The consequences of caesarean section for the mother. The consequences of a caesarean section - how real are the fears. incisional hernia

Sometimes, to help the baby be born, obstetricians have to resort to emergency measures - surgical intervention. What is a caesarean section? This is a delivery operation, during which the fetus is removed from the incision of the uterus. Undoubtedly, it has its advantages compared to the process laid down by nature: it is carried out on a certain day, does not provoke bleeding and ruptures, a woman experiences a minimum of discomfort during childbirth, etc. But there are also a lot of side effects from such an operation - both for the woman in labor and for the newborn. Moreover, complications can manifest themselves both immediately and quite long time later. They are called early and late. And you definitely need to know about them before you decide to put your signature under the consent to delivery by caesarean section.

Risk factors for the newborn

Here are the main risk factors to which the baby is exposed:

Natural childbirth may begin earlier if the estimated date is erroneously determined;
Babies born by caesarean are most likely to have breathing problems;
When the uterus is cut, the doctor can injure the baby (although there are only a few such cases);
"Kesaryata" (as physicians call those born by surgery) are quite difficult to adapt to the new environment;
Babies born naturally push out fluid that has accumulated in their lungs. And the birth process enhances their blood circulation. This does not happen with a caesarean section. As a result, the baby has problems with the cardiovascular and respiratory systems;
If anesthesia was used during the operation, this negatively affects the baby's breathing - it is too weak, superficial.

In fact, any birth process carries the risk of complications, regardless of whether the child is born naturally or through surgical intervention.

But after natural childbirth, the baby feels much better, and his mother soon fully recovers. Unfortunately, the same cannot be said about surgical intervention.

If, for medical reasons, an operation is necessary, then it must be agreed to. But in no case should you insist on a caesarean section just because you are afraid of childbirth, as such.

C-section- a surgical operation during which the fetus is removed through an incision in the uterus

Complications in the mother

Any extraneous, and even more so surgical intervention in the functioning of body systems, one way or another, has consequences, and they are different for everyone. In most cases, they can be avoided thanks to the skill of the doctors and the appropriate qualified care after the operation.

Each person is purely individual, therefore, each woman in labor undergoes the operation in her own way, and complications after a cesarean section can be very serious for someone, and someone can do without them completely.

But knowing what to expect even under the most unfavorable set of circumstances will never hurt you. Even if nothing like this happens to you, which can sincerely be wished to all expectant mothers without exception.

On internal organs

Blood loss

Unfortunately, blood loss is the most common postoperative complication. It occurs after the incision of the uterus.

With a natural delivery, a woman loses about 250 ml of blood, while with a caesarean section - a liter, and sometimes more. Most likely, this is due to the initial defects in the development of the placenta or seals connective tissue after operations.

Such large blood losses must be replenished, as a weakened body in postpartum period not capable of intensive hematopoiesis. To do this, after giving birth, doctors put a dropper to the woman in labor, which provides her with substances that replace blood.

Adhesive processes

Adhesions are seals formed by fragments of scar tissue. They grow together inside after the operation.

Adhesions appear due to the fact that they protect the body from purulent processes. But besides this, they also do not allow the internal organs to function normally.

Rarely do they cause adhesive disease when the intestines hardly perform their functions, and the person feels pain in the abdominal cavity.

It is sometimes impossible to identify the formation of such seals, but everyone can take preventive measures. Doctors recommend that a woman in labor immediately after discharge undergo a course of physiotherapy, as well as daily exercise therapy.

There is another method of treatment when adhesions are removed by surgical intervention. But in this case, the likelihood of their reappearance is very high.

Violation of intestinal motility

After a caesarean section, there may be disturbances in intestinal motility. But digestive system recovers quite quickly, although it also depends on the intensity of the adhesive process.

You can restore the work of the intestines with the help of balanced nutrition, adherence to the daily routine, as well as physiotherapy exercises.

endometritis

Exactly this severe complication after artificial delivery. Endometritis develops as a result of penetration, together with air, of microbes and viruses into the uterine cavity open during the operation. Signs of endometritis appear within a week after a caesarean section.

Symptoms of endometritis:

lower abdominal pain;
a sharp increase in temperature;
bad feeling;
sleep disorders;
loss of appetite;
rapid pulse;
secretions acquire Brown color or are purulent.

To prevent this disease from developing, doctors prescribe antibiotics to the woman after the operation. To prevent and diagnose endometritis, it is necessary to undergo an examination by your doctor in a timely manner (within a week after childbirth).

Seam problems

Problems with stitches begin immediately after childbirth. And sometimes they make themselves felt even a few years after the operation. In this regard, complications related to sutures are divided into early and late.

Early Complications

Bleeding in the suture area, hematoma formation

Such bleeding occurs with improper suturing blood vessels or suturing. They start after processing. postoperative wound and dressings - in cases of inaccurate manipulations. The method of treating bleeding is medication.

