Optimal time for caesarean section. Second caesarean section: what is important to know? Cesarean section: indications, timing, recovery

Hello dear readers on my blog! At what gestational age is a planned caesarean section performed?- the question of every expectant mother, who will have such an intervention. Do not worry, you will not be able to give birth before the due date, and if you suddenly “want”, then the planned caesarean will turn into an emergency one!

Usually, mothers wait until the appointed day, and all because the doctor selects the optimal time for the operation based on the history and course of the patient's pregnancy. But we will still try to consider in more detail the period of planned operative delivery, and also understand what indications are pushing doctors and mommy to carry out such a serious surgical intervention.

What is a planned caesarean section?

The best way to give birth to a baby is naturally, but, unfortunately, this method is not always acceptable for a mother for medical reasons, and some women simply refuse it out of fear.

However, if the problem does not pose a great danger, the doctor will still try to insist on independent childbirth.

In the case when a woman cannot give birth on her own, since the life or health of the mother and the future of the baby may depend on this, the gynecologist unconditionally stops at the surgical intervention and sets the date for it, this situation is called planned caesarean section .

In what cases a caesarean section is indicated for a woman, we will consider below.

What is the duration of the operation?

Firstly, I want to note that a normal full-term pregnancy is considered at term - 37 weeks. A baby born before this time is considered premature.

Of course, there are exceptions when the operation is still performed earlier, but this is only in cases where the further course of pregnancy is impossible or threatens the mother or baby (due to severe course, acute hypoxia, impaired blood flow and other serious problems).

What week of pregnancyschedule a planned operation?

With twins, a planned caesarean is prescribed a little earlier - on 37-38 weeks.

Why is the operation scheduled earlier if there are several bladders? The fact is that with multiple pregnancies, the risk of premature birth is very high. Therefore, the more babies a woman expects, the sooner she is placed in a maternity hospital under observation. For example, if a mother is expecting twins, then antenatal hospitalization takes place at 36 weeks, if triplets - then at 34-35 weeks. Then the woman undergoes the necessary examination, and if there is no threat and suspicion of premature birth, then a planned caesarean section is prescribed no earlier than 37 weeks.

In the case when a woman is diagnosed with placenta previa, then surgical intervention is performed at a period of 38 weeks, of course, if childbirth does not begin earlier than this period.

When is the best time to do a caesarean section??

Basically, a planned cesarean is assigned to women at a time close to natural - 39-40 weeks.

Indications for a planned caesarean section

Until recently, the operation was performed only according to strict indications, but now such a luxury is available to almost everyone. Of course, such childbirth will cost much more than natural childbirth. But many mothers are attracted to this type of delivery because they do not have to endure contractions and attempts, and they will not experience all the difficulties and complications (possible breaks) of natural childbirth.

But behind the cloudless veil lies another truth. A caesarean section, like any other intervention, is dangerous for the female body by the development of unwanted complications. What is worth only the recovery period after surgery and the effect of anesthetics on the tiny organism of the fetus.

When is a caesarean section performed??

Indications:

placenta previa;
at ;
"fresh" or poorly healed scar on the uterus after previous interventions;
2 or more scars on the uterus;
anatomically narrow pelvis;
clinically narrow pelvis (large toddler);
severe divergence of the pubic bones;
problems with the hip joints and pelvic bones;
with uterine myoma;
tumors;
serious vision problems;
pathologies of the cardiovascular system;
malposition;
bad experience of previous pregnancies;
malformations in the baby;
serious chronic diseases of the mother;
late difficult pregnancy (if the mother is over 40 years old).

Repeated cesarean

Pregnancy after a cesarean section is allowed no earlier than after 2-3 years. If pregnancy occurs earlier, then there is no need to hope for independent childbirth.

Ideally, of course, if the second and subsequent births after operative delivery will take place naturally. But if there is evidence, the woman needs to have a second caesarean section.

The second and third caesarean sections are accompanied by a high risk of developing undesirable consequences (for example, the divergence of the old scar) and severe bleeding. Therefore, whenever possible, subsequent surgical interventions on the uterus should be avoided.

Thus, a second caesarean section can be very dangerous for the mother!

A caesarean section can be emergency and planned, that is, carried out at a predetermined time or earlier than this time, or even for a woman who did not have this operation planned. What to expect from operative delivery? How is a woman prepared for it? What are the difficulties in restoring the body after surgery? And what are the reasons for a planned caesarean section?

