A caesarean birth (C-section) is a surgical procedure to deliver a baby by making an incision (cut) in the front wall of the mother’s abdomen & her uterus.
C-sections are recommended for women who carry high risk pregnancy, that is, the pregnancy in which either the mother or the baby is at risk of losing life or develop life threatening complications. Also some mothers prefer to go for C section to avoid the pain of normal vaginal delivery.
Some of the indications are:
Prolapsed cord (cord comes before the baby)
Disorders of placenta
Abnormal presentation of the baby – where head does not come out first
Pelvis is small & head of the baby is big
Uncontrolled hypertension of pregnancy
Too much or too less of amniotic fluid around the baby
C-section is performed by a trained obstetrician (the doctor who is trained for management of pregnancy & is able to perform normal &caesarean delivery) along with the team of anaesthesiologist (who is trained in giving anaesthesia), trained nurses & other operating room staff. A paediatrician or neonatologist (child specialist) is also present in the operation theatre to take care of the new born baby.
A C-section is performed in the operation theatre of delivery unit of the hospital. Spinal anaesthesia is given in the lower spinal cord (lower back), which makes the body numb from abdomen to feet, but the patient is awake during the surgery.
The numbness lasts for 3-5 hours, depending upon the type of anaesthesia used. General anaesthesia may also be given in some cases. The mother is shifted to the operation theatre for C-section.
Prior to the surgery, she is made relaxed by engaging her into a conversation & by telling her brief about the spinal anaesthesia and C-section.
The anaesthesia doctor explains about the spinal anaesthesia. The patient is made to lie down on the operation table, facing towards the wall.
Local anaesthesia is given on the small area on the back. Spinal anaesthesia is then given on that area with the help of spinal needle.
After the spinal anaesthesia, the patient is asked to lie down facing the ceiling.
If the C-section is an emergency, the time from incision to delivery takes about 2 minutes.
In a non-emergency, a C-Section birth can take 10 to 15 minutes, with additional 45 minutes for the delivery.
A catheter is inserted in the urethra to collect the urine. The area is shaved if required.
The doctor then cleans the abdomen with the antiseptic solution & covers the area with sterile drapes.
The doctor then makes an incision (cut) in the lower part of the tummy. It is either transverse (most common) or vertical. Then a cut is made in the uterus & baby is pulled out of the uterus.
The baby is shown to the mother & umbilical cord is clamped & cut.
The baby is handed over to the paediatrician or neonatologist. The baby either cries by herself/himself or is made to cry by the doctor.
After the ‘cry’, the baby is cleaned, weight is measured, respiratory rate is noted, and clinical examination is done & then wrapped in the sterile drapes and handed over to the mother.
In the meantime, Placenta is removed from the uterus & incisions are sutured.
The baby may be transferred to the neonatology unit for examination & observation.
After the procedure is over, the mother is shifted to the recovery room. After observation for a few hours, she is shifted to the normal room. No doubt the couple & the family are overwhelmed by the birth of the baby. However, you may feel tired.
Engorgement of breast may make you feel uneasy.
Women may experience mood swings/changes after the delivery.
You may feel pain at the incision site, for which painkillers are given at regular intervals.
Some patients may complain of nausea and vomiting, which is usually controlled by the medications. It usually takes 2-6 weeks for incisions to heal & recover from the surgery.
Mothers should take adequate rest, but start moving out of the bed from 2nd day of C-section. They should take good nutrition, and plenty of fluids. No prescribed medications should be neglected.
Risk and Complications
In majority of the cases, the C-section is safe. However, there are few risks either during the surgery or afterwards. Some of the complications are:
Anaesthesia related complications
Pain at the site of spinal anaesthesia
Injury to other organs (urinary tract)
Blood clot in lungs
Injury during delivery
Infection at the incision site
Severe pain at the incision site
Scar at the incision site
Will my husband be allowed inside the operation theatre?
Usually in the advanced Indian hospitals, husband of the lady is allowed inside the operation theatre. However, you should always confirm it from your doctor, if the hospital protocol permits so.
Can the 2nd baby be delivered vaginally after 1st baby was born via C – Section?
It is possible in some cases. You should consult with your doctor regarding the possibility of vaginal delivery after C-section.
What is the cost of C-section in Indian hospitals?
The cost of C-section varies with the type of hospitals. The cost is usually INR 70k - 1 lakh in Indian hospitals.
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