Caesarean section: how and when to do it, recovery, reviews

The happiest day in every woman's life is the day she becomes a mother. The feeling that a new little person has been born, who has been carefully carried under your heart for 9 months, who needs love and care, is simply indescribable. And even the problems that often get in the way of a pregnant woman are not able to overshadow this event. Some women, for various reasons, are not able to give birth naturally, so doctors, in order not to risk the lives of both the baby and the mother, prescribe a caesarean section. In what cases does this happen, how the operation is performed, how recovery occurs and much more - we’ll talk about all this today.

Indications for caesarean section

In practice, doctors are often faced with the fact that women in labor themselves want to prescribe a caesarean section. This is mainly due to the fear of pain that accompanies the process, and stories that it is with such childbirth that the risk of birth injuries is significantly reduced. And, paradoxically, women for whom such childbirth is indicated for health reasons resist the procedure with all their might, striving to bring the baby into the world naturally. After all, experiencing all the feelings of birth is incredibly pleasant.

We will disappoint those who think that a caesarean section is a simple birth and does not cause any harm. Yes, the woman does not feel the process of childbirth at all and does not experience any pain. But then, when the anesthesia wears off, all the sensations are released wholesale, so much so that some mothers cannot even move for several days. A caesarean section is a full-fledged operation, after which complications can also occur. A scar forms on the uterus, which can cause subsequent infertility or miscarriage. Of course, the risks are significantly reduced if the procedure is carried out in a good perinatal center and is handled by professionals. Considering this, asking for a caesarean section without indications is not at all as advisable as it might seem at first glance. It's a completely different matter when there are medical indications for this.

So, here are the cases in which experts obviously predict surgery:

• Placenta adherence. If the placenta is located below the uterus, then this threatens severe bleeding at the time of natural birth, which increases the risk to the life of both the baby and the mother. The operation itself can be performed at 38 weeks, and sometimes earlier, if circumstances so warrant, for example, bleeding from the vagina is observed.
• Early placental abruption, with its initially normal location. During the normal course of pregnancy, its detachment occurs after childbirth. However, there are cases when detachment occurs when the birth itself is still far away. The woman begins to bleed, which also poses a threat to the life of the mother and baby, so urgent surgery is required.
• In cases where the scar from a previous cesarean section is considered ineffective. This title is awarded to him if an ultrasound shows that the thickness of the seam is less than three millimeters, the contours are uneven and there are other defects.
• If there are two or more scars on the uterus, this increases the risk of uterine rupture at the time of natural childbirth, so specialists also prescribe surgery some time before the planned date of birth.
• The woman in labor has a very narrow pelvis, which makes it difficult for the baby to come out naturally.
• Deformed pelvic bones and the presence of tumors are also an obstacle to natural childbirth.
• Tumors in the uterus, ovaries, and pathologies of the pelvic organs can simply block the birth canal.
• Large fruit size. A baby is considered as such if he weighs 4 or more kilograms.
• The presence of symphysitis in an expectant mother is a divergence of the pubic bones. But in the presence of such a diagnosis, a cesarean section is not always necessary. A radical measure is taken only if: the child’s weight is over 4 kg, the discrepancy is over 1 cm, severe pain and a narrow pelvis of the expectant mother are noted.
• Uterine fibroids(multiple and large sizes).
• Presence of gestosis.
• Severe diseases of the heart, blood vessels, nervous system, diabetes, etc.
• Ruptures of the birth canal III at the time of previous vaginal births.
• Enlarged veins in the vaginal area.
• Pelvic or transverse position of the fetus.
• Long-term infertility in combination with pathologies.
• The age of the woman giving birth is over 30 years.
• Post-term pregnancy.
• Cancer, regardless of where it is located.
• Exacerbation of genital herpes.

The list is long, but these are not all the reasons. The listed points imply setting a date for a planned caesarean section. But it also happens that a woman initially planned to give birth naturally, but various kinds of problems force doctors to take emergency measures and perform a cesarean section at the moment of contractions. So, at the time of birth, a cesarean section can be done if:

• the baby cannot be delivered naturally, as the laboring woman’s narrow pelvis interferes;
• if the waters break, but labor itself does not occur;
• a woman cannot give birth for a long time, which begins to increase the risk of death of the baby;
• there are signs of baby hypoxia, which is determined by the baby’s rapid heartbeat, which does not stop;
• umbilical cord prolapse is observed - if a caesarean section is not performed urgently, the child is highly likely to die;
• improper placement of the fetus.