Inflammation of the seams

It occurs when the seams are not properly cared for. Signs of inflammation are:

redness of the skin on the seam and around it;
edema;
purulent or bleeding at the site of the incision;
heat.

In order to avoid such consequences, it is necessary, upon detection similar symptoms see a doctor who will prescribe a course of antibiotics. If you show negligence, then further suppuration and outpatient treatment are quite possible.

Divergence of seams

The divergence of the seams is a rare type of complication. This usually happens a week before the stitches need to be removed.

The most common causes are heavy lifting (more than 4 kg), as well as infection of the wound. Take proper care of the incision site and strictly follow your doctor's instructions. And you this problem will not touch.

Late Complications

Ligature fistulas

it small seals, formed as a result of inflammation of the seam around the stitching thread. Fistulas appear when an infection enters the wound.

Over time (it may take several months after the operation), the thread is rejected, and touching the places where it was laid causes pain.

When diagnosing for early dates the complication responds quite well to treatment. AT advanced stage- The consequences are very severe.

Hernia

This is an uncommon type. late complications. It appears along the longitudinal section during several operations performed at regular intervals.

colloidal scar

Just an aesthetic defect that does not pose any danger to health. If a woman decides to get rid of him, then this can be done easily and simply with the help of modern methods cosmetology.

Consequences of anesthesia

Complications from anesthesia are divided into two types, depending on the method of anesthesia performed.

General anesthesia

It is worth remembering that general anesthesia affects both the expectant mother and the baby. The effects of its use may appear immediately, or after a few months.

With early signs of complications in the newborn, deviations in the activity of the nervous and respiratory systems are observed, and with late signs, hypoxic-ischemic encephalopathy may develop.

After the operation, a tracheal tube is inserted into the child, because of this, his throat may be injured, and a cough will appear. The most severe consequences occur when, when the tube is removed, the contents of the stomach enter the trachea.

And in a parturient woman, anesthesia can cause allergic reaction up to anaphylactic shock.

spinal anesthesia

The main consequence is high pressure so doctors use preventive measures but they don't always help. Often such anesthesia hits the nervous system of the baby and mother. Moreover, it is also dangerous because it has a limited duration of action.

Epidural anesthesia

This is a rather complicated procedure that requires appropriate qualifications of medical personnel. With an overdose of anesthetics, complications can be different - from toxic poisoning up to death.

An overdose can also cause respiratory arrest and cardiac arrest.
Convulsions and loss of sensation in the lower extremities are possible.
Caesarean section begins to be carried out 15-20 minutes after the administration of the drugs. During this time, the pressure in a woman in labor may fall, which is fraught with the development of fetal hypoxia.
It all depends on individual characteristics maternal organism. In obstetric practice, it is not uncommon that epidural anesthesia does not anesthetize at all.
Due to the negligence of the anesthesiologist, the anesthetic can get completely into other tissues, and this often causes sharp pains in the back. And later - frequent and severe headaches.

Prevention

Unfortunately, there are quite a few consequences that occur after a caesarean section, and their severity can be the most unpredictable. With natural delivery, such complications are much less.

In case of detection of the slightest signs of them, a woman should immediately consult a doctor. In the postoperative period, listen to any changes in your health very carefully.

In order for the consequences of artificial delivery to be as small as possible or, in the very the best option, was not at all, it is necessary to carefully monitor the state of one's health. Quite simple daily measures will help prevent complications.

Independent control of the state of the seams.
Measurement of body temperature.
Observation of the nature of the discharge.

Moreover, large physical exercise and excessive physical activity. But also sedentary image life is not suitable for the prevention of complications after caesarean section. Must practice daily special gymnastics, and preferably - attend sessions of physiotherapy exercises and train under the supervision of a specialist.

Video "Caesarean section: how to prepare and what complications are possible?"

Of course, it is better when the birth takes place according to the script written by Mother Nature herself. But if such a development of events is impossible for some reason, there is no doubt about the expediency of surgical intervention. It will save the life of both mother and child. And with proper care, many postoperative complications can be avoided. Most importantly, be vigilant. Do not take your health and the well-being of your newborn baby lightly. And very soon, all the excitement associated with childbirth, all the complications and consequences will be left behind. And ahead of you is only the boundless joy of motherhood and a happy future ...

Many expectant mothers believe that a caesarean section is perfect way delivery: there are no exhausting contractions, the risk of birth trauma for the baby and mother is minimized, everything goes quickly and easily. Alas, this is far from the case. The consequences of abdominal surgery for the female body are well known: the risk of bleeding and the formation of adhesions, infectious diseases and difficulties with subsequent pregnancy and childbirth. Here we will look at how a caesarean section affects the baby and how children develop after caesarean section.

Is a caesarean section dangerous for a baby?

Disputes about what is preferable for a child - natural childbirth or caesarean section - do not subside. Supporters operative delivery give numerous examples of serious injuries to the baby during natural childbirth.

