Cesarean section and timing of its implementation. Planned caesarean section

Each pregnancy in a woman proceeds in a new way, not like the previous one. Childbirth, respectively, also goes differently. If for the first time the baby was born with the help of gynecological surgeons, this does not mean that now everything will happen according to the same scenario. What if there is a second caesarean section? What is important for a woman to know? Can surgery be avoided? These and some other questions will be answered in today's article. You will learn about how long a planned second caesarean section is, how the body recovers after manipulation, whether it is possible to plan a third pregnancy, and whether it is realistic to give birth on your own.

Natural childbirth and caesarean section

We will find out how it is carried out and what indications the second caesarean section has. What is important to know? The natural appearance of a child is a process conceived by nature. During childbirth, the baby goes through the appropriate paths, experiences stress and prepares for existence in the new world.

Caesarean section involves the artificial appearance of a child. Surgeons make an incision in the woman's abdomen and uterus, through which the baby is taken out. The baby appears abruptly and unexpectedly, he does not have time to adapt. Note that the development of such children is more difficult and more difficult than those that appeared during natural childbirth.

During pregnancy, many expectant mothers are afraid of the caesarean section. After all, the advantage has always been given to natural childbirth. A few centuries ago, a woman after a cesarean had no chance of survival. In earlier times, manipulation was carried out only in already deceased patients. Now medicine has made a big breakthrough. Caesarean section has become not only a safe intervention, but in some cases necessary to save the life of the child and mother. Now the operation lasts only a few minutes, and the possibilities of anesthesia allow the patient to remain conscious.

Second caesarean section: what is important to know about the indications?

What does the doctor pay attention to when choosing this route of delivery? What are the indications for a second intervention in the natural process? Everything is simple here. The indications for the second caesarean section are the same as for the first operation. Manipulation can be planned and emergency. When prescribing a planned caesarean section, doctors rely on the following indications:

• poor eyesight in a woman;
• varicose disease of the lower extremities;
• heart failure;
• chronic diseases;
• diabetes;
• asthma and hypertension;
• oncology;
• traumatic brain injury;
• narrow pelvis and large fetus.

All these situations are the reason for the first intervention. If after the birth of the child (the first) the diseases were not eliminated, then the operation will be performed during the second pregnancy. Some doctors are inclined to this opinion: the first caesarean section does not allow a woman to give birth herself anymore. This statement is erroneous.

Can you give birth on your own?

So, you are recommended a second caesarean section. What is important to know about it? What are the real indications for the operation, if the woman's health is all right? Re-manipulation is recommended in the following cases:

• child has;
• after the first caesarean section, two more years have not passed;
• the suture on the uterus is untenable;
• during the first operation, a longitudinal incision was made;
• abortions between pregnancies;
• the presence of connective tissue in the scar area;
• the location of the placenta on the scar;
• pathology of pregnancy (polyhydramnios, oligohydramnios).

An emergency operation is performed with an unforeseen divergence of the scar, weak labor activity, a serious condition of the woman, and so on.

You can give birth on your own if a second caesarean section is recommended. What is important to know? Modern medicine not only allows a woman the natural process of childbirth, but also welcomes it. It is important that the expectant mother is carefully examined. Conditions for natural childbirth after caesarean section are the following circumstances:

• more than three years have passed since the first operation;
• the scar is wealthy (muscle tissue predominates, the area stretches and contracts);
• thickness in the seam zone is more than 2 mm;
• no complications during pregnancy;
• a woman's desire to give birth on her own.

If you want a second child to appear naturally, then you should take care of this in advance. Find a maternity hospital that specializes in this matter. Discuss your condition with your doctor in advance and undergo an examination. Attend scheduled consultations regularly and follow the recommendations of the gynecologist.

Management of pregnancy

If the first birth took place by caesarean section, then the second time everything can be exactly the same or completely different. For future mothers after such a procedure, there should be an individual approach. As soon as you find out about your new position, you need to contact a gynecologist. A feature of the management of such a pregnancy are additional studies. For example, ultrasound in such cases is done not three times for the entire period, but more. Diagnosis before childbirth is becoming more frequent. The doctor needs to monitor your condition. After all, the entire outcome of pregnancy depends on this indicator.

