What is Cesarean Delivery?

Cesarean Birth

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What is Cesarean Delivery?

Cesarean delivery; It is the removal of the baby from the incisions made in the abdomen and uterus, that is, the delivery by surgical method. Since cesarean delivery is performed under anesthesia, the mother does not feel pain during the operation.

During the procedure, epidural or spinal anesthesia is given and the lower back is completely numbed. General anesthesia can also be performed if deemed necessary.

Cesarean delivery; It is a birth method that the doctor who follows the pregnancy process decides, taking into account the health of the mother. However, in some cases, a cesarean delivery can be made due to complications that occur during normal delivery.

Therefore, instead of making a comparison between cesarean section and normal delivery; It is necessary to decide on the appropriate delivery method, keeping the health of the mother and baby in the foreground.

What are The Preferred Situations for Cesarean Delivery?

  • Progression of Birth:

Cesarean section is preferred in cases where the cervix (cervix) is not dilated enough for birth despite the strong contractions in the mother continue for hours. Failure to progress in labor is one of the reasons why cesarean section is preferred.

  • The Baby’s Stress:

A change in the baby’s heartbeat can be a sign that the baby is under stress. Again, the baby’s lack of oxygen also puts the baby under stress. In such cases, the doctor may decide that a cesarean delivery is a better option.

  • An Abnormal Position of the Baby in the Womb:

As you get closer to birth, the baby moves into a head-down position in the womb. However, some babies may have trouble positioning. In these babies; Foot (breech position) or shoulder (transverse position) may come to the lower part of the uterus, that is, the first part of the body that will emerge at birth. Problems in positioning may also cause cesarean delivery to be preferred.

  • Multiple Pregnancy:

In multiple pregnancies such as twins and triplets, babies may have problems with positioning. Therefore, cesarean delivery may be a safer option in multiple pregnancies.

  • Placental Diseases:

Cesarean delivery is preferred in cases such as placenta previa, where the placenta is located in the cervix.

  • Umbilical Cord Problems:

Cesarean section may be a safer method of delivery when problems such as entanglement in the umbilical cord are encountered.

  • Mother’s Health Problems:

A cesarean delivery can be performed if the mother has a serious illness in vital organs such as the heart and brain. Again, active genital herpes infection in the mother during delivery may also require cesarean delivery.

  • Narrow Birth Canal:

In cases such as hip fracture, the presence of large fibroid tissue, which will cause narrowing of the birth canal; vaginal delivery can be difficult. Again, if the baby’s head or itself is larger than normal, it also makes vaginal delivery difficult. In such cases, cesarean delivery may be considered a better option.

  • Previous Cesarean Delivery:

In women who had a previous cesarean delivery; Depending on the incision made for the cesarean section and other factors, cesarean delivery may be repeated. Although cesarean section is not a necessity for mothers who gave their first birth by cesarean section, cesarean section is usually repeated in practice.

When is Cesarean Delivery Performed?

There are some situations in terms of mother and baby so that cesarean delivery can be preferred. The evaluation of these conditions is made by the doctor monitoring the pregnancy. It is possible to examine the cesarean delivery as the reasons originating from the mother and the baby.

What Are The Maternal Causes?

The health of the mother is very important for a healthy pregnancy process. Of course, in this case, genetic factors are also very effective. Cesarean delivery can be performed by evaluating the physiological and genetic condition of the mother.

  • When the reasons arising from the mother are evaluated, the previous uterine surgeries or cesarean deliveries come first. The opinion among the public that cesarean delivery is required after all uterine surgeries is a wrong approach.
  • However, there is a risk if the previous operation is an operation that may cause the uterus to rupture in normal delivery. Operations in which fibroid structures larger than a certain size are removed by cutting the uterus may be included in the risk group. It also poses a risk in surgeries where the uterus is opened and re-sewn.
  • The presence of conditions in the mother’s medical history that may prevent normal delivery may also require cesarean delivery. Especially advanced lumbar hernia is one of these obstacles. In addition, orthopedic and neurological diseases that may cause limitation of movement in the pelvic bones of the mother may also pose an obstacle for normal delivery.
  • Another situation that cesarean delivery can be preferred is the HPV virus. Depending on the HPV virus in the mother, warts may occur on the genital organs. This is a risky situation for normal birth to occur.