Usually, a woman will know about a possible operation, if there are any grounds for it, in advance, a few weeks before the expected date of the onset of labor, from the doctor of the antenatal clinic leading her pregnancy. However, it is not up to him to decide whether there will be an operation or not. And it is not the doctor who issues a referral to the hospital for his patient to undergo a planned caesarean section. From the doctor leading the pregnancy, only a referral to the maternity hospital is required, namely, to the department of pathology of pregnancy. The question about the operation, its necessity, timing, anesthesia is taken directly by the doctors of the maternity hospital.

Usually, a planned cesarean is done at a time as close as possible to the expected date of birth. But without special indications not on weekends or holidays. This is especially true in the conditions of small maternity hospitals in small towns, where there are no anesthesiologists constantly on duty in the maternity hospital.

Upon admission to the department of pregnancy pathology, a woman is carefully examined. Even if she had already taken urine and blood tests before hospitalization, she will definitely retake everything. In addition to general tests, they take blood from a vein for HIV, RW (syphilis), hepatitis, biochemical analysis, sugar, blood group and Rh factor. For a long time, especially with low blood pressure, in the morning, on an empty stomach, when donating blood from a vein, a woman may become ill. If you were already unwell at the time of blood donation, ask the nurse to take her sample from you in a supine position, on the couch. Eat a piece of chocolate right after. It will quickly restore your vigor.

Preparing for a planned caesarean also includes going around different doctors. Necessarily ophthalmologist, therapist, otolaryngologist. An ECG is performed the day before surgery. An interview with an anesthesiologist. If hospitalization is carried out a few days before surgery, a woman may be given a dropper with saline. This is necessary to saturate the body with fluid, because during surgery a large blood loss is expected. This liquid will go to replenish it. In addition, as a standard, women are given intravenous injections of Piracetam, a drug that improves cerebral blood supply.

In the evening before the operation, the woman is given an enema. Bowel cleansing is repeated in the morning. A catheter is placed in the bladder. Well, then, the work of doctors and honey. sisters. How a planned cesarean operation goes - how successful it is depends on them, well, on the individual health characteristics of the woman in labor and the course of her pregnancy. The woman is given spinal (epidural) anesthesia or endotracheal (general) anesthesia. The incision of the peritoneum is usually performed in the lower segment of the abdomen, transverse, rarely vertical. The second heals worse and gives more complications. Therefore, it is performed only when an emergency caesarean section is performed, especially in case of premature pregnancy, or planned, but with a life-threatening condition of the woman in labor or the child. This type of incision is bad for its unaesthetic and long-term healing. This not only reduces the quality of life of a woman in the first months after surgery, but also negatively affects the onset and course of the next pregnancy. So, complications after a planned caesarean section in the form of an inconsistent scar on the uterus, in the case of a horizontal incision, are rare. True, not only the type of incision plays a role here, but also the operation and the postoperative period.

Thus, the following emerge pros and cons of a planned caesarean.

Pros:

no labor pain;
there is no fear that the child will have a birth injury;
no ruptures of the perineum, cervix.

Minuses:

long recovery after caesarean section, healing of sutures and problems in the form of hernias and other surgical complications;
problems with the establishment of breastfeeding (due to the untimely application of the child to the breast and its rare sucking);
often developing endometritis (inflammation of the uterus), requiring antibiotic treatment - common consequences of a caesarean section;
possible divergence of the scar during the next pregnancy;
postoperative pain;
the need to use contraception, pregnancy planning not earlier than two years after surgery.

Indications for a planned caesarean section and the timing of its implementation

There are many reasons why doctors may decide to operate on a woman. These are just some of the most common ones.

1. Clinically narrow pelvis. This is the case when there is a very strong narrowing of it. The doctor clearly understands that the child cannot be born on his own. But more often, some narrowing of the pelvis is diagnosed, in which it is still possible to give birth to a small child on your own.

2. High degree of myopia (nearsightedness). The question of the operation is decided after consultation with an ophthalmologist. It often happens that a woman is still allowed into natural childbirth, but with the use of epidural anesthesia and they try to shorten the period of attempts as much as possible.

3. The threat of divergence of the scar on the uterus. At what time is a planned caesarean section done and how it goes depends on the viability of the scar on the uterus, that is, its thickness throughout. If there is a suspicion of its failure, the operation can be postponed to an earlier date, 37-38 weeks.