Be sure to visit other specialists before delivery. You need to address to the therapist, the oculist, the cardiologist, the neurologist. Make sure there are no restrictions on natural childbirth.

Multiple and conventional caesarean section

So, you still scheduled a second caesarean section. At what time is such an operation performed, and is it possible to give birth to yourself with a multiple pregnancy?

Suppose that the previous delivery was performed surgically, and after that the woman became pregnant with twins. What are the predictions? In most cases, the outcome will be a second caesarean section. At what time do it - the doctor will tell. In each case, the individual characteristics of the patient are taken into account. Manipulation is prescribed for a period from 34 to 37 weeks. With multiple pregnancies, they do not wait longer, as rapid natural childbirth can begin.

So, you are carrying one child, and a second caesarean section is scheduled. When is the operation done? The first manipulation plays a role in determining the term. Re-intervention is scheduled 1-2 weeks earlier. If for the first time a caesarean was performed at 39 weeks, now it will happen at 37-38.

The seam

You already know at what time a planned second caesarean section is made. The caesarean is re-performed along the same suture as the first time. Many expectant mothers are very concerned about the aesthetic issue. They worry that the whole belly will be covered with scars. Don't worry, it won't happen. If the manipulation is planned, then the doctor will make an incision where he passed for the first time. The number of external scars you will not increase.

Otherwise, the situation is with the incision of the reproductive organ. Here, with each repeated operation, a new area for the scar is selected. Therefore, doctors do not recommend giving birth by this method more than three times. For many patients, doctors offer sterilization if a second caesarean section is scheduled. When they are admitted to the hospital, gynecologists clarify this issue. If the patient wishes, the fallopian tubes are ligated. Do not worry, without your consent, doctors will not carry out such a manipulation.

After surgery: recovery process

You already know about when the second caesarean section is shown, at what time it is done. Reviews of women report that the recovery period is practically no different from that which was after the first operation. A woman can stand up on her own in about a day. A newly-made mother is allowed to breastfeed a baby almost immediately (provided that illegal drugs were not used).

The discharge after the second operation is the same as during natural childbirth. Within one or two months, there is a discharge of lochia. If you have had a caesarean section, then it is important to monitor your well-being. Consult your doctor if you experience unusual discharge, fever, deterioration in general condition. They are discharged from the maternity hospital after the second caesarean section for about 5-10 days, as well as for the first time.

Possible Complications

With a second operation, the risk of complications certainly increases. But this does not mean that they will definitely arise. If you give birth on your own after a caesarean section, then there is a chance of a scar divergence. Even if the suture is well-founded, doctors cannot completely exclude such a possibility. That is why in such cases, artificial stimulation and painkillers are never used. It's important to know about this.

During the second cesarean, the doctor has difficulties. The first operation always has consequences in the form of an adhesive process. Thin films between organs make it difficult for the surgeon to work. The procedure itself takes longer. This can be dangerous for the child. Indeed, at this moment, potent drugs used for anesthesia penetrate into his body.

A complication of a second caesarean can be the same as the first time: poor contraction of the uterus, its inflection, inflammation, and so on.

Additionally

Some women are interested: if a second caesarean section is performed, when can I give birth for the third time? Experts cannot answer this question unambiguously. It all depends on the condition of the scar (in this case, two). If the seam area is thinned and filled with connective tissue, then pregnancy will be completely contraindicated. With wealthy scars, it is quite possible to give birth again. But, most likely, this will be the third caesarean section. The possibility of natural childbirth decreases with each subsequent operation.

Some women manage to give birth to five children by caesarean section and feel great. Much depends on the individual characteristics and technique of the surgeon. With a longitudinal incision, doctors do not recommend giving birth more than twice.

Finally

A caesarean section performed during the first pregnancy is not a reason for a second procedure. If you want and can give birth on your own, then this is only a plus. Remember that natural childbirth is always a priority. Talk to a gynecologist about this topic and find out all the nuances. Good luck!

