What is C section Delivery??

C section delivery is also known as Cesarean delivery.  It’s a surgical process where baby is taken through incision in the abdomen and uterus. Mother wont feel any pain during the operation but may feel the sensation like pulling & pressure and mostly awake to hear & see their baby being born. Usually mother's lower body numbed from the waist down by giving them regional anaesthesia(epidural & spinal block or combined regional anaesthesia). It’s a major surgery & takes longer time to heal then vaginal birth. Some women experienced long term pain & weakness after C-section. Cesarean delivery is generally avoided before 39 weeks so that child gets proper time to develop in the womb. In rare case if any complication arises then the c section performed before 39 weeks. Now its become a common procedure to deliver a baby.

Reasons For C-Section Delivery

Well C section could be planned or unplanned. In unplanned cases there are few risk factors involved because of which doctors decide for C Section.

  • Baby head is bigger than the birth canal.
  • If baby is in distress i.e. changes in baby's heartbeat
  • Abnormal position of baby where baby's buttock or feet enter the birth canal first or shoulder first which is also known as breech or traverse positions.
  • Early pregnancy complications
  • Problems with placenta such as placenta praevia(‘Low-lying placenta’ where the placenta covers, or reaches the internal os of the cervix), placenta abruption or placenta accerata.
  • Tachycardia(is a condition which exceed the normal resting rate) in the mother or baby after amniotic (water) rupture i.e water sac bust.
  • After water sac rupture the hypertension in mother or baby.
  • Pre-eclampsia is a pregnancy complication where a pregnant lady is having high blood pressure, protein in urine & swelling in their legs, feet & hands. It can be from mild to severe 
  • Prolapsed umbilical cord i.e. the cord slips through the cervix ahead of the baby.
  • Previous C- Section delivery
  • Mother has active genital herpes which could be transmitted to baby
  • Reduced oxygen supply to baby.
  • Baby's weight is more than 4.5 kg.
How C-Section Happen??
  • Before the surgery, doctors wont allow the pregnant lady to eat or drink anything for around six to eight hours. 
  • They prepared the pregnant lady by placing the intravenous (IV) in the veins in their arm or hand to provide fluid & medication which is required after the surgery. Also take blood sample to know the full blood count & blood group because in c-section the average blood loss is approximately 500-1000 ml. 
  • Catheter will be inserted into the bladder to drain it before caesarean to reduce the risk of bladder injury. 
  • Most caesareans are performed under regional, epidural anaesthesia or combined spinal & epidural anaesthesia (CSE) which numb the lower portion of the pregnant lady. This is generally injected to the spinal block. This is usually preferred because it allows mother to be in their sense or awake & interact immediately after the baby born. 95% regional anaesthesia is used for deliveries & most commonly used spinal & epidural or combined anaesthesia (CSE).


Operation Procedure

Now the operative procedure comes where several layers are needed to incision before get to the uterus. Doctor cleans the skin with antiseptic & antibiotics just prior to "skin incision".

Skin incision is generally done with either Pfannenstiel or Joel-Cohen these are both transverse lower abdominal skin incisions. Sharp & blunt dissection into the abdominal is  made through several layers as follows
  • Skin
  • Camper’s fascia (superficial fatty layer of subcutaneous tissue)
  • Scarpa’s fascia, (deep membranous layer of subcutaneous tissue)
  • Rectus sheath, (anterior and posterior leaves laterally, that merge medially)
  • Rectus muscle,
  • Abdominal peritoneum (parietal)
  • Finally the gravid uterus reveals
How is the incision performed?
  • The visceral peritoneum is incised which is covering the lower segment of the uterus & then it pushed down to reflect the bladder which holds the incision open by Doyen retractor. 
  • Beneath the line of peritoneal reflection, uterine incision is made on the lower segment of uterine segment which is a transverse curvilinear incision & it is extended digitally ( i.e. extension is made bluntly). 
  • After that the baby is delivered cephalic/breech from the pressure manually applied or pushing downward at the top of mother's uterus. 
  • Then delivery of placenta by controlled cord traction by Surgeon. After that the uterine cavity is ensured empty and then closed with two layers then the rectus sheath is closed & finally the skin either with sutures or staples. 
  • Dissolvable stitches(suture) are used to close the uterus. These stitches gradually dissolves as the incision heals & these sutures are made of those materials which a body can break down easily. These stitches generally takes about 6 months to completely dissolve. 
After C section, the doctors usually shifts the patient for almost 12 hours to ICU for observation & also monitor the vaginal blood loss. Observations are recorded on an early warning score chart. After 12 hours the patient shifted to a room where doctor encourage patient to walk within 24 hours. This short walk can help the patient to ease gas pain, prevent blood clot & helps in bowel movement. 

Right after surgery patient may not able to eat or drink anything so doctor will first see if your body is even ready for liquid diet or not because after surgery sometimes intestines are not actively moving food forward so initially doctor will ask you to follow a liquid diet for 2-3 days before eating solid foods. When doctor see patient body is ready for solid food then they allow them to eat. Eating, drinking & removal of catheter is encouraged to speed up the recovery.  

After C Section doctors encourage patients to drink as much water as they can & also ask to walk as much as possible & some very light exercises are also suggested to ease the abdominal pain like rotating your feet or gradually bend knee while lying on bed.