4. Breech presentation of the fetus or other, not head. A planned caesarean section with a breech presentation of the fetus is done if the woman is carrying a boy. Fortunately, modern ultrasound machines make it possible to almost accurately determine the sex of a child. Or if the baby weighs more than 3.5 kg and the woman is nulliparous. Girls can be allowed to give birth on their own to multiparous women if the weight of the child is less than 4 kg, and in the maternity hospital there is the possibility of an emergency operation. The transverse position of the fetus is an absolute indication for surgery.

5. Symphysite. A planned caesarean section at 39 weeks or even earlier is done with this pathology. The term depends on the degree of divergence of the pelvic bones of a pregnant woman and her well-being. With pronounced symphysitis, independent childbirth is contraindicated. An accurate diagnosis is made on the basis of ultrasound data.

6. Non-occurrence of labor activity, despite ongoing "stimulating" therapy. Sometimes it happens that the fetus already has signs of “overripeness”, there is reason to believe that it has hypoxia, there is little amniotic fluid, but childbirth does not begin in any way. Then, especially if a woman is over 28 years old and is giving birth for the first time, doctors may recommend that the expectant mother be relieved of the burden by surgery. What week is a planned caesarean section done in this case? Usually, adverse signs of a post-term pregnancy appear at 41-42 weeks. That is, the timing for the operation is individual.

7. Some cardiovascular diseases, heart defects. If a woman is generally well pregnant, the maternity hospital may suggest that she be hospitalized immediately at the onset of labor, or when, as a result of examining the cervix, it becomes clear that an independent birth is about to begin. At what time is a planned repeated caesarean section done - you ask? As close as possible to the onset of natural childbirth. Indeed, otherwise, the likelihood of difficulties with adapting to the external environment in the fetus remains high. Sometimes even full-term babies who were born by caesarean section, but prematurely, have problems with spontaneous breathing. That is, often a planned second cesarean is done for a period of about 40 weeks, when the amniotic fluid leaves, or the woman begins to feel cramping pains.

Less often, the reasons for the operation are varicose veins in the vaginal area, pronounced hemorrhoids (there is a possibility of thrombosis of the nodes).

When childbirth cannot be carried out through the natural birth canal, one has to resort to surgery. In this regard, expectant mothers are concerned about many questions. What are the indications for a cesarean section and when is the operation performed according to urgent indications? What should a woman in labor do after an operative delivery and how does the recovery period go? And most importantly - will the baby born through surgery be healthy?

A caesarean section is a surgical operation in which the fetus and placenta are removed through an incision in the abdominal wall and uterus. Currently, 12 to 27% of all births are by caesarean section.

Indications for caesarean section

The doctor may decide to conduct an operative delivery at various stages of pregnancy, which depends on the condition of both the mother and the fetus. At the same time, absolute and relative indications for caesarean section are distinguished.

To absolute indications include conditions in which vaginal delivery is not possible or is associated with a very high risk to the health of the mother or fetus.

In these cases, the doctor is obliged to deliver by caesarean section and nothing else, regardless of all other conditions and possible contraindications.

In each case, when deciding on a caesarean section, not only the current state of the pregnant woman and the child is taken into account, but also the course of pregnancy in general, the state of health of the mother before pregnancy, especially in the presence of chronic diseases. Also important factors for deciding on a caesarean section are the age of the pregnant woman, the course and outcomes of previous pregnancies. But the desire of the woman herself can be taken into account only in controversial situations and only when there are relative indications for a caesarean section.

Absolute indications for caesarean section:

narrow pelvis, that is, such an anatomical structure in which the child cannot pass through the pelvic ring. The size of the pelvis is determined even during the first examination of the pregnant woman, the presence of a narrowing is judged by the size. In most cases, it is possible to determine the discrepancy between the size of the pelvis of the mother and the presenting part of the child even before the onset of labor, but in some cases the diagnosis is already made directly in childbirth. There are clear criteria for the normal size of the pelvis and narrow pelvis according to the degree of narrowing, however, before entering into labor, only the diagnosis of anatomical narrowing of the pelvis is made, which allows only with some degree of probability to assume a clinically narrow pelvis - a discrepancy between the size of the pelvis and the presenting part (usually the head) of the child. If during pregnancy it is found that the pelvis is anatomically very narrow (III-IV degree of narrowing), a planned cesarean section is performed, with II degree the decision is made most often directly during childbirth, with I degree of narrowing, childbirth is most often carried out through natural birth canal. Also, the cause of the development of a clinically narrow pelvis may be incorrect insertion of the fetal head, when the head is in an extended state and passes through the bone pelvis with its largest dimensions. This happens with frontal, facial presentation, while normally the head passes through the bone pelvis bent - the baby's chin is pressed to the breast.

