Cesarean Section and Delivery

There are times when a pregnant women will not be able to give birth to a baby vaginally. When vaginal births are too risky or the birth must happen very quickly, a cesarean section, or c-section, is chosen by the obstetrician for the safety of both baby and mom.

About 80% of cesarean sections are done for one of the following four reasons:

1. Repeat cesarean section
2. Abnormal labor progress
3. Non-Reassuring fetal status (some call it "fetal distress")
4. Breech (baby with head up/butt down)

Other reasons for a cesarean delivery include premature babies, placenta previa, abruptio placentae, high blood pressure, big baby, medical complications.

A C-section is a safe but major operation with few complications. There is nothing commonplace about opening the abdominal cavity in order to birth a baby and thus the safety and health precautions surrounding the C-section are very stringent. Often, the father will be allowed to sit in the room while the baby is born, but the surgical area will be protected from view by a drape leaving dad to sit with mom the entire time.

C-sections are often performed under so-called "regional anesthesia", either spinal or epidural anesthesia, with mom awake and able to talk and understand the entire procedure. Mom will often be sleepy or sedated to a point where she may appear groggy. The anesthesia used to numb mom will either be an epidural anesthesia or a spinal anesthesia. The epidural leaves the anesthesiologist the option to use more or less anesthesia as needed. The spinal, on the other hand, is a one shot delivery of anesthesia that cannot be controlled nor repeated.

During the cesarean section, the lower abdomen just below the bikini line will be cut from hip to hip. This cut is offically called a "Pfannenstiel incision" named after the obstetrician Hermann Joannes Pfannenstiel (1862-1909). It is more commonly called a “bikini cut” due to the fact that the resulting scar can be hidden when mom chooses to wear a bikini in the future. After the outer layers of the abdomen are opened, the obstetrician will quickly cut through the layers of muscle and connective fibers until the uterus is reached.

Once the doctor has reached the uterus, the time has arrived to introduce baby to the world. The obstetrician will cut through the uterus and break the bag of waters surrounding baby. The baby will be lifted from the abdomen, quickly shown to mom and dad and rushed off for the first tests of his or her life.

After the baby is removed from the belly, the obstetrician will then tend to mom. The uterus will be removed from the abdominal cavity and placed on the stomach or it may be left isnide the abdomen, and the placenta and any debris left from the weeks of gestation are removed. Once the uterus is clean, sutures will close the opening in the uterus. The doctor will suture the fascia surrounding the muscles and then the skin in order to completely close the wound.

After the surgery and post recovery, mom will be given an IV solution to help the uterus contract back to normal, pre-pregnancy size. This IV medication will cause cramping and may be slightly painful.

The recovery time after a C-section can range from 3 weeks to 12 weeks depending on the mom and the level of activity after the operation. Mom will usually stay in the hospital from 3 to 4 days after surgery to make sure there are no complications with the surgery and that the body is returning to normal.