However, it cannot be argued that there are no injuries to the child during caesarean section. It happens that children born by caesarean section, get injuries to the spine, brain and spinal cord, fractures and dislocations, cuts and even amputation of the fingers. True, such cases are extremely rare and depend on the qualifications of the doctor. In addition, in case of injuries to the baby, they immediately carry out necessary treatment or surgery. Therefore, if you should choose a maternity hospital in advance, whose doctors have extensive experience in operative childbirth and are ready for any situation.

The effect of caesarean section on the child

In the process of natural childbirth, the baby is born, moving along the birth canal of the mother. The lungs of the child at this stage are compressed, amniotic fluid is removed from them, so after birth the baby can inhale full chest. Babies born by caesarean section do not go through this stage, so their lungs are full of amniotic fluid. Of course, after birth, the fluid will be removed, but a newborn baby after cesarean is much more susceptible to diseases. respiratory tract than his peer who came into the world naturally. It is especially difficult for premature babies after caesarean section: their respiratory system not fully formed.

If the mother had an emergency operation, then, most likely, general anesthesia was used, which means that the baby also got anesthetic substances. Such children after caesarean section are lethargic, suck poorly, and may experience nausea. In addition, a sharp pressure drop between the mother's womb and the outside world can lead to microbleeding.

One of the consequences of a caesarean section for a child is poor adaptation. The fact is that in the process of natural childbirth, the baby receives positive stress, in his body a whole bunch of hormones are produced that help the baby adapt to the world around him in the first hours of life. The “Caesarian baby” does not experience such stress, it is more difficult for him to adapt to new conditions. True, if the operation is performed on a mother who is already giving birth, then such a problem may not arise.

In addition, the features of children after caesarean section are hyperactivity and attention deficit disorder, low hemoglobin.

Caring for a baby after a caesarean section

Many mothers, having read about the consequences of a caesarean section for a child, were probably horrified. However, not everything is so scary: "caesareats" are usually fine cope with all the difficulties, and the development of a child after a cesarean after six months is no different from the development of peers who were born naturally. An exception can only be babies who have experienced acute hypoxia or.

Of course, such children need more attention and care. A newborn baby after a caesarean needs to be constantly next to his mother. Give your baby a massage, feed on demand, play with him.

Do not be afraid of operative delivery: very often a caesarean section for a child and his mother is the only possibility preserve health and even life.

In this article:

Expecting a baby is perhaps the most exciting time in a woman's life. So many worries and plans for the future. But the main subject of the expectant mother's worries is the upcoming birth. Great if the girl good health and no pathology is observed.

But what if the doctors recommend a caesarean section for pregnancy? The question, of course, is complex, because surgical intervention can hardly be called a natural process. Despite the fact that there are many disputes about this difficult operation, it has recently gained considerable popularity. No pain during childbirth, painful contractions and long hours of waiting - these are the reasons women are guided by, agreeing to surgery.

But it is worth understanding that such an operation has its consequences for both the baby and the mother. In addition, despite the professionalism of doctors, there may be various complications both during caesarean and in the postoperative period: bleeding, infection, poor healing seam, injury to connective tissues and many others.

Anesthesia - danger exists

If you decide to have a caesarean section, it is worth noting that the first danger may lie in wait for you during the procedure. The fact is that modern medicine offers two types of anesthesia:

General anesthesia.
and spinal anesthesia.

However, each of these types of anesthesia can lead to unpleasant consequences of a caesarean section. Therefore, it is worth seriously considering what type of procedure to choose, because it affects not only the woman in labor, but also the baby. When leaving general anesthesia, a woman may experience: a sharp headache, nausea, dizziness, muscle pain, confusion. Epidural anesthesia can cause serious damage to the spinal cord and nerve endings, moreover, there sharp pain in the back, trembling in the limbs.

Possible risks

Remember, each operation carries a certain risk for a person. The most common consequence of a caesarean section for the mother is an infection that can penetrate with the intervention of doctors. Bleeding and blood clots are also dangerous. In rare cases, due to the lack of professionalism of doctors, injury occurs to neighboring organs and tissues. Many note that after the operation, there may be problems with intestinal patency, and as a result, the woman in labor will suffer from constipation and experience pain. There are cases when surgeons seriously damaged the patient's bladder.

Stitches after surgery

Unfortunately, no operation is possible without stitches and scars. But the problem lies deeper: the aesthetic defect fades into the background. Indeed, in our time it is easy to get rid of such “marks” by grinding and special treatment. However, a woman in labor may experience diastasis, in which the edges of the seam diverge and heal poorly. In this case, you should immediately consult a doctor.