Mechanical obstacles that interfere with childbirth through the natural birth canal. A mechanical obstacle can be uterine fibroids located in the isthmus (the area where the body of the uterus passes into the cervix), ovarian tumors, tumors and deformities of the pelvic bones.

Threat of uterine rupture. This complication most often occurs during repeated births, if the first ones were performed using a caesarean section, or after other operations on the uterus, after which a scar remained. With normal healing of the uterine wall by muscle tissue, uterine rupture does not threaten. But it happens that the scar on the uterus turns out to be insolvent, that is, it has a threat of rupture. The failure of the scar is determined by ultrasound data and the "behavior" of the scar during pregnancy and childbirth. A caesarean section is also done after two or more previous caesarean sections, because this situation also increases the risk of uterine rupture along the scar in childbirth. Numerous births in the past, which led to thinning of the uterine wall, can also create a threat of uterine rupture.

Placenta previa. This is the name of its incorrect location, in which the placenta is attached in the lower third of the uterus, above the cervix, thereby blocking the exit of the fetus. This threatens with severe bleeding, dangerous both for the life of the mother and for the child, since in the process of opening the cervix, the placenta exfoliates from the uterine wall. Because placenta previa can be diagnosed by pre-labor ultrasound, an elective caesarean section is performed, most often at 33 weeks' gestation, or earlier if there is bleeding suggestive of placental abruption.

Premature detachment of the placenta. This is the name of the condition when the placenta separates from the wall of the uterus not after, but before or during childbirth. Placental abruption is life-threatening for both the mother (due to the development of massive bleeding) and the fetus (due to the development of acute hypoxia). In this case, an emergency caesarean section is always performed.

Presentation and prolapse of the umbilical cord. There are cases when the loops of the umbilical cord are presented in front of the head or the pelvic end of the fetus, that is, they will be born first, or the loops of the umbilical cord fall out before the birth of the head. This can occur with polyhydramnios. This leads to the fact that the loops of the umbilical cord are pressed against the walls of the pelvis by the fetal head and blood circulation between the placenta and the fetus stops.

To relative indications include situations in which vaginal delivery is possible, but the risk of complications during childbirth is quite high. These indications include:

Chronic diseases of the mother. These include cardiovascular diseases, diseases of the kidneys, eyes, diseases of the nervous system, diabetes mellitus, and oncological diseases. In addition, indications for caesarean section are exacerbations in the mother of chronic diseases of the genital tract (for example, genital herpes), when the disease can be transmitted to the child during natural childbirth.

Pregnancy after infertility treatment in the presence of other complications from the mother and fetus.

Some pregnancy complications which can endanger the life of the child or the mother herself during natural childbirth. First of all, it is preeclampsia, in which there is a disorder in the function of vital organs, especially the vascular system and blood flow.

Persistent weakness of labor, when the birth that started normally for some reason subsides or goes for a long time without noticeable progress, and medical intervention does not bring success.

Pelvic presentation of the fetus. Most often, a caesarean section is performed if the breech presentation is combined with any other pathology. The same can be said about a large fruit.

The progress of the caesarean section

With a planned caesarean section, a pregnant woman enters the maternity hospital a few days before the expected date of the operation. An additional examination and medical correction of the identified deviations in the state of health is carried out in the hospital. The condition of the fetus is also assessed; cardiotocography (registration of fetal heartbeats), ultrasound examination is performed. The expected date of the operation is determined based on the condition of the mother and fetus, and, of course, the gestational age is taken into account. As a rule, a planned operation is performed at the 38-40th week of pregnancy.

1-2 days before the operation, the pregnant woman is necessarily consulted by the therapist and anesthesiologist, who discusses the anesthesia plan with the patient and identifies possible contraindications to various types of anesthesia. On the eve of the birth, the attending physician explains the approximate plan of the operation and possible complications, after which the pregnant woman signs the consent to the operation.

