Caesarean consequences for the mother. Possible complications after caesarean section for mother and child. physical activity restrictions

C-section is an abdominal operation in which the newborn is brought into the light through an incision abdominal wall and uterus. Some women consider operative childbirth absolutely safe for the further development of the baby and, in order to avoid painful natural childbirth, they even ask to perform a caesarean section “by own will". Others, on the contrary, believe that a cesarean section for a child is a stigma for the rest of his life, and a child born after a cesarean section will certainly have a developmental delay. Consider the most common stereotypes about the development of "Caesar" children and see how they correspond to reality.

Myth #1. Children-"caesarites" lag behind in physical development.

Undoubtedly, surgical intervention always has its risks. Due to the lack of normal compression chest the baby's first breath comes later, amniotic fluid often enters the Airways, and under the influence of drugs for anesthesia, the nervous system of the baby is inhibited. All this leads to disruption of the respiratory, cardiovascular and nervous systems. During and after the operation, the child's body experiences hypoxia (oxygen deficiency), which adversely affects early adaptation to new conditions, which can indeed have long-term consequences in the form of a delay physical development.

Caesarean children are at risk for lagging behind in gains in height and weight. But whether the baby will lag behind in physical development or not depends on many factors - in particular, on whether the caesarean section was planned or emergency.

An emergency operation is performed without prior special training when complications arose during natural childbirth. Undoubtedly, the risk in this case is many times higher than the risk of elective surgery.

The threat of a lag in the physical development of “caesarean” depends not only on the method of childbirth, but also on how the pregnancy proceeded, whether the woman has any chronic diseases. At severe course pregnancy, especially against the background of such diseases of the mother as diabetes, chronic pyelonephritis, hypertension, the risk of delaying the physical development of the baby is very high even during childbirth naturally. At the same time, if the woman is healthy, but the caesarean section was performed due to a clinically narrow pelvis (mismatch between the size of the pelvis of the mother and the size of the fetus, which makes it impossible for the normal course of natural childbirth), and if the operation was successful, it is likely that the child will have normal performance weight and height.

Mention should be made of the physiological decrease in body weight, which is observed in all children immediately after birth. Normally, in the first days of life, an infant loses up to 4–10% of its birth weight, and it is possible to restore the lost weight on an average of the 7–10th day of life. But "Caesarites" usually lose more weight (8-10%), and their initial mass is restored a little later (on the 10-14th day). But later on, proper care height and weight gains return to normal.

Thus, "Caesarites" do not always lag behind in physical development. In addition, the compensatory possibilities of the developing human body are huge, so the baby may well develop normally and grow up healthy, and sometimes even get ahead of their peers in terms of their physical indicators.

Myth #2. "Kesaryata" cry more often than children born naturally.

Cesarean section for a child due to oxygen starvation(the baby experiences it during and after the operation) adverse effect on the nervous system of the crumbs.

During natural childbirth, the baby, passing through birth canal mothers are under a lot of stress. This reaction is accompanied by the release huge amount hormones, activation of neurophysiological processes in the brain and has positive influence on the early adaptation of the newborn to new conditions of existence and on further development his nervous system.

Children after caesarean section do not experience this stress that is so positive for the body. On the contrary, under the influence narcotic drugs and anesthetics (which are used for anesthesia and pain relief during surgery), the nervous system of the newborn is in a depressed state.

But a caesarean section for a child is only a risk factor for developmental disorders of the nervous system, and not an indispensable condition for this. Therefore, having restored its activity a little later, the further work of the nervous system may well return to normal, and the baby will cry no more than children born naturally.

Myth #3. "Kesaryata" are always hyperactive children.

Hyperactivity is understood as a complex of neurological and behavioral disorders, manifested by impaired concentration and increased activity child. Indeed, a caesarean section for a child is one of the risk factors for the development of hyperactivity, which is a symptom of impaired maturation of the nervous system and a consequence of the pathological effects that were described above.

With modern competent treatment under the supervision of a neuropathologist and proper care for a child, hyperactivity can be dealt with. But still it is worth noting that the development of this syndrome is not a mandatory and common condition for babies born operational way.

