Explanation about Cesarean Section
A Cesarean Section (C-section) is a surgery to deliver your baby through an incision in your lower abdomen.
Reasons for Cesarean Section
There are several reasons why a C-section may be necessary, such as:
- A previous C-section
- The baby is in breech position
- Signs of fetal distress
- Labor that does not progress
- Other medical reasons
Surgical Procedure
An incision will be made either vertically below the navel, or horizontally just above the pubic bone.
Usually, the uterus is opened with a transverse (horizontal) cut. If it is difficult to take the baby out, the physician may need to make a “reverse T” or vertical incision, but this situation is rare.
A horizontal incision is generally safer for future pregnancies, because it lowers the risk of uterine rupture. During surgery, a catheter will be placed in your bladder.
Anesthesia
Spinal Anesthesia: Most often, spinal anesthesia is used, which makes the lower body numb while you remain awake.
General Anesthesia: If spinal anesthesia does not work, general anesthesia may be needed.
Risks of anesthesia include nerve injury, bleeding, and headache. The most common complication after spinal anesthesia is headache. To reduce this risk, please avoid bending your neck as much as possible after the anesthesia. When getting up, try to rise using your whole back, keeping your neck straight.
Positioning during spinal anesthesia
Usually, we place the needle while you are lying on your side.
To make it easier, please bring your knees up toward your chest and round your back like a cat. This helps open the space between the bones of your spine so the needle can go in smoothly. Sometimes, we may also do this while you are sitting. In that case, please lean forward and round your back.
In both positions, just breathe normally and try to relax. Now let me explain how to position your body.
The spaces between the bones in your spine are usually quite narrow.
By rounding your back, those spaces open up and it becomes much easier and safer for us to place the needle. Round your back. Place your right hand on your thigh. Push your back out, bringing your knee as close to your belly button as possible. Do not twist your body, as this will prevent your spine from twisting. Tuck your left shoulder in as much as possible.
Risks of Cesarean Section
Possible risks include:
- Injury to bowel, bladder, urinary tract, or nerves
- Bleeding and the need for blood transfusion
- Infection or injury to the baby
- Temporary breathing problems for the newborn
- Blood clots (deep vein thrombosis, pulmonary embolism)
- Wound problems, such as reopening of the incision
There is a small risk of injury to the bowel, bladder, urinary tract, or nerves, but if this happens, the doctor will repair it immediately. In some situations, you may need support from a medical specialist, depending on your condition.
Blood Transfusion
In rare cases, a blood transfusion may be needed if there is heavy bleeding. Risks of transfusion include fever, rash, breathing problems, or, very rarely, infection.
If a blood transfusion is needed, we will prepare a consent form and explain it to you again. If the bleeding does not stop, there may be a need for an emergency transfer to another hospital for your safety.
Prevention and Care
Blood Clot Prevention: To prevent blood clots, we use elastic stockings, air massage devices, and sometimes medication.
Mother-Baby Contact
If your baby is doing well, we encourage early skin-to-skin contact between mother and baby during the surgery.
Father Involvement
After the mother has about two hours of early skin-to-skin contact, we would love for the father to also enjoy early skin-to-skin contact with the baby.
Video Resources
Learn more about skin-to-skin contact:
Skin to skin contact during Cesarean section (Yui Clinic, Okinawa Japan)
Early skin to skin contact with dad
Future Pregnancies
After a C-section, there is a small risk of uterine rupture in future pregnancies, especially with TOLAC (Trial of Labor After Cesarean). At our clinic, we do not perform TOLAC.
Some women may later experience infertility, heavy periods, or pain due to the C-section scar. Rarely, pregnancy can occur in the scar area, which can cause heavy bleeding.
If you become pregnant within one year after a C-section, the risk of uterine rupture is higher, so contraception for at least one year is recommended. There is no absolute limit to the number of C-sections, but generally three is considered the safe maximum.
If you and your partner wish, sterilization (tubal ligation) can be performed during the C-section.
Conclusion
This is the explanation about Cesarean Section. If you have any questions, please feel free to ask.