On the night before the operation, the woman is given a cleansing enema and, as a rule, is prescribed sleeping pills. In the morning before the operation, the intestines are again cleaned and then a urinary catheter is placed. On the day before the operation, a pregnant woman should not have dinner; on the day of the operation, you should neither drink nor eat.

Currently, regional (epidural or spinal) anesthesia is most often performed during caesarean section. At the same time, the patient is conscious and can hear and see her baby immediately after birth, attach it to the chest.

In some situations, general anesthesia is used.

The duration of the operation, depending on the technique and complexity, averages 20-40 minutes. At the end of the operation, an ice pack is placed on the lower abdomen for 1.5-2 hours, which helps to contract the uterus and reduce blood loss.

Normal blood loss during spontaneous childbirth is approximately 200-250 ml, such a volume of blood is easily restored by a woman's body prepared for this. With caesarean section, blood loss is somewhat greater than physiological: its average volume is from 500 to 1000 ml, therefore, during the operation and in the postoperative period, intravenous administration of blood-substituting solutions is performed: blood plasma, erythrocyte mass, and sometimes whole blood - this depends on the amount lost during time of blood operation and from the initial state of the woman in labor.

emergency cesarean

An emergency caesarean section is performed in situations where childbirth cannot be quickly carried out through the natural birth canal without compromising the health of the mother and child.

Emergency surgery involves the necessary minimum preparation. For pain relief during an emergency operation, general anesthesia is used more often than during planned operations, since with epidural anesthesia, the analgesic effect occurs only after 15-30 minutes. Recently, spinal anesthesia has also been widely used for emergency caesarean section, in which, as with epidural anesthesia, an injection is made in the back in the lumbar region, but the anesthetic is injected directly into the spinal canal, while with epidural anesthesia - in space above the dura mater. Spinal anesthesia begins to work within the first 5 minutes, which allows you to quickly start the operation.

If during a planned operation a transverse incision is often made in the lower abdomen, then during an emergency operation a longitudinal incision from the navel to the pubis is possible. Such an incision provides wider access to the organs of the abdominal cavity and small pelvis, which is important in a difficult situation.

Postoperative period

After operative delivery, the puerperal during the first day is in a special postpartum ward (or intensive care unit). She is constantly monitored by an intensive care unit nurse and an anesthesiologist, as well as an obstetrician-gynecologist. During this time, the necessary treatment is carried out.

In the postoperative period, painkillers are prescribed without fail, the frequency of their administration depends on the intensity of pain. All drugs are administered only intravenously or intramuscularly. Usually anesthesia is required in the first 2-3 days, in the future it is gradually abandoned.

Without fail, for uterine contraction, drugs are prescribed for better uterine contraction (Oxytocin) for 3-5 days. After 6-8 hours after the operation (of course, taking into account the patient's condition), the young mother is allowed to get out of bed under the supervision of a doctor and a nurse. Transfer to the postpartum department is possible 12-24 hours after the operation. The child at this time is in the children's department. In the postpartum department, the woman herself will be able to start caring for the child, breastfeeding him. But in the first few days, she will need help from medical staff and relatives (if visits are allowed in the maternity hospital).

Within 6-7 days after the caesarean section (before removing the sutures), the procedural nurse daily treats the postoperative suture with antiseptic solutions and changes the bandage.

On the first day after a caesarean section, it is only allowed to drink water with lemon juice. On the second day, the diet expands: you can eat cereals, low-fat broth, boiled meat, sweet tea. You can completely return to a normal diet after the first independent stool (on the 3-5th day), foods that are not recommended for breastfeeding are excluded from the diet. Usually, a cleansing enema is prescribed to normalize bowel function about a day after the operation.

When you can go home, the attending physician decides. Usually, on the 5th day after the operation, an ultrasound examination of the uterus is performed, and on the 6th day, the staples or sutures are removed. With a successful course of the postoperative period, discharge is possible on the 6-7th day after cesarean section.

Alexander Vorobyov, obstetrician-gynecologist, Ph.D. honey. Sciences,
MMA them. Sechenov, Moscow

For many decades, this operation - caesarean section - allows you to save the life and health of the mother and her baby. In the old days, such surgical intervention was carried out extremely rarely and only if something threatened the life of the mother in order to save the child. However, caesarean section is now being used more and more frequently. Therefore, many specialists have already set themselves the task of reducing the percentage of births carried out by surgical intervention.

Who should perform the operation?