What Are The Causes Of Baby?

Cesarean delivery can be planned in order to prevent all the risks that may occur in normal birth due to the baby.

  • The most important reason related to babies is the baby coming upside down. In normal birth, the head of the baby should come out of the uterus first. The reverse of this situation creates risks at birth. Cesarean section is performed in order to prevent possible risks.
  • If the baby weighs more than 4.5 kilograms or if the mother has diabetes, the baby weighs more than 4 kilograms, which may require a cesarean delivery. Because these babies are likely to be attached to the uterus during normal delivery.
  • If the doctor who performed the birth thinks that the baby may be without oxygen due to some reasons during normal delivery, a cesarean delivery can be made. Because the baby’s not getting enough oxygen during birth can cause permanent diseases and even stillbirths.
  • It is possible for the doctor to plan a cesarean delivery against possible risks in twin births.
  • Cesarean delivery can be performed due to the closure of the birth canal by the placenta or all other abnormalities related to the baby.

At What Week Does Cesarean Delivery Occur?

The cesarean delivery plan is determined by the doctors. For this reason, cesarean section can be performed on a date that the doctor deems appropriate, without waiting for normal labor pains.

However, in order for the baby to be born in a healthy way, of course, it must have completed its development.

The baby’s growth process is followed month by month by the doctor and this information is taken into account when making the cesarean section decision. However, if we say in general; We can say that a cesarean section is performed at the 39th week of pregnancy.

How Long Does Cesarean Delivery Take?

Caesarean section is a surgical procedure that takes between 30 and 40 minutes. However, before this process, it is expected that the expectant mother will be prepared for surgery and the necessary anesthesia will be given.

For this reason, the cesarean section may take longer. Caesarean section is performed by an expert gynecologist (gynecologist and obstetrician). In the operating room, there are surgical nurses, anesthesia technician and anesthesiologist besides the doctor.

How Does a Cesarean Suture Work?

After the cesarean section, various cesarean suture methods are applied to close the cut tissues.

These sewing techniques are:

  • Aesthetic Cesarean Suture Applied Under the Skin:

It is not possible to see this seam from the outside with the naked eye. Self-dissolving sutures are used. It heals without a trace.

  • Staple Stitch:

It is applied one by one on the skin. It is taken after a certain period of time after the operation.

  • Thread Cesarean Stitch:

It is the classical cesarean section method applied on the skin. It does not dissolve on its own.

  • Adhesive Tape (Strip) Stitch:

Healing is achieved by combining the wound edges with a thin transparent tape.

What are The Advantages and Disadvantages of Cesarean Delivery?

Advantages of Cesarean Delivery:

  • It is the birth where the baby is born with the least risk.
  • Encountering risks is very rare.
  • Birth time is much shorter.
  • Since the mother will receive local or general anesthesia, she does not feel pain or pain.
  • Since the baby is brought to the world by being taken from the abdomen, not by advancing in the uterine canal, there will be no deformations in the uterine region.

Disadvantages of Cesarean Delivery:

  • While it does not pose much of a risk to the baby, it may pose a risk to the mother.
  • Various complications may develop.
  • Since open surgery is performed, there is a risk of infection.
  • Organ injuries may occur.
  • A hernia may occur in the operation area.
  • Recovery occurs much later than normal delivery.
  • Adhesion may occur in the abdomen due to the surgery.
  • The baby’s communication with the mother is delayed.
  • Infants have a higher respiratory distress rate.
  • The baby’s breastfeeding success will be lower.

How is Caesarean Done?

Following hospitalization, a special needle and catheter are usually placed in a suitable person in the veins in your arm to administer serum and medication intravenously. Certain medications may be given to reduce stomach acid and fluids in the mouth and nose.

In this process, your baby’s and your condition will be checked and you will be taken to the operating room when you are ready. Rarely, a catheter may be placed in the bladder before going to the operating room. However, the catheter is often applied in the operating room after the patient is anesthetized.

Generally, 2 types of anesthesia are used in cesarean section:

It is regional (Epidural or Spinal).

