What is a Cesarean?

My wife and I are concerned about having a cesarean section for the birth of our child. What does a cesarean birth entail?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

The surgical technique for a cesarean birth involves a skin incision above the pubic hair line, or up and down below the navel.

Vessels are cauterized and the membrane over the organs is cut, revealing the bladder, which is separated off the uterus to expose the uterus itself.

The physician palpates the baby for position and to stay away from vessels and the placenta and makes a scalpel incision, suctions the fluid from the uterus and enlarges the incision with her fingers.

The baby's head (or whatever is presenting near the pelvis) is grasped and delivered in much the same way as it is in a vaginal birth.

The baby's mouth and nose is suctioned and then he is placed on the mother's abdomen. The cord is cut and the baby is handed to the nurse who dries and warms and suctions the baby. After the baby is dry and stable, the father may bring the baby over for the mother to see and touch.

The placenta is then manually removed and the contents of the uterus (mostly clots) are evacuated and bleeding is minimized. The ovaries, tubes and bladder are inspected and the uterus is checked for lacerations.

The repair takes three times longer than the birth, with the doctor taking care to repair the uterus and be sure that the abdominal layers are sewn in the appropriate order until the skin is finally stapled or sutured.

If a cesarean is done for failure to progress and the baby is doing well, time can be taken to administer epidural anesthesia or a spinal block. If the cesarean is an emergency, general anesthesia is often given.

Recovery times depend upon the amount of maternal effort and fatigue prior to the birth, the amount of blood loss, the condition of the baby (stress), the support of the father and family and the mother's physical condition prior to the pregnancy and birth.

If all is well, the recovery in the hospital takes three to five days with two weeks of rest and gentle exercises at home. During this time, her only responsibility should be care of the baby. If the mother is called upon to do much more, recovery time is often longer, bleeding is heavier and the risk of postpartum depression may increase.

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