First of all, you should figure out how a caesarean section is done and what consequences await a young mother. By themselves, childbirth by the surgical method is quite safe. However, in some cases, operations are simply inappropriate. After all, no one is immune from risk. Many expectant mothers ask for a caesarean section only because of fear of severe pain. Modern medicine offers in this case epidural anesthesia, which allows a woman to give birth without pain.

Such births are performed - caesarean section - by a whole team of medical workers, which includes specialists of a narrow profile:

Obstetrician-gynecologist - directly extracts the baby from the uterus.
Surgeon - performs an incision in the soft tissues and muscles of the abdominal cavity to reach the uterus.
A pediatric neonatologist is a doctor who takes in and examines a newborn baby. If necessary, a specialist in this profile can provide the child with first aid, as well as prescribe treatment.
Anesthesiologist - performs anesthesia.
Nurse anesthetist - helps to administer anesthesia.
Operating nurse - assists doctors if necessary.

The anesthesiologist should talk to the pregnant woman before the operation to determine which type of pain relief is best for her.

Types of caesarean section

Indications for caesarean section can be completely different, and the operation is performed in certain cases in different ways. To date, there are two types of childbirth carried out with the help of surgical intervention:

Emergency surgery is performed if any complication occurs during childbirth that requires urgent removal of the baby from the uterus. A planned caesarean section is performed in situations where the doctor is concerned about the progress of childbirth due to complications that arose during pregnancy. Let's take a closer look at the differences between the two types of operations.

Planned caesarean section

A planned operation (caesarean section) is performed with epidural anesthesia. Thanks to this method, a young mother has the opportunity to see her newborn baby immediately after the operation. When carrying out such a surgical intervention, the doctor makes a transverse incision. The child usually does not experience hypoxia.

emergency caesarean section

For an emergency caesarean section, general anesthesia is usually used during the operation, since the woman may still have contractions, and they will not allow an epidural puncture. The incision in this operation is mainly longitudinal. This allows you to remove the baby from the uterine cavity much faster.

It is worth noting that during an emergency operation, the child may already experience severe hypoxia. At the end of the cesarean section, the mother cannot immediately see her baby, as they do a cesarean section in this case, as already mentioned, most often under general anesthesia.

Types of incisions for caesarean section

In 90% of cases, a transverse incision is made during the operation. As for the longitudinal one, they are currently trying to do it less often, since the walls of the uterus are greatly weakened. In subsequent pregnancies, they can simply overstrain. A transverse incision made in the lower part of the uterus heals much faster, and the sutures do not break.

A longitudinal incision is made along the midline of the abdominal cavity from the bottom up. To be more precise, to a level just below the navel from the pubic bone. Making such an incision is much easier and faster. Therefore, it is he who is usually used for emergency cesarean section in order to extract the newborn baby as quickly as possible. The scar from such an incision is much more noticeable. If doctors have the time and opportunity, then during the operation a transverse incision can be made slightly above the pubic bone. It is almost invisible and heals beautifully.

As for the second operation, the seam from the previous one is simply excised.
As a result, only one seam remains visible on the woman's body.

How is the operation going?

If the anesthesiologist performs epidural anesthesia, then the site of the operation (incision) is hidden from the woman by a partition. But let's see how a caesarean section is done. The surgeon makes an incision in the wall of the uterus, and then opens the fetal bladder. Then the child is removed. Almost immediately, the newborn begins to cry a lot. The pediatrician cuts the umbilical cord, and then performs all the necessary procedures with the child.

If the young mother is conscious, then the doctor shows her the baby right away and can even let her hold it. After that, the child is taken to a separate room for further observation. The shortest period of the operation is the incision and removal of the child. It takes only 10 minutes. These are the main advantages of a caesarean section.

After that, doctors must remove the placenta, while treating all the necessary vessels with high quality so that bleeding does not start. The surgeon then sews up the cut tissue. A woman is put on a dropper, giving a solution of oxytocin, which accelerates the process of uterine contraction. This phase of the operation is the longest. From the moment the baby is born to the end of the operation, it takes about 30 minutes. In time, this operation, a caesarean section, takes about 40 minutes.

What happens after childbirth?

After the operation, the newly-made mother is transferred from the operating unit to the intensive care unit or intensive care unit, as a caesarean section is performed quickly and with anesthesia. The mother should be under the vigilant supervision of doctors. At the same time, her blood pressure, respiratory rate, and pulse are constantly measured. The doctor must also monitor the rate at which the uterus is contracting, how much discharge and what character they have. It is mandatory to monitor the functioning of the urinary system.

