C-Section: Time to Make The Cut!

C-Section: If you were to crash a “mommy and me” playgroup, this is very likely what you would see: a gang of glassy eyed dazed women sporting stale and questionable attire encrusted with mysterious substances and, seated upon each of their laps, a sweet, chubby and healthy baby.

This forum is where mom’s regularly spill the grueling details of their birth.

Some birthing stories involve hours of harrowing pain and anguish as the mom powers through a natural medication free birth, while others share that they felt a mere tweak, gave a push, had a poop and welcomed their newest addition to the world.

The reactions to these stories are mostly of shock and awe, but given how Cesarean or c-sections are portrayed these days, any story about this – planned or unplanned – is often met with either:

a) Mewed sympathies; or

b) Poorly concealed disgust

My Short Personal Story Of A C-Section:

For the delivery of my baby girl, I had a unscheduled c-section.

Long story short, I would not dilate.

Nothing I did for roughly 15 hours helped me along.

I was dancing, squatting, every position I could muster on the medicine ball and just walking aimlessly… and no go.

I never dilated.

My water just broke and this little girl said, I’m changing my mind and I am not going to leave this comfy spot!

Of course, I was scared and wasn’t sure I wanted to be “robbed” of giving birth vaginally for my first baby.

But to quote my OB exactly, the safest ways to have a baby are:

1. Vaginal birth
2. Scheduled c section
3. Unscheduled c section

Number 3, I guess wasn’t bad.

My OB just simply asked me, “Do you want to have this baby now?” and by that time I was so exhausted, tired and nauseated, I just said…. yes.

Anani and I after birth

My newborn daughter, Anani, and I minutes after birth.

You can read about the details of my entire pregnancy and surgery here.

What’s So Bad About A C Section Anyway?

The truth is, no one really cares whether or not you have a c-section.

Yes, you will meet the odd person who will spew facts like how one in three babies today are delivered by c-section and how it’s all a huge conspiracy so that doctors can make more cash.

But if you rewound history and were able to view the birth tapes of families from fifty years ago, a lot more birth stories would have unhappy endings.

A lot of people seem to have forgotten that issues like breached babies, high blood pressure and prematurity often resulted in the death of the baby, the mom, or both and that these deaths have been largely eradicated because of c-section deliveries.

Why A C Section Should Be A Part Of Every Birth Plan.

There are so many birthing options available today that doctors and midwives ask parents to write down a “birth plan” prior to delivery.

From having your baby at home in your own bed on top of a tarp to giving birth in a birthing center in a tub to delivering in a hospital loaded up on painkillers, you and your partner can enjoy the birthing experience however you want it.

Or, at least how you hope to have it.

The unfortunate truth is that not everyone can have the birth they have envisioned for the past several months or years.

This is particularly true if you suddenly find yourself in an emergency situation and need to have an unscheduled c-section.

Some of the most common reasons for an unplanned c-section include:

  1. Your baby suddenly becomes distressed (i.e. a drop in heart rate)
  2. Your labor has been long and your cervix still has its “No Exit” sign illuminated in the doorway
  3. Instruments such as forceps have been unsuccessful (or you do not want to use them)
  4. A previous c-section scar is on the verge of tearing or has torn (this happens to one in two hundred women)
  5. The baby’s cord has become prolapsed

An emergency situation doesn’t need to crop up for a mom to be able to choose to have a c-section, however.

Below is a sweet story of delivery by an unplanned c-section: PurpleKisses1110

Planned or elective c-sections happen for a number of reasons, including:

  1. You’ve already had a c-section and enjoyed the experience
  2. Your baby is breached and external cephalic version (also known as “ECV”) is not recommended
  3. It’s a multiple birth and the first baby is not head down, is sideways, or continues to wriggle around and change position
  4. You are dealing with severe pre-eclampsia or eclampsia
  5. You have heart issues
  6. Your previous vaginal birth was traumatic enough to scare you away from an encore performance
  7. You were unfortunate enough to catch genital herpes for your first time in your third trimester

A c-section  may be part of your original birth plan or it may not.

But regardless of your plans, the reality is that a c-section is a life saving procedure for both mom and baby which should be considered and thought out before delivery day.

How Long Does C Section Take?

