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Pregnancy

Are You Ready For A C-Section?

Planning or considering a caesarean section a.k.a C-Section as your birth plan? Here’s everything you need to know to help you better prepare for it, especially if you’re a first time mama. How different is it from natual birth and what are some major considerations to think about before a C-Section?

We spoke to Dr Arundhati Gosavi, Associate Consultant at NUH Women’s Centre to get all your burning FAQs about a caesarean section answered.

Q: What is a C-Section delivery and how different is it from a natural birth delivery?

C-Section is the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. A natural delivery is when the baby is delivered through vaginal route aided by effective uterine contractions.

Q: What are some reasons for C-Section deliveries?

There could be several reasons for Ceserean delivery.

A doctor may recommend a planned (elective) CS for the following reasons:

  • if the mother have had a previous cesarean with a rare type of “classical” vertical uterine incision or more than one previous c-section
  • when the placenta is low in the uterus and covers the cervix, the baby is in breech or transverse position
  • if the mother is carrying more than one baby and if the first baby if not in the head down position but mostly, higher-order multiples require a c-section
  • if the mother is carrying a very large baby or very small (growth restricted)
  • when baby is in breech position

The mother will also be recommended to have C-Section if she is HIV positive and have high viral load; she has genital herpes outbreak; or if the baby has some anomalies that may make the vaginal delivery unsafe for the baby.

An unplanned or emergency C-Section during labour may happen if the baby shows signs of distress or umbilical cord slipping out of cervix or there are sudden conditions compromising the mother’s heath, like massive bleeding.

Q: How long does a typical Caesarean delivery operation take?

A typical non complicated Cesarean delivery takes about 45-55 minutes on an average.

Q: What are some things first-time mums need to know about caesarean delivery?

  • Before the surgery, she would be asked to sign a consent form and make a final decision about the mode of delivery with her obstetrician.
  • She would need to fast for about 6 hours before the delivery. About 3-4 hours before the scheduled timing of her CS, she can report to the hospital. There, she would receive an antacid and anti-vomiting medication before the surgery. She would also receive anaesthesia so that pain is not felt during the delivery. A catheter will be inserted in the urethra to allow continuous drainage of urine.
  • During the surgery, she would receive IV antibiotic. The mother would be able to hold the baby once she is in the recovery or once her condition is stable. She would receive painkillers and generally be able to get out of bed within 12 to 24 hours and go home within three to four days after the delivery. Vaginal bleeding may be experienced about 4 weeks after her delivery.

Q: Is it true that once a woman has undergone a C-section delivery, she would not be able to give birth naturally in her next pregnancy?

No, this is not true. It depends on the type of scar on the uterus. Some complications, like uterine infections, that may happen during or after C-Section might cause the scar to poorly heal. Do seek the doctor’s opinion.

If she has only one previous uncomplicated C-Section with a horizontal lower uterine incision, and her baby is healthy and in a head down position, she may be a good candidate for a vaginal birth after caesarean, or VBAC.

Q: How much longer will a mum need to fully recover after a C-section?

She will be able to do most of her routine activities in about 2 weeks. There can be variations if the mother has any risk factors or if any complications happen during or after the delivery.

It will typically take 8 to 12 weeks to resume rigorous exercise and physically strenuous works.

Tips for mums who are considering C-Section

  1. Have a discussion with the doctor as they would explore the reasons for anxiety and address concerns.
  2. If C-Section is done for emergency reasons, mothers may not have as much time to accept the decision or have their concerns addressed. It is natural for them to be worried. However, the doctor will discuss with the mother in detail as soon as both mother and baby’s conditions are stable.
  3. Speaking to a woman’s emotional health worker or a relative or close friend who recently had a C-Section, and/or watching a C-Section video may be of help as well. However, bear in mind that every individual is unique.
  4. Most importantly, stay calm and happy during the delivery and in post-operative period as too much anxiety may affect the breast milk supply.

 

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