After a caesarean section, the mother is prescribed antibiotics to avoid inflammation, as well as painkillers to relieve discomfort.

Of course, the disadvantages of a caesarean section may seem significant to some. However, in some situations, it is precisely such childbirth that allows a healthy and strong baby to be born. It is worth noting that a young mother will be able to get up only after six hours, and walk on the second day.

Consequences of surgery

After the operation, stitches remain on the uterus and abdomen. In some situations, diastasis and suture failure may occur. If such effects occur, you should immediately consult a doctor. Comprehensive treatment of the divergence of the edges of the suture located between the rectus muscles includes a set of exercises specially developed by many specialists that can be performed after a cesarean section.

The consequences of this surgical intervention, of course, are available. The very first thing to highlight is an ugly seam. You can fix it by visiting a beautician or a surgeon. Usually, to give the seam an aesthetic appearance, procedures such as smoothing, grinding and excision are carried out. Keloid scars are considered quite rare - reddish growths form above the seam. It should be noted that the treatment of this kind of scars lasts a very long time and has its own characteristics. It must be carried out by a professional.

For a woman, the state of the suture that is made on the uterus is much more important. After all, it depends on him how the next pregnancy will go and what method the woman will give birth to. The suture on the abdomen can be corrected, but the suture on the uterus cannot be corrected.

Menstruation and sexual life

If there are no complications during the operation, then the menstrual cycle begins and passes in the same way as after natural childbirth. If a complication nevertheless arose, then the inflammatory can proceed for several months. In some cases, menstruation can be painful and heavy.

You can start having sex after childbirth with a scalpel after 8 weeks. Of course, if the surgical intervention went without complications. If there were complications, then you can start having sex only after a thorough examination and consultation with a doctor.

It should be borne in mind that after a cesarean section, a woman should use the most reliable contraceptives, since she cannot become pregnant for about two years. It is undesirable to carry out operations on the uterus for two years, as well as abortions, including vacuum ones, since such an intervention makes the walls of the organ weaker. As a result, there is a risk of rupture during a subsequent pregnancy.

lactation after surgery

Many young mothers who have undergone surgery worry that it is difficult to breastfeed after a cesarean. But this is absolutely not true.

Milk from a young mother appears at the same time as women after natural childbirth. Of course, breastfeeding after surgery is a little more difficult. This is primarily due to the characteristics of such genera.

Many doctors fear that the baby may get part of the antibiotic in the mother's milk. Therefore, in the first week, the baby is fed with a formula from a bottle. As a result, the baby gets used to it and it becomes much more difficult to accustom him to the breast. Although today babies are often applied to the breast immediately after surgery (on the same day).

If you do not have indications for delivery by caesarean section, then you should not insist on an operation. After all, any surgical intervention has its consequences, and it is not for nothing that nature has come up with a different way for the birth of a child.

C-section is an operation in which a child is born not through the natural birth canal, but through an incision in the anterior abdominal wall.

Almost every 3 women have to face it. Knowing the indications for surgery will not be superfluous, but even useful. This will allow you to carefully prepare and tune in morally.

With the approach of the cherished birthday of your baby, expectant mothers think about childbirth. It will not be superfluous to know in what cases a caesarean section is performed.

Reasons for surgery may include:

relative, when the refusal of the operation borders on a high risk for the health of the mother and child.
absolute. There are not so many of them. These are those cases when childbirth through the natural birth canal is not possible or can lead to the death of the mother and child.

Recently, more and more often, the operation is performed with a combination of several factors. When each of them in itself is not a reason to have an operation.

But the combination of 2 or more becomes the cause of the operation. For example: a primiparous woman over 30 years old and a large fetus over 4 kg. By themselves, neither a large fetus nor age is the reason for the operation. But together this is an argument.

There are planned and unscheduled caesarean or emergency. With a planned operation, indications for it arise in advance, even during pregnancy. For example, high myopia. The woman and the doctor have time to prepare. Complications in such cases are rare.

Emergency surgery can be performed at any time and even during natural childbirth. For example, with fetal hypoxia, placental abruption.

When is a caesarean section performed?