Whether you’re strolling into the hospital like a boss and ready to have this baby or are in the midst of a crisis situation, the typical c-section procedure is a tightly scripted procedure which will take only ten minutes to perform (followed up by a half an hour of stitching, but you’ll be too distracted “oohing” and “awwing” over your new baby to care).

Or in my case, I was in and out of sleep. I wish I could remember more of what went on.

What Happens During A C Section?

So what actually happens from “Point A” to “Point B”?

Step 1: The Routine IV

You’ll receive an epidural or a spinal block.  You’ll feel numb and wobbly, but you’ll stay awake throughout the procedure.

Step 2: The Shave And Cleanse

If necessary, your abdomen will be shaved and then washed with an antiseptic solution.

Step 3: The Catheter (AKA Why You’re Glad You Already Got That Epidural)

Operating room staff will  insert a catheter into your gladder and the sterile drapes will then be placed over your tummy.

At this point, your partner will likely enter from stage left in hospital garb and will begin telling cornball jokes or down you in annoying play by play commentary.

Tell them to sit down, hold your hand and be quiet if necessary (after all, you’re having a baby!)

Step 4: The Block

At this point a short screen will be used so that you cannot see your abdomen and so that the area remains sterile.

If you want to watch the action, add “placing a mirror in the room to watch” as part of your birthing plan, or ask that the doctor lift your baby up for a quick “peek-a-boo” when he or she enters the world.

Step 5: The Initial Meet And Greet

This is what it has all been leading up to, all forty weeks (or so): meeting your newest family member.

The surgeon will cut the cord, remove the placenta and then quickly check all of your reproductive organs to make sure they’re still cool after the surgery.

Absorbable stitches will be used to heal your uterus and either surgical staples or stitches will be used to heal your abdominal incision.

Below is a C-section delivery (Very Graphic! Beware.): r qutami

You may also receive antibiotics or oxytocin.

Your blood pressure, pulse, breathing rate and bleeding will be checked regularly while you and your partner become acquainted with the person who has been kicking your bladder and sending you to the toilet in embarrassingly short intervals for the past several months.

While we’re here, let’s share a quick dose of reality: your body just went through more than it has likely gone through.

We have all seen the movies where the parents fawn over their new infant for hours at a time, but you’ll likely feel incredibly worn out and want to get some shut eye.

Let your partner or family look over the new baby while you enjoy your much deserved siesta or ask for the baby to be taken to the nursery.

C Section Complications – How Safe Is This Incredibly Common Procedure?

C-sections are extremely safe, but just as with a vaginal birth, complications can and do happen.

Some of the most common complications include:

  • Negative reactions to medications or anesthesia
  • Blood loss
  • Infection
  • Blood clots

Other internal organs may be injured, such as the bladder or the bowel, though these injuries can almost always be treated with additional surgery.

It is also possible for the uterus to become irritated or inflamed (endometritis).

The greatest concern parents typically have when looking into c-sections is the effect it may have on their baby.

While babies born by C-section are at a higher risk of transient tachypnea (quickened breathing resulting from excess fluid in the lungs) this condition passes quickly (within a day).

Post C Section – The Cesarean Recovery Process

A lot of us have bore witness to the initial recovery stages of a c-section: we arrive at a friends’ home to meet the baby with a lukewarm lasagne and flowers, sit down for a cup of tea and watch the new mom flail while in mid-sneeze or mid-chuckle, desperately grasping for a pillow to press against her abdomen.

For the first four to six weeks, new moms who have had a c-section need to be very cautious and be vigilant in protecting the new scar in her abdomen.

The scar will be sore, which means you will need to take it easy and make sure that the wound remains clean, but you will also need to protect the area with a pillow when ever you are feeding and cuddling with the baby, suspect you may laugh (stick to dramas and documentaries), or think you may cough or sneeze.

To put it simply, treat your abs right. The less pressure they have to deal with right now, the better.

Pain relieving drugs are essential to your comfort, and don’t be afraid to take a stool softener that will help you do a number two.

Constipation is incredibly common after pregnancy and all new moms are full of dread prior to pushing out those first few poops after birth.

C-sections may be considered a major surgery, but when deemed medically necessary, they are likely the safest way for your baby to enter the world and for you to spend the rest of your life loving and agonizing over them (bonus points: your baby won’t be born with a cone-shaped head!).