But the suture on the uterus requires much more attention - after all, success will depend on its condition next pregnancies. One of the most unpleasant consequences after a caesarean section can probably be called a ban on conception for the next 2-3 years. This also applies to the abortion procedure - it is not advisable to carry it out. Doctors say that during this period, damage or injury to the walls of the uterus should not be allowed, in order to avoid divergence of the seam. If these recommendations are not followed, the risk of miscarriage and the development of a number of diseases increases.

physical recovery

Despite the fact that childbirth during surgery is painless, the mother will face the main problems in the postoperative period. The fact is that a woman needs almost 1.5-2 months to fully recover from the operation. And such restrictions bring serious inconvenience:

In the early days, it is very difficult to take care of the baby.
Do not take baths (prefer showers).
Do not overexert yourself physically - training, lifting weights, running are prohibited.
Intimate life requires restrictions - sex is possible only 5-6 weeks after birth. Be sure to consult with your doctor if your body is ready for sexual activity after surgery. In addition, it is worth resorting to reliable contraception. It is necessary to exclude the onset of pregnancy for the next couple of years.

Menstrual cycle

If the caesarean section was successful, mommy should not worry - menstruation will come at about the same time as during natural childbirth. But the absence of this "event" may indicate the onset of complications. In such a situation, it is necessary to undergo an examination by a gynecologist. Note that sometimes the recovery of the cycle can be from 3 to 6 months, depending on the complications that have arisen after a cesarean section.

Breast-feeding

Many mothers do not want to have surgery, fearing that they will lose the opportunity to breastfeed their child. There is a rational "grain" in this - immediately after surgery, the baby is not applied to the breast, for fear of getting drugs into milk. They can inflict on a child serious harm. But the problem is that they begin to feed the baby with a bottle, after which he is in no hurry to take his mother's breast. You should not overstrain and make efforts to “extract” milk when the baby refuses natural feeding. If mommy is patient and persistent, practicing several times a day in natural feeding, the baby will soon take the breast.

Consequences for the baby

Unfortunately, the operation does not pass without a trace, not only for the mother, but also for the baby. When the time comes to be born, the so-called period of hypernation begins - the state of the fetus, in which it “falls asleep”, adapting to the upcoming passage through the birth canals. All physiological process slow down, becoming more "economical" for the body. Such a mechanism is a natural process that was invented by nature in order to protect the child from severe stress during sharp drop pressure at birth.

With a caesarean section, the consequences are completely different: the baby does not undergo training, but is immediately subjected to incredible pressure. This process can lead to the formation of microbleeds in the brain. There are also cases of reduced brain activity at the "Caesarites". American scientists say if an adult had to experience pressure during a caesarean section, he would simply die from pain shock. Another problem for such children may be the entry into the bloodstream of drugs that are used to relieve the mother. They can negatively affect nervous activity infant, cause heart and intestinal problems.

First breath

Based on many studies, doctors have made important conclusion: carrying out a caesarean section is fraught with consequences for the child. Before the moment of birth, the amount of hormones - catecholamines - sharply increases in children. It is these substances that trigger the breathing process and “drain” the lungs from fluid. During surgery, such a process simply does not occur and the risk of suffocation increases, the child's lungs open with difficulty.

heart little man starts to work very quickly, trying to provide the lungs with blood, and there is fluid present. Because of this process, the baby may develop dystrophic atrophy in the heart, like in the elderly. The respiratory rate of "caesareans" is almost 2 times less than that of naturally born.

Another theory says: the baby does not pass through the birth canal, and as a result, there is no compression chest. It is this pressure that helps to get rid of the amniotic fluid in the lungs.

Psychological component

There is a theory that has not found its practical confirmation: babies born during surgery are much more difficult to adapt to the world around them. It is believed that the so-called stress hormone was not produced and the baby simply does not know how to adapt to new conditions. But scientists say that psychological health depends more on upbringing than on the way you were born. Often such children suffer from excitability and hypertonicity.

Features of caring for babies "cesareans"

With such children, it is recommended to start walking outside later. They need to be swaddled for a longer time than normal babies. Hypothermia or, conversely, elevated temperatures should not be allowed.
Due to the fact that children can suffer from hyperactivity, they sleep worse at night, often cry and get scared for no reason.
It is recommended that in the first month of life the child sleep with his mother, so he quickly adapts to the world around him.
"Kesaryata" gain weight very slowly, so it is necessary to spend as long as possible breast-feeding.
To strengthen the immune system, it is recommended to perform daily gymnastics, gradually increasing physical activity. Must attend water procedures: swimming, and further hardening of the child.

Whether or not to do the operation is decided not only by the expectant mother on her own, but also by the doctor. But do not think that a caesarean section is easy procedure, which is not capable of harming you and your child. However, if there are serious risks to the life of the mother or baby, it will be better and safer to perform such an operation.

Useful video about caesarean section

A caesarean section is surgical method delivery, in which an incision is made in the anterior wall of the abdomen and uterus to remove the baby. In the past, caesarean section (CS) was performed very rarely, because in the absence of antibiotics and normal anesthesia, more than half of the women died after such an operation.

From the middle of the twentieth century, caesarean sections began to be actively used in the presence of certain indications, but the mortality rate of mothers was still quite high. Last years the situation has improved significantly, the technique of the operation has changed, new methods of anesthesia have appeared. Unfortunately, this has led to the fact that today caesarean section is used very often and without indications.

