Everything you want to know about Cesarean Section!

If you are a mother-to-be, or if someone in your family is about to have a baby, you have probably heard of a 'cesarean section' or `(C-section)`. Although some people are a little afraid of it, it is actually a very helpful and sometimes indispensable thing to protect the life of the mother and the baby. So today we will talk about what this cesarean section is, why it is done, how it is done, and what happens after it, in a simple way that you can understand.

What is a cesarean section (C-section)?

Simply put, a cesarean section is a surgical procedure to deliver a baby through small incisions in your abdomen and uterus. Doctors usually decide to deliver a baby this way when it is difficult to deliver normally, or when there is a risk to the mother or the baby. Remember, sometimes this can be a life-saving procedure. These surgeries are performed by obstetricians and gynecologists – or, in the case of a government hospital, by senior doctors in that field (under the supervision of obstetricians and gynecologists).

Why is a cesarean section sometimes necessary?

There are many reasons why a cesarean section may be performed. Some are planned in advance, while others are performed in an emergency. Let's look at both.

Scheduled C-Sections

Sometimes the doctor knows in advance that there is a risk of a normal delivery. In such cases, a cesarean section is scheduled a day in advance. Here are some such cases:

• Baby's position: The baby is in the breech position, breech position, or transverse position. However, sometimes the baby can be turned before delivery, or special techniques can be used to help the baby to be delivered normally.
• Birth defects in the baby: If the baby has a severe birth defect such as ``Hydrocephalus`` (water filling the head).
• Placental problems: If the mother has problems with her placenta. For example, a condition called ``Placenta Previa``, which means the placenta is located too low in the uterus, covering the cervix .
• Mother's health conditions: If a normal delivery is risky for the mother or the baby due to a health condition in the mother (for example, high levels of the HIV virus in the body, or active genital herpes).
• Multiple pregnancy : In some cases of multiple pregnancies, such as twin births.
• Previous surgeries:If the mother has previously undergone uterine surgery, or if she has previously had a cesarean section. However, it should be noted here that many mothers can deliver their next baby normally, even if they have previously had a cesarean section. We call this `VBAC (Vaginal Birth After Cesarean)`.

Emergency C-Sections

Some cesarean sections are performed suddenly and unexpectedly. This can happen during pregnancy, during labor, or when there is a problem with the mother or baby. Here are some examples:

• Labor pains stop or slow down: If the pain of childbirth is not coming properly, seems to have stopped, or is going slowly, and the medications given are not helping.
• Placental abruption: If the placenta separates from the uterine wall prematurely, this is called ``Placental Abruption''.
• Umbilical cord problems: If the umbilical cord is pinched (this can affect the baby's oxygen supply) or if the umbilical cord enters the vagina before the baby is born ( umbilical cord prolapse ).
• Fetal distress: Changes in the baby's heart rate indicate that the baby is not getting enough oxygen.
• The size of the baby: If the baby's head or entire body is too big to come out of the birth canal.

If your doctor says you need a cesarean section, you can get a second opinion from another doctor, unless it's an emergency. But in the end, it's best to trust the doctor's decision.

How is a cesarean section (C-section) performed?

Let's look at some of the things that usually happen during a planned cesarean section. Your support person (husband, family member) can stay with you in a surgical gown. (However, this may not be possible in an emergency cesarean section.) Before the operation begins, the anesthesiologist will talk to you about what will be done to make you feel no pain. Most often, they use what is called ``Regional Anesthesia''. This means that only a certain area of ​​the body is numbed. This is used to reduce pain during both vaginal birth and cesarean sections. Here are some things they will do to prepare you for the operation:

• Various devices (Monitors) are installed to monitor things like your heart rate, breathing , and blood pressure .
• An oxygen mask or a small tube placed in your nostrils will be used to give you oxygen.
• A small tube (catheter) will be inserted into your urethra to drain urine (this may feel a little uncomfortable, but it is not painful).
• An intravenous line (IV) will be placed in your arm or a vein in your arm to give you saline.
• Your stomach area will be thoroughly washed and the hair from your navel and lower abdomen area will be removed.
• A curtain will be placed to cover your stomach area.

After you are anesthetized, your doctor will make an incision in your abdomen – usually a horizontal incision (1-2 inches above your pubic hairline, sometimes called a “bikini cut”). Your doctor will then gently pull your abdominal muscles apart and bring them closer to your uterus. Another incision will be made in your uterus. This incision can be vertical or horizontal. Doctors often use a horizontal incision because it is more likely to result in a vaginal birth (VBAC), or cesarean section. After the incision is made, your baby will be gently removed. Your doctor will suction and clean your baby’s mouth and nose, clamp the umbilical cord, and cut it. You will be able to see your baby right away, just like during a normal delivery. After that, your baby will be cared for by a nurse or doctor for a few minutes. Next, the obstetrician will remove the placenta from your uterus and close the uterus with dissolvable stitches. The incision in your abdomen will be closed with stitches or surgical staples. These staples are usually removed painlessly after a few days. If your baby is doing well, you will be able to hold and breastfeed your baby in the recovery room. If you have to stay in bed, you may need someone to help you breastfeed your baby.