There are many reasons why a caesarean section may be prescribed, but only a doctor decides whether to perform an operation or give birth naturally, after conducting many tests. To avoid disastrous consequences, always listen to a specialist, because not only your health and life, but also that of your baby is at stake.

At what time is a caesarean section performed?

Caesarean section can be planned or urgent.  As soon as it becomes clear that the woman will give birth by cesarean section, the specialist sets an approximate date for the operation. But sometimes inconsistencies occur and contractions begin earlier than planned; in this case, an emergency caesarean section is organized.

In general, the timing is determined individually, but, as a rule, it is 39 weeks. If you have to undergo an urgent operation (when contractions occur) before this period, the baby may have breathing problems. But such cases more often occur with repeat cesarean sections.

How to do a caesarean section

Let us consider in general terms how a caesarean section operation proceeds.

Preliminary preparation

First comes the preparation. A pregnant woman, as a rule, is placed in a hospital in advance in order to carry out all the necessary examinations, to understand that the child has grown enough and is ready to be born. Most often, the operation occurs in the morning, so the last meal of the expectant mother should be no later than six in the evening on the eve of childbirth. This is done to ensure that the stomach is empty in order to avoid food entering the respiratory tract of the woman in labor. The next morning, all necessary hygiene procedures are carried out: enema, pubic depilation, changing into special clothes. This is followed by transport to the operating room. Before the operation, anesthesia is given, a catheter is inserted into the bladder (it is removed a few hours after birth), the stomach is disinfected and a screen is installed near the mother’s chest so that the latter cannot see anything.

Anesthesia for caesarean section

In terms of anesthesia, there is a choice: general anesthesia and epidural. The latter involves inserting a very thin tube through a needle into the exit site of the spinal cord nerve roots. It sounds creepy, but the woman feels discomfort literally within a couple of seconds when the puncture itself occurs. Then everything in the body below the waist is completely paralyzed. General anesthesia is applicable only in the most extreme cases, when doctors cannot wait for the first to act. Here everything is as usual - intravenous administration of preliminary anesthesia, then anesthetic gas with oxygen is injected through the tracheal tube, after which a special drug is injected that relaxes the muscles.

Caesarean section

Once the anesthesia has completely taken effect, doctors begin the operation. First, an incision is made in the abdomen. There are two types of incision: transverse (above the pubis) and longitudinal (from the pubis to the navel). The latter is done in emergency cases, when you need to get the baby urgently and quickly. After this, the doctor spreads the muscles, makes an incision in the uterus, and opens the amniotic sac. The baby is brought out, after which the placenta is removed. The uterus is sutured with self-absorbing threads, which disappear after a couple of months. Next comes the abdominal wall. Finally, a sterile bandage is applied and ice is applied to help the uterus contract faster, which also helps stop bleeding. The duration of the operation is about twenty to forty minutes, and the baby itself is born already on the tenth day, and sometimes earlier.

During the day after the operation, the young mother is in the intensive care unit, and doctors carefully monitor her condition. After which, if everything is fine, the woman is transferred to the ward. To ease the pain in the postoperative period, mommy is given painkillers and drugs that help the uterus contract and normalize the functioning of the gastrointestinal tract.

If the operation itself went without complications, then doctors allow the woman in labor to get up after six to seven hours. First, carefully sit down on the couch, and then stand for a while. It is strictly forbidden to strain or do even the slightest physical activity, as this can lead to the seams coming apart.

The expectant mother should buy a special bandage in advance, which will significantly alleviate the condition after the operation.

Caesarean section: pros and cons

Let's look at the main pros and cons of a cesarean section. Pros:

• During an operative birth, there are no injuries to the birth canal, such as incisions and ruptures.
• The duration of the birth itself practically does not exceed forty minutes, and there are no contractions or pushing. While natural childbirth can last for hours, or even days.

As for the minuses, these are:

• Psychology - some mothers complain that they do not feel unity with the baby; there is no strong feeling that now they feel like full-fledged parents.
• Severe pain that comes after the anesthesia wears off.
• A scar on the stomach that lasts for life.
• There are more chances of complications occurring since a full-fledged surgical intervention occurs.
• For one and a half months you cannot take a bath, only shower.
• Problems with lactation often occur.