This state of affairs is facilitated by the conviction of the majority of the population that natural childbirth is more dangerous for mother and child than caesarean. For example, many believe that trauma to a child during vaginal delivery is the cause of cerebral palsy (CP). Although 100% of the causes of this pathology are still not known, studies have shown that children born by caesarean section suffer from cerebral palsy no less than others.

Many will be surprised by this figure, but according to studies, the risk of complications for mother and child during a caesarean section is 7 times higher than during a natural birth.

This is partly due to the fact that caesarean sections are often performed on women who already have complications at the time of delivery (for example, severe pathology heart) or the condition of the child causes concern. But the fact remains that vaginal delivery is safer than a caesarean section.

Despite this, in some countries, for example, in Brazil, the rate of CS is higher than natural childbirth, in Turkey the prevalence of caesarean is more than 40%.

Women are captive to their delusions, and doctors follow their lead, as they receive a lot of money for the operation. For physicians, a caesarean section is also a time saver, because the operation lasts forty minutes, while natural childbirth can last 10-12 hours or even longer.

However, some expectant mothers experience this intense fear before labor pain that they themselves insist on the operation, despite the persuasion of the doctor. If the doctor of a state maternity hospital can refuse to perform an operation without evidence, then in private clinic the patient is always welcome. Therefore, the number of cesarean sections is growing all over the world and many doctors and even the World Health Organization are concerned about this.

However, this does not mean that a caesarean section is bad. In some cases, surgery is the only way to ensure a favorable outcome of childbirth if there is a threat to the life and health of the mother and (or) child.

Indications for caesarean section.

A caesarean section can be planned (for example, if there is a transverse position of the fetus) or emergency if the child develops hypoxia or other complications during childbirth. Indications for surgery are absolute (without surgery, the life of a child or mother is exposed to big risk) and relative.

Absolute indications for caesarean section.

From the mother's side: the presence of tumors and septa in the vagina, fibromatous nodes in the lower part of the uterus, deformities of the small pelvis, infectious diseases of the mother in active phase, some types of placenta previa, scars after operations on the uterus, a disproportion between the width of the pelvis and the size of the fetus.

From the side of the child: wrong presentation, some types multiple pregnancy, some fetal malformations, fetal hypoxia.

Relative indications for caesarean section.

Some cardiovascular diseases mothers, high myopia, uncontrolled diabetes and hypertension large fruit, weakness of labor activity. Maternal age over 35 years is not an indication for CS.

Indications for caesarean section: a complete list.

Indications for caesarean section on the mother's side: a list.

Pathology of the placenta. Central placenta previa (the placenta completely covers the internal os of the cervix) or partial presentation with severe bleeding.

Premature detachment of a normally located placenta in the absence of conditions for immediate delivery through the natural birth canal.

Anomalies of labor activity that cannot be corrected with medications.

Fruit-pelvic disproportions: clinically narrow pelvis, anatomically narrow pelvis.

Anatomical obstacles to childbirth through the natural birth canal. States after some surgical operations on the crotch. Cicatricial changes or severe varicose veins of the cervix and vagina.

Malformations of the uterus and vagina, pelvic tumors that interfere with the birth of a child through the natural birth canal. Traumatic injuries spine or pelvis.

Incipient or impending uterine rupture.

Two or more scars on the uterus or an incompetent scar, as well as a scar after a corporal caesarean section.

Lack of effect from the treatment of severe preeclampsia when urgent delivery through the natural birth canal is impossible.

Extragenital pathologies of the mother: arterial hypertension 3rd stage, aneurysm major artery, some lung diseases, coarctation of the aorta and other diseases that require the exclusion of attempts. In the presence of concomitant diseases to the mother, experts give their opinions on the method of delivery.

Some infectious diseases of the mother: primary genital herpes in the third trimester, HIV infection with a viral load of more than 1000 copies.

History of stillbirth in conjunction with other obstetric pathologies.

Fetal indications for caesarean section: list.

Incorrect position and presentation of the fetus. Incorrect position of the fetus after the outflow of amniotic fluid. High straight standing arrow-like seam. Incorrect insertion of the fetal head (frontal, front view facial).

Breech presentation of the fetus with an estimated weight of more than 3700 grams or in the presence of other relative readings to KS. Breech presentation of the fetus with excessive extension of the fetal head.

Multiple pregnancy with breech presentation first fetus.

Fetal hypoxia in the absence of conditions for urgent delivery through the natural birth canal.

Prolapse of the umbilical cord.

Some fetal malformations.

Pregnancy after the use of reproductive technologies and long-term treatment infertility.

How is a caesarean section done?

During a planned operation, epidural anesthesia is usually performed, which allows a woman to be conscious and see her child in the first minutes of his birth. An emergency caesarean section is done mainly under general anesthesia, as it starts to act very quickly.

