, the planned caesarean section allows you to have no problems before birth, but to have a slower recovery afterwards.

Each woman must be able to evaluate both alternatives and decide according to her safety: a caesarean section with a happy mother is always better than a spontaneous birth with a mother destroyed by the experience. The birth path must leave a beautiful memory in the life of women.

Read also: After a caesarean, book

Can a natural birth be performed after a caesarean section?

Absolutely yes, clearly the maternal conditions must first be evaluated and specifically:

  • the distance from the previous birth,
  • the tightness of the scar,
  • the type of contractions that occur
  • as well as obviously all the elements that are evaluated in each pregnancy to understand whether or not spontaneous birth is indicated.

If all the conditions are met, the so-called "trial labor"Or when labor sets in, we are carefully monitored but we let everything proceed spontaneously. And in most cases spontaneous birth occurs. It must objectively be said that not all facilities in the country are in favor of this procedure and not all of them are equipped to support it, because the operating room is always required in the event of an emergency caesarean section. However, in each region there are certainly as many hospitals as they can, and indeed they encourage this type of birth in women who feel capable of enduring labor.

Caesarean and artificial breastfeeding

While there's no reason why you can't breastfeed even after a cesarean, many moms are leaning towards bottle feeding. There is nothing wrong with that and you don't have to feel guilty because you will not be less mothers if you have given birth to your child with a caesarean and you will feed him with a bottle. The important thing will be the care and love with which you welcome your baby.

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