It is not always recommended for a woman to give birth on her own. In the presence of a number of complications or features of the body, childbirth is carried out using a planned caesarean section. This method consists in the fact that the baby is brought into the light through an incision in the peritoneum and uterus. Such surgical intervention is used in almost a third of childbirth in the country. Some of them are carried out not because of the testimony of a doctor, but because of the unwillingness of mothers to endure pain during labor.

Indications for surgical intervention are divided into primary and secondary. The first are related to physiological causes. In this case, the need for a caesarean section is not even discussed. In the presence of secondary causes, the doctor decides whether an operation should be performed or whether childbirth can take place naturally. However, when a baby is born on its own, the risk of complications is high.

Main indications:

Secondary indications:

Types of caesarean section

There are two types of cesarean section: emergency and elective.

Scheduled caesarean section

In the absence of an urgent need for an operation and the normal state of the fetus, the first planned caesarean section is mainly carried out for a period of 39-40 weeks. By this time, the child is already fully formed and is able to breathe independently.

A second caesarean section is scheduled a couple of weeks earlier than this date. It is usually carried out at 38 weeks of pregnancy.

But there are cases when, as a result of emergency events, for example, premature detachment of the placenta, the doctor decides to perform the operation much earlier than the due date. Also, this can happen with a sharp deterioration in the condition of the woman in labor and her fetus. A caesarean section can be performed at 37, and even at 35 weeks. The fetus is not yet full-term, the lungs may also not be developed. A neonatologist examines the baby after birth, identifies problems with breathing, weight and pathologies, if any, and makes a decision for further actions with the baby. If necessary, the child is connected to an artificial lung ventilation system and power supply through a tube.

The duration of the operation is appointed by the surgeon approximately. A week before the birth, the expectant mother is hospitalized and undergoes all the necessary examinations. And only after receiving their data, the doctor appoints a specific date and time.

Advantages and disadvantages of the method

The undoubted advantage of a caesarean section is that it saves the lives of two people, while natural childbirth could lead to their death. Many mothers note the undoubted advantage of the operation is its speed. There is no need to spend long hours in the birthing chair, tormented by contractions. A quick operation will save the woman in labor from unbearable pain and will take only about half an hour. In this case, the child will be delivered to the light during the first 5-7 minutes. The rest of the time will take suturing. Also, this kind of birth of a baby saves the mother from the possibility of damage to the genitals.

Unfortunately, this method of giving birth to a child has many disadvantages. Those who believe that a caesarean section is an excellent way to have a quick and painless childbirth are deeply mistaken.

The main disadvantage of caesarean section is the appearance of various complications after the operation.

Placenta previa in subsequent births, the likelihood of removal of the uterus due to accrete placenta, internal scarring, heavy bleeding and inflammation in the uterus, complications with the healing of sutures - this is an incomplete list of what a woman can get as a result of childbirth by caesarean section.

Many mothers often complain that after such a birth they do not feel enough emotional connection with their child. They assume the wrongness of what is happening, and even become depressed. Thankfully it doesn't last long. Constant contact with the baby brings the mother back to normal. But the restriction in physical activity in the first time after childbirth, including lifting the baby in her arms, is a serious problem for a young mother. After the operation, it is difficult for her to provide proper care for the newborn. Therefore, at this time, more than ever, she needs the help of the household.

A difficult exit from anesthesia, weakness after surgery, an impressive scar, too, few women will be pleased. Abstinence from intimate life in the first months can be a serious test for a couple.

Caesarean section does not pass without a trace for the baby. With artificially induced childbirth, the baby may have remnants of amniotic fluid in the lungs, which is fraught with complications in the future. Inflammation of the lungs is not uncommon in newborns born as a result of caesarean section. Premature birth can also affect the baby's immunity and susceptibility to infections. Such children are easily susceptible to various diseases.

Before performing a caesarean section, the expectant mother must give her consent and choose the method of anesthesia. Everything is documented. Even if it is necessary to carry out emergency surgery directly during natural childbirth, the doctor must obtain the consent of the woman in labor.