The operation lasts 30-45 minutes. In most cases, a horizontal incision is made in the lower abdomen, which allows a woman to feel confident on the beach and in the pool, to wear open swimwear. Occasionally, there are cases when other types of incisions are needed.

The baby is removed literally a few minutes after the start of the operation. The child is shown to the mother, they can even put it on the breast, depending on the rules of the hospital and the condition of the woman in labor, then they take it away and continue the operation.

After the operation, in many maternity hospitals there is a practice of laying the baby on the father's stomach - this is necessary so that the skin of the newborn is populated with "native" microbes.

For some time after the operation, the mother is closely observed, and then transferred to the postpartum ward. It is advisable to be in the ward with a husband or other assistant, since it is very difficult for a woman to take care of a baby herself.

What is the danger of caesarean section for the mother.

Since a cesarean section is a surgical intervention, complications are possible both during the operation itself and after it. If a woman has already experienced a caesarean section, then with each subsequent operation, the risks to her life and health increase.

There is a possibility of injury during the operation Bladder, ureters, intestines, nerve fibers and vessels adjacent to the uterus. Infectious, thromboembolic (associated with blockage of blood vessels by a thrombus) complications and side effects associated with anesthesia.

After cesarean uterus shrinks worse than after natural childbirth, so there is a risk of bleeding. After surgery, there are often problems with urination, constipation, pain in the legs. The danger of caesarean section for the mother is also the likelihood of divergence of the seams, infection of the postoperative wound.

scar tissue and postoperative adhesions may cause chronic pain and prevent future conception.

In order to minimize the risk of postoperative complications, you need to follow the doctor's recommendations for suture care, lifestyle, diet, and ask your doctor for any symptoms you should immediately seek medical help.

Why is a caesarean section dangerous for a child?

The child may have a head injury, tachypnea (increased shallow breathing) on the first day, prematurity. When a caesarean section is performed before the onset of natural childbirth, there is a risk that the due date is incorrect and the baby is not yet ready for birth. A caesarean section is also dangerous because the lungs of a child who has not gone through contractions and attempts are less prepared for breathing.

Benefits of a caesarean section

The main advantage of caesarean section was and remains the ability to save the child, and sometimes the mother, if they are in danger. Also, a caesarean section allows the mother to avoid unnecessary worries, choose the date of birth in advance. According to some studies, women after CS are less likely to suffer from urinary incontinence after childbirth.

Disadvantages of a caesarean section

Naturally, the big disadvantage of a caesarean section is that after the operation, mommy feels bad, her stitches hurt. There are restrictions on caring for a child, you cannot lift him, and so on. Recovery period after surgery lasts longer than after natural childbirth. Women after caesarean are more susceptible postpartum depression feel helpless after surgery. Also, after a cesarean, it is more difficult to establish breastfeeding, milk comes a little later.

Although a caesarean section is abdominal operation and it has many risks, its importance cannot be overestimated. With the help of a caesarean section, the lives of both mother and child can be saved in cases where natural childbirth is impossible or dangerous for any reason.

Therefore, thoughtlessly refusing a caesarean section is just as wrong as doing it on a whim. It is advisable to perform a caesarean section when the risk of complications after surgery is less than the danger that threatens the mother and child without the intervention of surgeons.

More often, future mothers are afraid that the baby will not scream and start breathing, since he was born “artificially”, he will need a special health care and it will not be possible to see it after birth, there will not be such an important period of merger for mother and fetus.

At the same time, there are ardent supporters of caesarean section. On the contrary, they consider the operative method of childbirth more humane and aesthetic than physiological childbirth, and they regard the prospect of caesarean section as an opportunity to enjoy the benefits of medical progress. Proponents of operative delivery argue that "surgical" childbirth is much safer for the baby, as it takes less time, is not associated with loss of energy and the risk of birth injuries during the passage of the fetus through the birth canal, and is completely controlled by physicians. Opponents of caesarean section try to avoid it at all costs, supporters, on the contrary, seek the opportunity to choose the operational tactics of obstetric care at will. Such conflicting opinions are explained by the lack of knowledge about the operation itself and about everything connected with it. And, as it usually happens, against the background of a lack of information, all kinds of speculation and myths are born.

Myth No. 1. A planned caesarean section is harmful to the baby, since it is always carried out in advance, without waiting for the natural onset of labor.

Indeed, in cases where even the onset of labor poses a risk to the health of the mother and baby, the operation is specially carried out in advance. However, even in that case, the concept of “in advance” is very relative: a planned caesarean section is carried out strictly after 38-39 weeks of pregnancy, when the fetal maturation is completed and it is ready for birth (pregnancy is considered full-term from the 38th to 42nd week). There are few indications for such early delivery:

Placenta previa - attachment of the placenta in the cervical region, in which it partially or completely blocks the exit from the uterus; in this case, the very first contractions can lead to placental abruption and endanger the life of the mother and fetus.

Incompetent scar on the uterus - thinning postoperative scar from a previous caesarean section or other operation on the uterus: the onset of contractions can lead to rupture of the uterus along the scar.