Belly after caesarean section

After a caesarean section, ladies are concerned about how to get rid of their belly fat. The process is complicated by the fact that for quite a long time all physical activity is prohibited. So, in order to get closer to the previous ideal and return your tummy to its attractive appearance, you can adhere to the following rules:

• In no case should you start exercising after a caesarean section earlier than two months later; in some cases, recovery takes longer. Before starting classes, you must consult with a supervising specialist. He will assess the current condition and make recommendations. Even if the go-ahead is received, the loads must be started gradually.
• Even simple walks with your baby can be used as a way to get in shape. Walk moderately but briskly for about an hour a day. This way you will “kill” two birds with one stone: both the baby will breathe fresh air and your muscles will sooner become toned.
• It is better to start physical activity with simple bends. Everyday things can be done differently. For example, wash not in a washing machine, but by hand, wash the floors not with a mop, but with your hands.
• As soon as your baby gets older (about three to five months), start playing with him in a way that uses his muscles. For example, lie down and place your baby on your chest and begin to rise a little. This way the abs will sway and the baby will have fun.
• Maintain proper nutrition. This will normalize the functioning of the gastrointestinal tract and not gain weight.
• Wear a bandage, it significantly helps speed up the process of shaping your belly.

Suture after caesarean section: photo

Recovery after caesarean section

After the operation, pain relief is provided for several days. In order to prevent blood stagnation, it is necessary to ensure the movement of the body: first it will be turning over on the bed, and then it is permissible to stand up. 6-7 hours after the operation, you need to start therapeutic exercises, which the doctor will tell you in detail - this is stroking the abdomen, chest, lower back, etc.

You can take special food and switch to a normal diet only from the fourth day. Discharge from the hospital usually occurs only on the seventh day. By this time, it is permissible to take a warm shower with baby soap. Baths are strictly prohibited for two months.

After discharge, it is very important that relatives take over all housework during recovery. Bathing the baby, changing his clothes and other manipulations should be done in such a way as not to bend over, so it is recommended to get a high changing table.

The following are strictly prohibited:

• lifting weights, over four kilograms (if the baby is pressed to the chest, then you can carry it);
• colds - so you need to dress warmly and take care of your health;
• sexual life - until the lochia stops coming out, and this is about eight weeks.

After discharge, listen carefully to the doctor, who will definitely give recommendations for a speedy recovery, taking into account your current condition. Coordinate any action with your gynecologist in order to avoid complications and disastrous consequences.

What to eat after a caesarean section

The doctors themselves advise the mother about nutrition. As a rule, on the first day you should not eat anything at all, just drink water. All nutrients enter the young mother’s body exclusively through injected medications.

If the operation went well, then on the second day broths, dietary meat (only boiled and always pureed), various drinks (fruit drinks, juices, decoctions), cottage cheese and yogurt are considered acceptable.

The third day may include cutlets and meatballs made from lean meat, porridge cooked in water, kefir, and baked apples. Consult with a specialist about subsequent nutrition in order to make it as complete as possible.

Sports after caesarean section

The introduction of sports into everyday life should happen very smoothly, but not earlier than after a couple of months. Always coordinate everything with your doctor. It's best to start with the usual morning exercises which will tone the muscles. If you overdo it ahead of time, the sutures on the uterus and abdomen may come apart, which will have disastrous consequences.

Discharge after caesarean section

In the first week after the CS, bright burgundy clots appear, these are lochia and this is normal. When the baby is feeding, the discharge may increase - this is also normal, as the uterus contracts. Already on the fifth to seventh day, the discharge is significantly reduced and becomes mostly spotty. Over time, they will become lighter and acquire a slimy texture. In a healthy body, after two months only leucorrhoea should be released.

If there is no discharge at all, you need to urgently consult a doctor; this may indicate a bend of the uterus or a spasm, which provokes stagnation of blood. Heavy discharge should also be a reason for contacting - this can be a signal of inflammation, especially when everything is accompanied by fever and poor health.

Listen to your body, if you have the slightest problem, don’t think that it will “go away on its own” - be sure to go to the doctor. The recovery period after a cesarean section is a crucial period when you need to be very attentive to yourself and your health!