It is applied more frequently than general anesthesia. In both procedures, following an injection from the waist, the waist down is anesthetized.

  1. Epidural Anesthesia:

It is possible to give continuous painkillers through a tube advanced through the spinal column and to prevent pain after cesarean section. In epidural anesthesia, the legs can also be moved.

  1. Spinal Anesthesia:

A needle is made from the waist. However, in this form of anesthesia, the waist down is both numb and it is not possible to move the legs. This drowsiness and immobility completely disappears a few hours after the surgery.

  1. General Anesthesia:

  • The patient is completely asleep. Since there is no consciousness in this deep sleep state, the patient’s breathing is supported by support. For this reason, a tube is placed in the patient’s trachea and breathing is provided. In some patients after the surgery, burning in the throat, feeling of swallowing and coughing develop due to this tube placed in the trachea.
  • In cesarean section, the incision is made from the panty line, just one or two cm above the hairy area in the groin.
  • Rarely, a perpendicular incision can be made in the midline towards the navel, but today this type of incision is used only in special cases.
  • The uterine incision is made in the same way as the skin, transversely and from a point close to the lower part of the uterus.
  • With this cure, less bleeding occurs with an incision, and the possibility of uterine rupture in the next pregnancy is reduced. Rarely, a vertical incision can be made from the apex of the uterus down.
  • It can be used in situations where the baby needs to be reached quickly or in some situations where the baby’s partner is located in the front incision line.
  • After the uterus is opened, the baby is reached and within a few seconds the baby is taken out of the uterus and the umbilical cord is cut. After the baby is born, the baby’s partner is taken out of the uterus, the inside of the uterus is cleaned and the uterus is closed with stitches. Subsequently, the other incisions made in the abdomen are repaired with the help of stitches and the last skin incision is closed and the surgery is terminated.

What Are the Risks and Complications for the Mother in Caesarean Section?

The majority of these risks are general risks in abdominal surgery.

  • Infection:

It can be at the incision site, uterus, and other pelvic organs.

  • Bleeding and Blood Loss:

There is more bleeding in cesarean sections than in vaginal delivery. Approximately 6 out of 100 women are given blood.

  • Organ Injuries:

It is more common in organs such as the bowel and bladder, especially in surgeries after the first.

  • Adhesion:

There may be adhesions at the surgical site and to the operation site. This increases the risks of placenta previa and placenta abruptia in future pregnancies.

  • Long Stay in Hospital in Caesarean Section:

Longer hospital stay than vaginal delivery.

  • Healing Time Extends:

It takes longer to heal than a vaginal delivery.

  • Drug Reaction Risk:

The risks associated with anesthesia are greater.

  • Surgical Risk in Caesarean Section:

Hysterectomy, bladder injuries

  • Emotional Changes in Caesarean:

There are more affective disorders than vaginal delivery.

What are The Risks and Complications for the Baby in Cesarean Section?

  • Early Birth:

If the gestational age is not calculated correctly, preterm delivery can be made.

  • Respiratory Problems:

More in babies born by cesarean section

  • Fetal Injury:

While making an incision in the uterus, an incision may occur in the baby very rarely.

What Should Be Considered After Cesarean Section?

  • Although cesarean section is thought to be a difficult operation, this process can be easily overcome if the mother takes care of herself after the cesarean section. Every mother is different. It is important that you follow the advice your doctor will give you specifically.
  • The mother should avoid activities that will tire herself after the surgery. The presence of seams should not be forgotten, and movements that will force the stitches should not be made. It is necessary to pay attention to the consumption of plenty of fluids.
  • In cases where the mother has pain after cesarean section, painkillers prescribed by the doctor can be used.
  • Consuming plenty of fluids is important for the healing process.
  • Sexual intercourse should be avoided for a certain period of time.
  • After cesarean delivery, the mother can return to her old daily life within a week. There is no time limit to start breastfeeding.
  • Depression, depressed mood, and extreme fatigue may occur due to hormonal changes in the mother after cesarean section.
  • It should be known by the mother that these emotional distresses are temporary. If disturbing psychological problems occur, the mother can apply to the psychiatry clinics of the hospitals to get specialist support.
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