The transverse position of the fetus - the pressure of the uterus on the baby, located perpendicular to the axis of its contractions, can lead to serious injuries fetus.

In other cases, when the first contractions are not dangerous to the health of the mother and fetus, it is not only possible, but also preferable to wait natural beginning tribal activity. AT last days before childbirth in the body of the expectant mother occurs hormonal changes, which has a complex effect on herself and on the fetus. Hormones released after the 38th week of pregnancy prepare mother and baby for the upcoming birth, stimulate the onset of lactation, prepare the baby for the start of an independent life, and contribute to recovery after childbirth.

Myth number 2. Cesarean section is done under anesthesia, and it is dangerous for the child.

Many different fears are associated with this myth: here is the fear of “not getting out” of anesthesia, and the harm of anesthesia for the work of the central nervous system, and harmful action drugs for anesthesia on the fetus and, finally, the fact that a woman will not be able to take a psychological part in the process of childbirth. These fears are certainly greatly exaggerated, but they cannot be called completely groundless: the use of general anesthesia in obstetrics is associated with significant risks to the health of the mother and fetus. That is why in 93% of cases not only planned, but also emergency operations caesarean sections are currently performed using regional anesthesia. For obstetric operations spinal anesthesia is used - a type of regional anesthesia that excludes pain sensitivity at the level pelvic organs. Before the start of the operation, an anesthetic is injected into the area of the spinal canal in the lumbar region. After a few minutes, the patient disappears pain sensitivity below the injection site. At the same time, consciousness and other types of sensitivity are completely preserved.

The advantages of spinal anesthesia over general anesthesia are obvious:

anesthetics injected into the spinal canal do not enter the general circulation and do not harm the fetus;
no need for artificial ventilation lung and drug regulation blood pressure and the heartbeat of the woman in labor;
the risks associated with the exit from anesthesia, the effect of anesthesia on the nervous system of the mother and fetus are reduced to zero;
the patient during operative delivery is conscious, can communicate with the staff and monitor the progress of the operation, hears the first cry of the newborn and can see him immediately after birth - an important psychological component that gives the effect of participation in childbirth.

Today, general anesthesia for anesthesia of operative labor is used only in cases where spinal anesthesia is not possible for technical reasons (for example, with complex injuries lumbar spine). This is less than 5% of all transactions. In other cases, caesarean section is performed under spinal anesthesia.

Myth No. 3. With operative delivery, there is no period of merge between mother and newborn.

This statement is also false, as is the opinion that during a caesarean section, the mother cannot see the newborn. Immediately after extraction, it is shown to the woman in labor, the gender of the baby is called, and it is applied face down to the mother's cheek. This tactile contact immediately after birth is called the fusion period. This technique, which is also practiced during physiological childbirth, is very important with psychological point vision. It helps to reduce psycho-emotional stress, which is inevitably associated with the moment of birth for the woman herself and the newborn. In addition, during physical contact, the mother “transmits” to the fetus normal microflora of your skin, strengthening its immunity and protecting it from harmful effects environment.

The difference between the fusion period during natural childbirth and during operative delivery is only that in the first case the baby is placed on the mother’s stomach, and in the second case it is applied to the cheek and chest (even when a caesarean section is performed under general anesthesia, the newborn is applied to the mother’s cheek) . This is a common practice today, it is not necessary to specifically discuss it with the doctor in advance. If the operation takes place under spinal anesthesia, the patient hears the first cry of the baby, can examine it and consciously experience the period of fusion.

Myth number 4. With operative delivery, early attachment of the crumbs to the breast is impossible.

Also, a completely unfounded opinion: in this regard, there are no technical differences between operative and physiological delivery in principle! The first application of the baby to the breast occurs a few minutes after his birth - immediately after the initial examination by the neonatologist. The procedure for examination by a pediatrician during a cesarean section is absolutely no different from a similar procedure for natural childbirth. And in exactly the same way as in natural childbirth (of course, with good health newborn and immediately upon completion of the examination), it can be applied to the mother’s breast, this will not interfere with the doctors at all and will not affect the course of the operation.

Myth No. 5. After a caesarean section, the mother and newborn are observed not in the postpartum ward, but in intensive care.

Actually it is not. Mom after surgery really needs special medical supervision and care, but she does not require any resuscitation measures.

In the first hours after operative delivery (usually from 12 to 24 hours), the puerperal is observed in the intensive care unit of the operating unit. The staff of this department is constantly in the ward, monitoring its general condition. At favorable course early postoperative period after 12 hours of observation expectant mother help her get up, take a shower and transfer her to the postpartum ward.

The baby, after examination by a neonatologist in the operating room, is taken to physiological department newborns, where he is under the supervision of pediatricians for 12–24 hours (while the mother is in the intensive care unit). Birth itself operational way is not an indication for the child to be hospitalized in the intensive care unit. After intensive monitoring of the puerperal ends and she is transferred to a regular postpartum ward, a “family reunion” occurs: the baby is brought to her mother for breastfeeding, and if her health allows, they are transferred to a permanent stay with her.