Placental abruption. This starts bleeding. It doesn't always bleed out. It can accumulate between the uterus and the placenta. The placenta exfoliates even more. The child suffers from hypoxia - oxygen starvation. Woman due to blood loss. It is necessary to urgently remove the child and stop the bleeding.
Placenta previa. The placenta blocks the entrance to the uterus. Therefore, natural childbirth is not possible. When contractions begin, the cervix opens, the placenta in this place exfoliates and bleeding begins. Therefore, they try to operate on such women on the appointed day before the onset of labor.
Prolapse of the umbilical cord. Sometimes the loops of the umbilical cord fall out of the uterus during childbirth before it is completely open. They are sandwiched between the bones of the pelvis and the head or buttocks of the fetus. Oxygen ceases to flow to the child, he may die. It is necessary to complete the birth within a few minutes.
The discrepancy between the size of the pelvis of the mother and child. If the baby is too large, then he will not be able to be born on his own. What is called, will not get through. Here, a caesarean section would be the best way to help the woman without harming the baby. Sometimes this circumstance can be clarified only during childbirth. Women begin to give birth themselves, but when there are signs of a size mismatch, they are given a caesarean section.
Transverse position of the fetus. The baby in a normal birth should lie upside down. If it lies in the uterus across. That kind of birth is not possible. After the outflow of amniotic fluid, there is a risk of prolapse of the fetal handle, leg or umbilical cord. It is dangerous for his life. In such situations, they try to plan the operation before the onset of childbirth.
Eclampsia and preeclampsia. This condition is a serious complication of pregnancy. In difficult cases, the work of internal organs is disrupted, blood pressure rises to critical numbers. The risk of hemorrhage in the internal organs increases: the retina, brain, liver, adrenal glands, etc. To help a woman, it is necessary to perform an emergency delivery - cesarean.
After operations on the cervix. Why? Because natural childbirth will damage the cervix.
Obstacles that do not allow childbirth through the natural birth canal. Tumors of the uterus, bladder, pelvic bones. Significant narrowing of the pelvis, as well as its deformation.
Fistulas between the vagina and the rectum or bladder. As well as ruptures of the rectum in previous births.
Chronic diseases of women. These are diseases of the eyes, heart, nervous system, endocrine system, joints and bones, as well as chronic infectious diseases hepatitis C and B, HIV infection. The decision in this case is made by doctors of other specialties: ophthalmologists, surgeons, infectious disease specialists. The approach here is planned. A woman knows in advance about the upcoming operation and prepare for it.
Breech presentation of the fetus. Natural childbirth is possible. But since there is a risk of injury to the child and mother, they often resort to caesarean section.
Extension insertion of the head. During childbirth, the head should bend as much as possible. To pass through the narrow pelvis of the mother. But there are times when something prevents her from doing it. The head is bent. In this case, its size is too large.
Scar on the uterus. It can remain both after cesarean, and after operations on the uterus to remove myomatous nodes and others. Natural childbirth is possible with one scar on the uterus. 2 or more scars are an indication for caesarean section. Natural childbirth after cesarean is possible only if the scar is consistent according to ultrasound. And the woman does not have pulling pains in the lower abdomen and spotting.
Fetal hypoxia or oxygen starvation. The child receives insufficient nutrition and oxygen. This condition can occur acutely, for example, with placental abruption or prolapse of the umbilical cord. Or develop gradually. Entanglement of the umbilical cord around the neck, cysts and infarcts of the placenta. Shell attachment of the placenta. Sometimes a child due to chronic hypoxia lags behind in growth and is born small.
If indications for childbirth occur between 28 and 34 weeks, then a caesarean section should be performed. Since childbirth for a premature baby can be fatal.
identical twins, as well as triplets.
twin twins, if the first child is in a breech presentation or lies across the uterus.
Weakness of tribal forces. When the cervix refuses to open during labor despite treatment.
Pregnancy after IVF, as well as long-term infertility treatment in combination with other factors.
The woman's age is over 30 combined with other factors.
Post-term pregnancy in combination with other causes.

Important! Caesarean section is not performed at the request of the woman. Since this is a very serious intervention with many complications.

At the same time, there are no contraindications to this operation if the refusal of it will have negative consequences for the woman. But it is undesirable to perform it if there is an infection of any localization in the body, and also if the child has died.

When a caesarean is prescribed, the doctor decides. The task of the expectant mother is to trust the doctor and tune in to a successful outcome of childbirth.

Other related information

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Cesarean section with breech presentation of the fetus: what is important to know?
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