What is a C-Section?

A C-section, or Cesarean section, is the surgical procedure used to deliver a baby or babies. It requires an incision into the abdominal area and into the uterus. Originally the option to perform a C-section was only exercised when a vaginal delivery would put the baby’s or the mother’s life or health a substantial risk. That has changed in recent years. Many women have opted for c-sections, their decisions having nothing to do with health risks. In 2004, 29.1 percent of all babies born were delivered by c-section in the United States. This is an increase of more than 40 percent since 1996.

Many experts think that up to one half of all c-sections are unnecessary. Thus, the U.S. government is trying to reduce that rate. Women need to be informed of the facts concerning c-sections before they deliver.

Types of C-Sections

An important distinction between the types of c-sections lies in the types of incision. The classical Cesarean section involves a midline longitudinal (up and down) incision which allows a larger space through which to deliver the baby. The incision runs from just under the mother’s belly button to just above the pubic hairline. However, it is rarely performed today because it is more prone to complications.

Most commonly used today is the lower uterine segment section. The incision is a traverse (running parallel above the pubic hairline) cut just above the edge of the bladder. With this procedure there is less blood loss and easier repair.

The emergency c-section is performed once labor has started.

A crash c-section is performed in an emergency, where complications present themselves suddenly during labor. In this instance, quick action needs to be taken to prevent the deaths of the mother and/or the baby.

A Cesarean hysterectomy includes the removal of the uterus. This may be due to stubborn bleeding or when the placenta cannot be separated from the uterus.

Porro’s Cesarean is a c-section followed by the removal of the uterus, ovaries, and oviducts. Or, a Porro-Muller c-section in which the uterus is lifted from the abdominal cavity before the fetus is extracted.

A repeat Cesarean is performed when a patient had a previous c-section.

Complications

Complications of labor and factors impeding vaginal delivery include:

• Prolonged labor or a failure to progress (dystocia)
• Fetal distress
• Cord prolapse
• Uterine rupture
• Placental problems (placenta praevia, placental (placenta lining has separated from the uterus), or placenta accrete (an abnormal attachment of the placenta to the middle layer of the uterine wall).
• Breech or transverse positions
• Failed induction of labor (induced labor)
• Failed instrumental delivery (use of forceps and other instruments)
• Overly large baby
• Umbilical cord abnormalities
• Contracted pelvis
• Pre-eclampsia (hypertension in association with high protein count in the urine)
• Hypertension
• Multiple births
• High risk fetus
• HIV infection of the mother
• Sexually transmitted diseases (STDs)
• Previous c-section

As you can see, there are many factors that can influence a physician’s decision to perform a c-section; not everything is cut and dry.The presentation of some of these complications will undoubtedly required a c-section, while some problems can be dealt with, allowing a vaginal delivery. Speak with your health care professional about any concerns you may have regarding c-sections.

Anesthesia

Both general (a state of total unconsciousness) and regional (body is totally numb, usually from breast bone through the legs) anesthesia are acceptable for use during a c-section. Regional anesthesia is preferred because it allows the mother to be awake and interact immediately with her baby. Regional anesthesia is less risky than general anesthesia. Regional anesthesia is used in 95% of c-section deliveries.

General anesthesia may be necessary because of specific risks to the mother or baby. Patients with heavy or uncontrolled bleeding may not tolerate the effects of regional anesthesia. General anesthesia is also preferred in very urgent cases, such as fetal distress, when there is no time to perform regional anesthesia.

Recovery

There’s just no way around it, giving birth is painful. In vaginal deliveries, some women experience long and dreadful labor. Some women sail through quickly with little more than cramps. It is the same with c-sections. For some, the very act of turning onto your side in your bed is excruciating. Some women sail through a c-section claiming it’s the only way to go. The fact is that a Cesarean section is major surgery and should be treated as such.