If there are no special indications for the operation, medical workers recommend that women give birth on their own. But many naively choose a caesarean section, believing that they will get rid of painful and long contractions. But before signing the consent to the operation. You should carefully consider whether you are ready for the possible complications after such a birth? Maybe you should not risk your future health and give birth to your child without the intervention of a surgeon?

Video - caesarean section. School of Doctor Komarovsky

The fact that I was waiting for a caesarean section, I knew from childhood. Not a single oculist would allow her to give birth herself.

When people ask me how it all went, I answer that I am ready to go through it at least every day. And it is true!

No, I'm not a masochist at all. It’s just that the very fact of the birth of the long-awaited son overshadowed all the difficulties that I had to go through. And this operation is not so terrible, as they say about it.

I hope my positive experience of going through a caesarean section will dispel your fears, help you know what you have to go through, what to be prepared for.

The most important

The main thing is your adequate attitude towards cesarean section: if it is not possible to give birth on your own, cesarean is a great alternative.

I am not tormented by guilt or shame that I could not give birth on my own. Do not be afraid of the possible consequences - I have a separate one about this. Thanks to the right attitude, I avoided postpartum depression, lactation problems and other horror stories that are written about on the Internet.

Positive attitude towards caesarean section will help you avoid many of the problems that new mothers often face when undergoing this operation, especially emergency.

When to go to bed for a planned caesarean

Ideally, as close as possible to the expected date of delivery. In practice, doctors are often in a hurry to put a pregnant woman in the hospital - just in case.

The doctor also sent me to the hospital 2 weeks before the birth. Fortunately, in the emergency department they returned home to carry the pregnancy. As a result, I went to bed 5 days before the operation. And it's still early!

The operation was performed 1-3 days before the expected date of delivery. But according to my feelings, it was necessary to do a week later (at 41 weeks). After all, it is not without reason that childbirth usually occurs at 38-42 weeks, when the child is ready to be born.

Preparing for a caesarean section

Blood and urine tests are given in advance. There is a conversation with an anesthesiologist. In my case, also a trip to the optometrist. For elective surgery, epidural or spinal anesthesia is used. General anesthesia is used less and less - in special cases or with an emergency caesarean section.

The night before, the nurse gave a briefing on how to prepare for the operation and what to bring with you.

From 18:00 you can not eat or drink anything. At night - a tablet of valerian. At 5 am - cleansing enema, shower, hair removal. Then I bandaged my legs with elastic bandages.

I packed my bag for surgery.

• rubber slippers,
• mug,
• water bottle,
• phone (it was later taken away, because it was not allowed).

Personal belongings and things for the newborn, clothes, watches, rings and even earrings - all this is deposited with the nurse (they are then brought to the postpartum ward).

And finally, they came for me. In the treatment room, I undress, lie down on a gurney. A catheter is inserted into the urethra. I was afraid of this moment, but it doesn’t really hurt, it’s just unpleasant.

On a gurney they are taken to the elevator. We rise. Winding empty corridors and here it is - the operating room, the place where my son will be born.

How is a cesarean section performed?

I had spinal anesthesia. Worked quickly. A screen was placed in front of the stomach. When the doctor made an incision, there was a feeling as if they were being drawn with a pencil, no pain.

After 5 minutes they began to get the child. I expected it to happen quickly and easily, like in the commercials that I once watched. But no. The doctor and nurse (or midwife) put in a lot of effort, I saw how hard it was for them.

And then I got hurt. She said this, but the doctors reacted calmly. I realized that since they have such a reaction, then everything is in order. It remained to wait for them to finally get their son. The main thing is that everything is fine with him! I don't know how long it lasted, I thought it was too long.

And so my baby screamed. The neonatologist took him to her desk. I turned my head, trying to see what she was doing to him. And so she lay, looking at her son. The pain is gone. Instead, it was a feeling of euphoria. I became a mother!

It seems to me that the maternal instinct woke up in me even at the moment when I saw two stripes on the test. Every day and every month he is getting stronger. And here, in the operating room, it reached its climax.