Pregnancy after caesarean section

One of the disadvantages of a cesarean section is that doctors do not advise planning a second pregnancy earlier than two to three years later. During this time, the body has time to rest, renew itself and return to normal. But who actually listens to doctors? And in general, rarely does anyone plan pregnancy; it often comes as a surprise from above. General and specific recommendations for planning subsequent pregnancies are given on an individual basis by doctors who make conclusions based on the condition of the woman in labor.

Early pregnancy is fraught with negative consequences for both the child and the mother. The scar itself will not have time to heal and will be insolvent, which will lead to uterine rupture either during pregnancy or at the time of birth itself. If, despite all the warnings, a woman still becomes pregnant, then, most likely, doctors will suggest an abortion in order to prevent complications. And here the decision is made only by the mother herself. In fairness, it is worth noting that in practice, there are known happy cases of carrying babies whose conception occurred a month after a cesarean section. But these are rather exceptions, so you should not rely on luck, but make an informed decision.

In the process of conception itself, problems can arise only in cases where the operation was performed unprofessionally and doctors made mistakes, or in the presence of complications. In general, no matter how scary it may sound, after such an intervention even infertility can occur, so choose your maternity hospital carefully, fortunately, the birth certificate allows this.

Natural birth after caesarean section

Natural birth after cesarean is possible only in cases where the incision was made in a classic way (horizontally), there were no operations on the uterus (except for the cesarean itself), there are no serious diseases, and the institution where the birth is planned employs highly qualified specialists. It is also worth understanding that if you have previously had several caesarean sections, then natural childbirth is no longer recommended.

In practice, doctors themselves rarely allow natural birth after the first cesarean section. This is due to the risk that occurs in such situations. And, in order not to “play” with the life and health of the mother and baby, the secondary and subsequent births are organized in a manner similar to the first.

In any case, this is not a whim of the doctor, but is far from being an extra safety net, so you should not interfere with the actions of specialists and do not stand your ground, no matter how much you would like to give birth to a baby naturally.

Sex after caesarean section

After a natural birth, a ban on sexual relations is quite logical, because the vagina needs to recover. What after cesarean? After a caesarean section, similar rules apply. Many people believe that since the vagina was not used during childbirth, it means there were no injuries, therefore, sex can happen as soon as the desire arises. But no!

Yes, the birth canal is unaffected, but... Firstly, even with CS, discharge is observed for some time afterward, and you must wait until it stops. Secondly, the uterus was injured, and there is now a scar on it that needs to heal. Sex is the same physical activity, albeit more pleasant, and at the moment of orgasm the uterus contracts. Such an impact on an organ that has not yet healed can turn out to be extremely unpleasant, even to the point of the sutures coming apart!

Many people are concerned about sensations: whether they change; does it hurt? In fact, it is impossible to answer this question unequivocally, which is due to the characteristics of the organism. Almost everyone talks about unpleasant sensations; some even feel pain that does not go away for a long time. Hormonal changes are unpredictable and can have different consequences. A common problem that entails pain during intimacy is the lack of natural lubrication, which is precisely due to the “play” of hormones. As doctors say, there is no need to panic about this; after the cycle is restored, everything returns to normal.

But in any case, it is better to consult a doctor who will give recommendations on resuming sexual activity.

Caesarean section: reviews

A caesarean section should not be taken as an ordinary procedure - it is a full-fledged operation, during which anything can happen. Therefore, the doctor and medical staff who will participate in the process must be highly qualified so as not to harm either the mother or the baby.

As for the reviews of mothers, they are all different. On the Internet you can find truly horrifying reviews that bring tears to your eyes, but, fortunately, there are many more happy stories. There are a lot of complaints during the postpartum period and terrible pain from internal and external stitches. Those women who, in addition to cesarean, have had experience of natural childbirth, if possible, are not advised to choose a CS, but to give birth in a normal way. But often the type of birth is not chosen, but rather one accepts what is destined.

Take care of yourself, have an easy, quick and safe birth and a healthy baby!

In the video you can see in detail how a caesarean section occurs. This is truly unique footage of how, thanks to the professional actions of doctors, healthy babies are born and there are more and more happy mothers in the world.