What Is A Cesarean Section

What is a cesarean section? A cesarean section is the delivery of a baby through a cut (incision) in the mother’s belly and uterus. It is often called a C-section. In most cases, a woman can be awake during the birth and be with her newborn soon afterward. See a picture of a delivery by C-section. Indications for a Cesarean What are some reasons that would mean I would need a cesarean? Prolapsed cord (where the cord comes down before the baby), placenta abruptio (where the placenta separates before the birth), placenta previa (where the placenta partially or completely covers the cervix), fetal malpresentation (transverse lie, breech (breech can sometimes be managed by External Version, exercises or a vaginal breech birth), or asynclitic position), cephalopelvic disproportion (CPD, meaning that the head is too large to fit through the pelvis. This can also be over diagnosed, it can be caused by maternal positioning either from restraint to bed, lack of mobility or anesthetics.), maternal medical conditions (active herpes lesion, severe hypertension, diabetes, etc. (please note that these conditions do not ALWAYS mean a cesarean.)), fetal distress (This is a hot topic with the recent studies indicating that continuous electronic fetal monitoring increases the cesarean rate and does not show a relative increase in better outcomes. Discuss with your care provider how they define fetal distress and what steps are used to remedy the situation before a cesarean.), maternal exhaustion, and repeat cesarean, these are the main reasons for cesareans. Procedures for Cesarean What is the procedure for a cesarean? Some of these may go in a different order, and a few left out, but these are the basics: •

A catheter inserted to collect urine

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An intravenous line inserted

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An antacid for your stomach acids

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Monitoring leads (heart monitor, blood pressure)

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Anesthesia

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Anti-bacterial wash of the abdomen, and partial shaving of the pubic hair

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Skin Incision (vertical or midline(most common))

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Uterine Incision

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Breaking the Bag of Waters

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Disengage the baby from the pelvis

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BIRTH!!!! (Accomplished by hand, forceps, or vacuum extractor)

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Cord Clamping and cutting

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Newborn Evaluation

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Placenta removed and the uterus repaired

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Skin Sutured (Usually the top layers will be stapled and removed within 2 weeks.)

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You will be moved to the Recovery Room (If the baby is able s/he can go with you.)

Diagnosis/Preparation There are several ways that obstetricians and other doctors diagnose conditions that may make a c-section necessary. Ultrasound testing reveals the positions of the baby and the placenta and may be used to estimate the baby's size and gestational age. Fetal heart monitors, in use since the 1970s, transmit any signals of fetal distress. Oxygen deprivation may be determined by checking the amniotic fluid for meconium (feces); a lack of oxygen may cause an unborn baby to defecate. Oxygen deprivation may also be determined by testing the pH of a blood sample taken from the baby's scalp; a pH of 7.25 or higher is normal, between 7.2 and 7.25 is suspicious, and below 7.2 is a sign of trouble.