Great video below for recovery: ErinandBaby

Moms and other individuals who have not lived your life may judge and call c-sections unnatural, but consider this:

  • vaginal deliveries are not always exactly natural themselves these days (vacuums?  Forceps? And who wants to undergo an episiotomy and have their undercarriage cut from point “A” to point “B” anyway?).

The best birth in everyone’s opinion is the safest birth, and if a c-section is what brings that happy and healthy new chubby cheeked family member into your life, then so be it.

Bit Of History: When Was The First Cesarean Section?

There really is no way to be sure when or how the term of “Cesarean” came about or who even decided to cut open a woman to get the baby out.

c section history

Find all parts of this story here at the National Library of Medicine.

C Section Scars:

Going from this (not my personal photo):

c-section delivery

image credit to: Francois Etienne du Plessis

To the end result of a c-section scar: Below is my personal scar after 10 months as of April 1, 2016 – Not too bad.

My c-section scar 10 months later

Check out this c-section photo gallery here from: Baby Center

How Many C Sections Can You Have?

2 Key Risks That Can Occur With Multiple Caesarean Sections:

When it comes to caesarean sections (C-sections), there’s no limited to the amount of times one can be performed on you. However, the more C-sections you have, the higher the chance for complications and the longer each one will take to complete.

2 Key Problems That Can Develop From C-Sections:

Scar Tissue and Adhesions – Each time you have an operation, scar tissue will develop. All C-sections can lead to adhesions forming during the healing process.

Adhesions can cause your stomach’s organs to connect to one another or to your stomach wall and can result even if you have multiple C-sections.

46 percent of women tend to have adhesions after one C-section. 83 percent of women have them after three caesareans.

Another reason adhesions are so problematic is that they reduce the moment of your organs. It can also result in bowel obstruction.

And, it can also lead to problems with fertility, blocking or putting pressure on the fallopian tubes.

If you’ve got a numerous amount of scar tissue and need a C-section, your obstetrician may have a hard to making an opening in your womb.

This could result in a longer operating time and raises the risk for your doctor accidentally cutting into the bowel or bladder.

Blood Transfusions

If you’ve had multiple C-sections, you may need a blood transfusion. Each time you have a C-section, the chances for complications increases. It also causes problems with the placenta, which include:

  • Placenta previa (low-lying placenta)
  • Severe placenta accrete (placenta attaches to the muscle around the scar)

In cases like these, it can be difficult to take out the placenta after the birth, which can lead to serious bleeding. A worst case scenario is a hysterectomy (womb removal). While the chance for this happening is rather low, each C-section increases that possibility.

Be mindful of this if you want to have more children.

The only time a C-section should be performed is when there is no other choice for it. It’s a surgery, and it carries some inherent risks.

What You Should You Consider Before Getting Pregnant and Giving Birth

If you’ve already had a caesarean birth, it may be best that you talk to your doctor on the best way to proceed for your next baby. Factors that are often considered include:

  • Reason for prior C-sections
  • Age
  • Fertility history
  • Medical history

It’s also a good idea not to have babies back to back, so that your body can fully heal from a C-section. A two-year wait is typically recommended.

What Is A Planned Repeat Caesarean?

A planned repeat C-section is when you’ve decided, while pregnant, that your baby will be born by C-section.

Keep in mind that approximately two-thirds of women who’ve done a C-section will try for a vaginal birth with their next child… and are successful.

Giving birth this way is called VBAC.

Of course, a repeat planned C-section is when your obstetrician decides you should have another C-section surgery or when you decide that it’s best you undergo the procedure.

When Should A Woman Consider A Repeat C-Section?

Your doctor may advise you to have a C-section if he/she deems it would be safer than the vaginal birth method.

Such cases include:

  • There are pregnancy complications – placenta Previa or the baby is lying breech (bottom-down position).
  • A previous C-section with a vertical cut to the womb. (This is known as a high uterine incision and is done in cases where the baby is lying crossways or is extremely premature.)
  • You’ve had at least two C-sections.
  • You experienced a uterine rupture during a labor.

Each factor increases the risk factor for a vaginal birth, but it’s still possible to do the VBAC procedure. If you really want to give birth to your baby through the vaginal method, you need to speak with your doctor about it and make sure you’re fully aware of the risks.