Will you feel anything during the surgery?

You will not feel any pain during a cesarean section. However, you may feel a pulling or squeezing sensation. Many mothers are awake during a cesarean section because they have regional anesthesia (an epidural and/or spinal block) that numbs only the area below the waist. This way, they can see and hear their baby being born. A screen will be placed across your abdomen during the procedure, but you will be able to look up and see the baby being taken out of your womb. Sometimes, a mother who is having an emergency cesarean section may need to be given general anesthesia. This means that the baby is unconscious (or "asleep") during the birth and will not remember or feel any pain.

What are the risks of a cesarean section?

Cesarean sections performed today are generally safe for both mother and baby. However, as with any surgery, there are some risks. Some of the possible risks of a cesarean section include:

• Excessive bleeding (very rarely, a blood transfusion may be necessary)
• Infection of the wound ( Antibiotics are usually given to prevent this)
• Damage to the bladder or intestines
• Adverse reactions to medicines
• Blood clots
• Death (very rare)
• Possible injuries to the baby

Both regional and general anesthesia used during a cesarean section are considered safe for the baby, but they can cause problems for the mother, such as nausea and low blood pressure. Babies born by cesarean section can sometimes have difficulty breathing (transient tachypnea of ​​the newborn). This is because fluid from the lungs is not properly removed during labor. This usually resolves on its own within a day or two. Having a cesarean section may or may not affect future pregnancies and deliveries. Many mothers can have a successful and safe vaginal birth (VBAC) after a cesarean section. However, in some cases, future cesarean sections may be necessary, especially if the incision in the uterus was made vertically rather than horizontally. Having a cesarean section can also increase the risk of placental problems in future pregnancies.

In the case of an emergency cesarean section, the benefits far outweigh the risks. A cesarean section can be life-saving.

What is the recovery period like after a cesarean section?

As with any surgery, there is some pain and discomfort after a cesarean section. The recovery time is also slightly longer than after a normal birth. Mothers who have a cesarean section usually stay in the hospital for about 3 to 4 days. Immediately after the surgery, you may feel achy, nauseous, or sore – all normal reactions to the anesthesia and the surgery. If you had to have a general anesthesia for an emergency cesarean section, you may feel sleepy, confused, cold, scared, anxious, or even sad. Your medical staff will give you medicine to help relieve any discomfort or pain. In the first few days and up to a few weeks, you may experience:

• Feeling tired.
• Pain around the incision (the doctor will prescribe painkillers, or tell you about over-the-counter painkillers that are safe to use if you are breastfeeding).
• Bloating and constipation.
• It's hard to move around and lift the baby.

It may help to hold your incision with your hand when you sneeze, cough, or laugh. These sudden movements can be painful. To avoid putting unnecessary pressure on your incision, you should avoid driving or lifting heavy objects for a while.Ask your doctor when you can resume normal activities (usually between 6 and 8 weeks, once your uterus has healed). As with a vaginal birth, avoid having sex until your doctor says it's safe to do so (usually around 6 weeks after your baby is born). Taking frequent, short walks can help reduce some of the pain and discomfort after a cesarean section. It can also help prevent blood clots and keep your bowels moving. But don't push yourself too hard – take it easy, move around, and have someone help you, especially when going up and down stairs. If you have other children, ask friends, family, or neighbors for help with meals and chores for a while. Breastfeeding can be a little painful at first, but breastfeeding on your side, in the clutch hold, or in the football hold can help reduce the pressure on your stomach. Drink plenty of water to help your milk flow and prevent constipation. Cesarean scars fade over time. They will shrink and become skin-colored within a few weeks or months after delivery. Also, because the incisions are often made in the "bikini" area, the scars are not visible.

What do you do if you don't feel well soon?

If you have any of these symptoms , call your doctor immediately:

• Fever.
• Signs of infection around the incision (swelling, redness, warmth, pus).
• A sudden, increasing pain around the incision or in the abdomen.
• A foul-smelling vaginal discharge.
• Pain when urinating.
• Difficulty defecating.
• Excessive vaginal bleeding.
• Pain, swelling, or redness in the legs.
• Difficulty breathing or chest pain.
• Pain in one or both breasts.
• Feelings like depression.
• Thoughts of harming yourself or the baby.

Psychologically, if you were expecting a normal delivery, or if you went through labor and ended up having a cesarean section, you may feel a little disappointed. Remember, having a cesarean section does not make your baby's birth any less special, nor does it make your efforts any less valuable. After all, you went through a major surgery to bring your baby into the world!

Take-Home Message

A cesarean section is a major medical procedure performed for the health and safety of both mother and baby. Sometimes it is planned, other times it is an emergency.

You won't feel any pain during the surgery, and in most cases you'll be able to see the baby right after it's born.

It takes some time to recover after the surgery, and it is very important that you rest well and follow your doctor's instructions during this time. If you notice any discomfort or danger signs, see your doctor immediately. Finally, whether it is a cesarean section or a normal delivery, becoming a mother is an amazing experience. Best wishes for your journey!

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