For doctors, this is a daily routine. For a mother, this is one of the most important events in life.. Thanks to the neonatologist, who even without asking brought her son to me - for a kiss. For her, this is a trifle, for me - a moment that will forever remain in my memory. The son looks like a little gnome with a wrinkled nose. Our first kiss. And so they take him away. I just have to wait - until our next meeting there is still a whole day.

The rest of the time, the anesthesiologist entertained the doctors by reading bad reviews from the Internet about our maternity hospital. The whole operation lasted 40 minutes.

What about after the operation?

After the operation, you still need to stay in the intensive care unit for another day. I have the worst memories of this place.

There are five of us in the room. Everyone just got busted. The nurse may not be a bad person, but no one felt special kindness from her. As the anesthetic wore off, the oxytocin drips to contract the uterus only made the pain worse.

But the pain is nothing compared to the feeling of helplessness when you have to ask permission even to go to the toilet. In addition, it was impossible to talk with bedmates. Only sleep, drink and turn from side to side. Even walking around the ward was not allowed, although it is known that the sooner a woman gets up and starts moving, the better. In fact, no one wanted to go.

All this time my thoughts were only about my son. I dreamed that the next day would come soon, and we would see each other again. Luckily, at night they put a dropper with a strong sedative painkiller. And there is the morning, and the long-awaited meeting.

As you can see, the operation itself, despite some pain, left only pleasant memories. Subsequent rehabilitation is a trifle. The most important thing was waiting for me ahead - in

As you know, a caesarean section is nothing more than a surgical intervention, during which the fetus is removed from the mother's womb using an incision in the anterior abdominal wall and uterus. The decision to conduct such a planned operation is made depending on the presence of indications that do not allow natural childbirth.

At what gestational age is a planned caesarean section performed and what are its advantages?

With this kind of surgery, the likelihood of uterine rupture is sharply reduced. Besides? various kinds of complications observed during vaginal delivery during cesarean are less common. The operation also reduces the risk of uterine prolapse, which prevents heavy, uterine bleeding during childbirth.

If we talk about how long a planned cesarean is done, then this is most often 39 weeks. The thing is that it is by this time that a substance such as a surfactant begins to be produced in the body of the fetus, which contributes to the opening of the lungs at the first breath of the baby. If the operation is performed earlier than the specified period, the baby needs artificial ventilation of the lungs.

This kind of surgery is not always prescribed. The main ones for its implementation are:

• features of the anatomical structure (narrow pelvis);
• the presence of mechanical obstacles to childbirth in a natural way (myoma, bone deformities, tumor);
• having had a caesarean section in the past.

As for the last point, earlier, if a woman had already had a birth by caesarean section, then the subsequent ones were also carried out. Today, if there is a dense scar on the uterus, childbirth can also be carried out through natural routes. However, a repeated caesarean section is mandatory in the presence of such complications as a vertical incision of the uterus, uterine rupture, violation of placenta or fetus previa.

If we talk about how long a planned cesarean is done, then usually it is the same as with the first one - 39 weeks. However, if there is a risk of complications, it can be carried out earlier.

Like any surgical intervention, caesarean section is associated with the development of certain risks of complications. These primarily include:

• the development of adhesions and scars, which subsequently fasten together the organs located in the small pelvis and the muscles of the abdominal wall. This is accompanied by unpleasant sensations, discomfort;
• violation of placenta previa in subsequent births.
• accreted placenta. This complication occurs when the placenta cannot detach itself from the uterine wall. Therefore, manual separation is required, which is accompanied by severe bleeding. This kind of violation is observed in cases where a woman has already had 3 or more cesarean deliveries in the past.

The first day after the operation, the woman is under the supervision of doctors in the postpartum ward. Pain medications are prescribed for several days after the operation. At the same time, special attention is paid to the condition of the uterus, observing its contractility.

The sutures placed on the anterior abdominal wall are treated daily with antiseptic solutions, and then removed for 7-10 days. In the absence of complications in the mother, and if the baby does not have any disorders and was born completely healthy, discharge home occurs a week after the caesarean section.

Thus, doctors determine the choice of the period at which it is better to do a planned cesarean, based on the condition of the fetus and the pregnant woman. In the absence of any risks, such an operation can be performed with the onset of the first contractions in a pregnant woman.