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Medical technology and knowledge have made it possible for a very safe delivery for the mother and the baby through a c-section. According to history, the first C-section was performed by the Romans and Egyptians. Back then, the c-sections were performed dangerously without taking care of the mother’s health and hence causing the deaths of many mothers. 

In this article, Dr. Shweta Shah, one of the best gynecologists in Malad, Mumbai will discuss the procedure of a c-section also called cesarean delivery and its pros and cons. 

Read on to know more about c-section delivery,

What is a c-section?

Cesarean section, also known as a c-section, is a surgical procedure by which babies are delivered through an incision (a surgical cut) in the other’s stomach. This procedure is performed if the mother is at risk because of a vaginal delivery. 

Medical reasons for a c-section

According to the World health organization, a c-section must only be performed for a medical reason. Some c-sections can be performed on request by the mother, says Dr. Shweta Shah, one of the top gynecologists and obstetricians in Malad.

Some reasons include,

• Breech position: A breech position is when the baby is bottom first rather than the usual head first. Breech births have higher complications for the baby and the mother.
• Obstructed labor: It is considered obstructed labor when the baby cannot exit through the pelvis during childbirth. During an obstructed birth, the baby might not receive oxygen, resulting in death. Obstructed labor is also called prolonged labor wherein the delivery phase lasts for more than 12 hours.
  • Reasons for obstruction include:
    • Large and abnormally positioned baby – when baby’s shoulder does not pass below the pubic bone
    • Small pelvis – malnutrition and vitamin D can be the causes of a small pelvis.
    • Issues with the birth canal – if the mother has a narrow vagina.

• Fetal distress: It is called fetal distress when the baby is not receiving enough oxygen.
• Some characteristics determine fetal distress, such as the fetus’s movement, growth, and heart rate.
• Umbilical cord prolapse: When the Umbilical cord comes out with the uterus or before the uterus, it is called cord prolapse. The concern with cord prolapse is that pressure on the cord from the baby will compromise blood flow to the baby.
• Uterine rupture: Uterine rupture is when the uterus’s muscular wall tears during childbirth. 
• Placenta problems: 
  • Placenta praevia (when the placenta is near or over the cervix).
  • Placental abruption (when the placenta separates before childbirth).
  • Accreta (misplaced or abnormally placed placenta).
• Tachycardia: A heart rate exceeding the normal (100 beats per minute) is called tachycardia.

Procedure of C-section

The decision to have a cesarean is also called a planned cesarean. C-section can also be performed in emergency cases or if complications arise during labour, says Dr. Shweta Shah, one of the top gynecologists and obstetricians in Malad.

Below we’ll see the steps carried out during a C-section,

1. Anesthesia

Before the surgery, the doctor will give you anesthesia, also called an epidural. Epidural is regional anesthesia, meaning you will not feel any pain but will be awake during the surgery to witness your child’s birth. Anesthesia can take 20-30 minutes to administer; the numbing will happen quickly. 

2. Initial incision

The doctor will then make a horizontal incision (across the lower abdomen, below the belly button, and just above or below the start of pubic hair).

If an emergency or a complication arises, the doctor will make a vertical incision so the baby can be delivered quickly.

3. Follow up incision

The doctor will then make further incisions through the skin, fat, abdomen, and reach the uterus.

4. Suctioning of the amniotic fluids

After the doctor reaches the uterus, he will remove the amniotic fluids(Amniotic fluid is a clear, slightly yellowish liquid that surrounds the unborn baby during pregnancy). 

This will allow the doctor to hold and utilize the medical instruments during the surgery.  

5. Delivery of the baby’s head

The baby will most likely be in the pelvic area. Whatever part has entered the pelvis will be lifted out by the doctor. During this procedure, you might feel pressure, pulling, and even nauseous; this feeling will only last for a brief period.

Once the head is out, the doctor will suction the baby’s mouth and nose for fluids. In a vaginal birth, these fluids are removed during the labor itself. In a cesarean birth, the doctor has to remove the fluid. 

6. Delivery of the baby’s head and shoulders

Once the doctor removes the fluids, the doctor will try to pull out the rest of the body. Your doctor will gently maneuver the baby back and forth so that the baby will emerge fast.

The doctor will keep checking for any umbilical or any other complications. 

7. Baby’s birth

Your baby is finally here. The surgery might have lasted for 10-15 minutes. The baby will be given to you in a drape. The doctor will cut the umbilical cord, and then the baby will be placed in a warmer, where your baby will be suctioned again to clear the amniotic fluid. 

8. Delivery of the placenta

The placenta will be removed and examined by the doctor. Closing up the whole cut part of the abdomen takes up to 1 hour to complete. 

During this time, you can breastfeed the baby or hold the baby. 

9. Closing the incision

After the entire process, the surgeon will stitch your incision. The doctor will close the abdominal incision with staples or stitches. 

10. Recovery

You will have vaginal bleeding for two weeks which is normal. You’ll be recommended to stay at the hospital for 2-4 days. The doctor will watch you for an hour to see if your vital signs are steady and stable. 

Dr. Shweta Shah, one of the top gynecologists and obstetricians in Malad says during the first week, avoid any physical strain. Walking and moving around  is encouraged to promote quick recovery.