What Are C-Sections All About?

What Are C-Sections All About?

October 2014

For all mums-to-be, it’s good to understand all the options when it comes to labour and your baby’s save arrival. Your midwife is the very best person to speak to for more information about this. Here, Project-B’s resident midwife, One Born Every Minute’s Gemma Raby gives us an overview of what caesareans are all about.

Gemma says: “Caesarean sections or ‘C-sections’ are common – with around 1 in 4 women having one each year. Out of these, around 40 per cent are planned (elective).  A caesarean is viewed as major surgery, so you are not immediately entitled to one should there be no physical or mental reason to have one.  Your midwife will discuss all the risks and benefits before a decision is made and if it’s a non-emergency then ultimately the decision will be made by a senior obstetrician, usually during an antenatal clinic appointment.

The majority of caesareans are done in an emergency situation – which usually happen when a normal vaginal birth would put you or your baby at risk.  There are varying degrees of this which are:

  1. You were planning a caesarean on a certain date, but your waters broke or you went in to labour before this.  Alternatively, you may have intended to give birth vaginally but your labour has stalled or is very slow, this could include Placenta Praevia where the placenta is covering the womb’s entrance or your baby is lying breech (bottom first).  In these cases, as long as you and your baby are well, your caesarean will go ahead within a few hours.
     
  2. There is a serious complication with either yourself or your baby during your labour but it is not immediately life-threatening.  In this case the caesarean will usually be done within about 75 minutes of the decision being made. 
     
  3. You or your baby face complication that is immediately life-threatening. This means your baby needs to be born as quickly as possible – which means this will usually happen within 30 minutes or less of the decision, depending on the complication.

The caesarean itself involves a specially trained surgeon cutting the front wall of your tummy and womb and removing the baby via this. Usually it takes 40-50 minutes but can be done quicker in an emergency.  Usually this is carried out under an epidural or spinal anaesthetic.”

The Baby Centre gives an excellent details overview of the whole caesarean procedure and is well worth a read here: http://www.babycentre.co.uk/a160/caesarean-section-overview#ixzz3DTuauIgM. Below is a summary of their article:

  1. Before surgery, you will need to change into a hospital gown, and remove all jewellery, though rings can be taped over. If you have a brace you'll need to remove it. 
     
  2. You will also need to take off make-up and nail varnish, so your skin tone can be monitored during the operation. If you have gel nail overlays, they will need to be removed with acetone remover. You won't be able to wear contact lenses. If you wear glasses, give them to your partner or midwife, so you can see your baby after the operation. 
     
  3. Your partner will in most cases be able to be with you during your caesarean, but will need to wear thin cotton theatre clothes and wear a mask, hat and special footwear. 
     
  4. You'll lie on an operating table which is tilted. This is so the weight of your uterus (womb) doesn't reduce the blood supply to your lungs and make your blood pressure drop

You'll then have:

  •  A blood sample taken, to check that you haven't got anaemia, as this means you won't be able to tolerate blood loss well.
     
  • A drip inserted into a vein in your arm, to give you fluids and drugs that prevent low blood pressure.
     
  • A regional anaesthetic that numbs your bottom half, via a spinal or epidural. It's safer for you and your baby than a general anaesthetic, which puts you to sleep.
     
  • A thin tube (catheter) inserted into your bladder via your urethra. Spinal or epidural anaesthetic can prevent your bladder from working properly, so the catheter empties it, ready for surgery. You won't feel it, due to the painkiller.
     
  • The area where the cut will be made shaved and cleaned with antiseptic.
     
  • White stockings, extra fluid, and blood-thinning injections to reduce the risk of a clot forming in one of your leg veins (deep vein thrombosis).
     
  • A cuff put on your arm to monitor your blood pressure, and electrodes placed on your chest to monitor your heart rate. You may also have a finger-pulse monitor attached.
     
  • A sticky plastic plate attached to your leg to act as a harmless earth for the electrical equipment used.
     
  • An injection of antibiotics to prevent infection.
     
  • Anti-sickness medicine to prevent vomiting.
     
  • Drugs, such as antacids, in case you need a general anaesthetic, to reduce the risk of pneumonia.
     
  • Strong pain relief during and just after the caesarean, as well as for any lasting soreness in the following weeks.
     
  • Oxygen through a mask.

Gemma goes on to say “In terms recovery, it is likely to take up to 6 weeks before you are back to normal, during which time you probably won’t  be able to drive, exercise or carry heavy things – possibly including lifting your baby in the days immediately after. Caesareans are classified as major surgery and require a lot of rest to aid recovery. Your hospital will give you painkillers to help with the discomfort and your midwife will show you how to clean your wound daily.  It’s advisable to wear loose comfortable clothes.

Second time around: 

Just because you’ve had a caesarean doesn’t mean you can’t opt for a normal vaginal birth with subsequent pregnancies.  Your midwife and healthcare team will talk through the options with you so the best decision can be made for the health and wellbeing of you and your baby.”

As always, we recommend you log on to the NHS for more general information and speak with your own midwife who is there to help you.  www.nhs.uk/conditions/caesarean-section