6 Drawbacks Of A Planned Repeat Caesarean

Each time you have a C-section, you increase your chances for major complications.

Such complications we talked about before can include:

Adhesions

These are bands of scar tissue that will develop while you heal.

Adhesions can cause the pelvic organs to stick to the stomach wall or one another. This is extremely painful. Half of all women who undergo a C-section will develop adhesions.

After two C-sections, the percentage increases to 75, and after three, that percentage increases to 83.

Scar Tissue

Scar tissue tends to develop after every operation, and will increase each time you undergo the procedure. With a lot of scar tissue, your doctor will have a hard time opening up the uterus, causing the surgery to go longer than expected.

It also increases the chance for your doctor to accidentally cut into your bowel or bladder.

Placenta Previa

Placenta Previa occurs when the placenta completely or partially covers the cervix, resulting in you undergoing a C-section. The possibility of this happening occurs for every C-section you have.

Placenta Accreta

This happens when the placenta has deeply embedded itself to the uterine wall instead of coming away after the birth. This will lead to bleeding, and is regarded as emergency surgical care due to the risk of life to you and your baby. This problem isn’t usually seen unless you’ve had three or more C-sections.

Hysterectomy

This operation involves the complete removal of the uterus.

Each time you have a C-section, you increase the chances for complications such as hysterectomy, blood transfusion and placenta accrete.

Breathing Issues For Babies

After a C-section, it’s not uncommon for babies to suffer with breathing problems. This is especially true when a C-section is done before 39 weeks gestation.

Your baby may need to stay in the NICU to help them with their breathing problems.  This tends to happen with multiple C-section births.

Several Benefits To Undergoing A Planned Repeat C-Section

Just as there are some negative points to undergoing a planned repeat C-section, there are also some advantages.

The chance for suffering with a uterine rupture decreases tremendously. A uterine rupture can put the life of your baby in jeopardy.

While it’s generally rate when the C-section is planned, it can occur in VBACs.

Planned repeat C-section timing can reduce the possibility of having a stillborn baby, which is an issue for women in late pregnancy.

With a planned repeat C-section, you reduce the possibility of the baby needing a bag-and-mask ventilation than you would with a VBAC.

There’s no contractions or pain women have during the VBAC but you will have a sore stomach and wound for a little while.

In short-term grand scheme of things, a planned repeat C-section decreases the chance for:

  • Stomach pain, pain from the stitches and bruising between the vagina and perineum (butt)
  • Heavy bleeding, occurring after the birth
  • Pee leakage when laughing or coughing (also called stress incontinence)

When looking at the long-term grand scheme of things, another C-section birth can protect your uterus from slipping into the vagina.

This is called a prolapse.

prolapsed uterus

There are other factors that can lead to a prolapse such as:

  • Previous vaginal birth
  • Number of babies you’ve had
  • Female family members – sister or mother – has experienced it
  • Your baby was big
  • You’re overweight
  • You’re constantly constipated

When you’re pregnant, your pelvic floor weakens and can cause stress incontinence, which is why you should do pelvic floor exercises – regardless of how you decide to give birth.

Another benefit is setting the date for when the baby will be born. This makes it easy for you to prepare yourself for the birth, especially if you need to set up care for other children. It also helps in planning for maternity and paternity leaves.

What Will Happen If Labor Starts Before You C-Section?

It’s quite possible to go into labor before you scheduled C-section date.

In fact, one in 10 women end up having this happen.

Should doctors confirm that you’re in labor, you may be rushed in for an emergency C-section. If you’re in the later stages of labor or your baby is being born before 37 weeks, your doctor may advise you to have a vaginal birth.

Your doctor will talk to you about this in order for you to understand what it all means for you and the baby.

Should You Have A Tubal Ligation After Your C-Section?

Before the doctor asks you if you want a tubal ligation, you need to think long and hard about this decision.

You should also consider the risks associated with it.

Your doctor may ask that you see a counselor to ensure you understand what you’re doing. You’ll need to give consent to the surgery a week ahead before it happens.

Doctors tend to wait on this option to ensure it’s really what a woman wants.

However, if it’s done right after the birth, the chance of it being more successful tend to be high.

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