Myth number 6. During a caesarean section, the natural mechanism for the birth of the fetus is completely disrupted.

This common opinion among future parents is also not entirely true. It has been established that the mechanism of fetal birth is extremely important for the normal onset of independent life. By the mechanism of birth is meant the successive change in environmental pressure that the fetus experiences during uterine contractions and movement through the birth canal. During contractions, the pressure acting on the fetus gradually increases, with attempts during the expulsion of the fetus, it becomes maximum, and at the time of birth it sharply decreases. It is this pressure difference that causes the baby to take the first breath at birth. Knowing the importance of this change in pressure for the normal start of the independent life of the baby, doctors in the process of operative delivery try to recreate the natural mechanism of birth as much as possible. In the absence of contraindications from the health of the mother and fetus, doctors try to plan the operation as close as possible to the expected date of birth, giving the baby the opportunity to experience training and even the first labor pains. During the operation itself, conditions are also created that mimic a natural birth for the fetus. Slit on the front abdominal wall usually does not exceed a length of 8-10 cm, the incision on the uterus is made even smaller and stretched in the process of extracting the baby. During extraction, the operating doctor inserts his palm into the incision in the uterus and fixes the presenting part (head or buttocks) of the fetus. Then the assistant (second doctor) presses the bottom from the outside ( upper part) of the uterus, simulating attempts, as a result of which the baby is born from the operating hole, insured by the hands of the operating doctor. As a result of such actions, the baby experiences tremors of the uterus and the pressure difference necessary for it.

Myth No. 7. "Kesaryata" are more excitable and more aggressive than other children, because they are born with the help of "aggressive" intervention.

And this statement can be called a real, one hundred percent myth: there is not a drop of reliable information. The method of delivery does not affect the character and behavior of a person in the future.

Increased excitability of the human nervous system may be the result of acute hypoxia (lack of oxygen). Thus, after an emergency caesarean section performed due to acute fetal hypoxia during childbirth, the child may indeed be characterized by increased excitability of the nervous system, which manifests itself, among other things, and a tendency to aggressive behavior. However, the cause of nervous excitability is not the method of delivery itself, but a complication that is an indication for surgery. A child who has experienced acute hypoxia in the process of physiological childbirth without surgical intervention, and a child born surgically due to hypoxia developed during childbirth, can equally be subject to excitability of the cerebral cortex. If the reason for the surgical intervention was not acute hypoxia, but, for example, high blood pressure the fundus of the mother or the incorrect position of the fetus, there will be no consequences for the child's nervous system as a result of a "surgical" birth.

Why is a caesarean section not done at will?

So, the myths have been debunked, unfounded accusations have been broken, there is no more fear for the health of the baby in the future of the operation ... One question remains: why is a caesarean section performed not at the request of future parents, but exclusively for special reasons? medical indications? After all, the operation is much faster than natural childbirth, it is completely anesthetized and eliminates the risk of birth injuries for the baby!

The main difference between operative delivery and physiological delivery is that the fetus does not pass through the birth canal and does not experience the pressure difference to the extent that it needs to “start” autonomous life processes.

At various pathologies fetus and mother, this fact is the advantage of caesarean section and determines the choice of doctors in favor of the operation: pressure drops for a long time become an additional burden for the crumbs. If a we are talking about saving the life of mother and baby, operative delivery is also preferable due to the temporary advantage: from the beginning of the operation to the extraction of the fetus, an average of no more than seven minutes passes. However, for a healthy fetus, a difficult path through the birth canal is preferable to a quick extraction from the surgical wound: the baby is genetically “programmed” for just such a birth scenario, and surgical extraction is additional stress for him. In the process of moving through the birth canal, the fetus experiences increased pressure from birth canal, which contributes to the excretion of intrauterine fluid released during the formation lung tissue. This is necessary for uniform spreading of the lung tissue during the first breath and the beginning of a full pulmonary respiration. No less important is the difference in pressure and for starters independent work its kidneys, digestive and nervous systems.

Caesarean section helps to save the life and health of mother and baby in situations where natural childbirth is dangerous or impossible. However, in the absence of such indications, natural childbirth is always preferable. Despite the fact that the process of childbirth takes much longer and is also associated with risks, nature prepares the baby for this way of being born - this natural stress helping him start an independent life.

First breath

Many people think that after a cesarean, a child cannot begin to breathe without the help of doctors. Additional medical care for the newborn in the first minutes after extraction is required only if the caesarean section was performed according to vital indications and the baby is in serious condition. Such indications include acute hypoxia (lack of oxygen) or asphyxia (respiratory failure) of the fetus. If the baby was born as a result of the usual planned operative delivery, his condition at birth will not differ in any way from the state of the newborn after physiological birth. In this case, he will not need additional medical help - immediately after extraction, he will independently take the first breath and scream.