Myth number 4. After a caesarean section, the mother will not have breast milk, and the child will develop worse.

It is known that the first drops of breast milk (colostrum) have a special nutritional and energy value compared with the composition of breast milk in the future. At normal flow childbirth in a natural way, the baby immediately after birth is applied to mother's breast and he gets those priceless drops. In addition, at the same time, the colonization of the intestines of the child occurs. beneficial microflora. Also, early attachment to the breast contributes to the further development of lactation.

scientific fact
An interesting study was conducted in which an electroencephalogram (EEG) was performed on children born naturally and operatively. The EEG registers electrical activity brain, which can be used to judge the functioning of the nervous system. In the course of the work carried out, it turned out that the “caesarites” had a recovery normal state of the brain occurs only on the 9-10th day of life, while in babies born naturally, normal EEG values ​​are recorded from the first days of life.

Often, children after a caesarean section are not applied to the mother's breast in the first hours of life. This is due to the severity of the woman's condition after surgery, and in some cases serious condition baby. Sometimes, as a result of the stress experienced by a woman in labor during a cesarean section and the lack of early attachment to the breast, lactation is disturbed. But breast milk contains essential substances and trace elements needed for normal growth and development of the child. It has been statistically proven that breastfed babies have best performance neuropsychic development compared to those who receive artificial nutrition.

Another important aspect is that, as a rule, a woman is prescribed antibiotics after surgery. If the drug can be used during breastfeeding, then the mother is allowed to breastfeed the baby. If the antibiotic is incompatible with breastfeeding, the newborn baby will have to be temporarily transferred to formula feeding.

It turns out that concerns about problems with breastfeeding after a caesarean section are justified to a certain extent. But many mothers who have undergone this operation manage to keep normal lactation and successfully breastfeed your baby. In addition, in the case of a caesarean section regional anesthesia(when only the lower half of the body is anesthetized and the woman is conscious during the operation), the newborn is applied to the breast immediately after childbirth, which in the future avoids many problems with lactation and, accordingly, the subsequent development of the baby.

Myth number 5. "Kesaryats" need special development programs.

Indeed, children born by caesarean section are under special care of the pediatrician and require closer medical attention. patronage and preventive examinations a pediatrician, a neurologist, and, if necessary, other specialists are carried out more often. This is necessary in order to identify a delay or deviation in the development of the baby as early as possible. However, for the most part, "caesarites" develop normally, and in this case, no special programs are required to accelerate their development.

If there is a delay in neuropsychic or physical development (as a rule, this occurs in the presence of several aggravating factors, and not only due to operative delivery), treatment of these deviations is prescribed.

A caesarean section, like any surgical intervention, is a risk for both the mother and the child, so it is not performed at the request of the woman alone. If, for one reason or another, the baby was born as a result of operative childbirth, do not despair and obviously expect problems with its development. With proper care, close supervision and timely diagnosis If any deviations arise, the child will grow and develop normally, and possibly, in some way, will be ahead of his peers.

Fear of childbirth overcomes almost every expectant mother, and it doesn’t matter if she has already gone through it or not. 'Cause lately everything large quantity pregnant women are thinking about a caesarean section. This method of delivery, in a sense, has even become fashionable. And it seems that everything is so simple: no pain, a few hours of sleep - and you wake up next to your baby, peacefully snoring in a cuvette for newborns. But is everything as cloudless as it seems at first glance? Of course, only you make the decision, but it is better to do this, knowing about all the consequences of a caesarean section.

First you need to understand what a caesarean section is. In general, this is a common abdominal operation, during which an incision is made in the abdomen and uterus, after which the child is removed. But, like any surgical intervention, a caesarean section cannot but affect the condition of the woman and, oddly enough, the baby.

The consequences of caesarean section for the mother

To be ready for the "surprises" associated with the proposed operation, we list the negative consequences that may lie in wait for mothers after surgical intervention:

• Painful sensations. If it seems to someone that the anesthesia done before the operation will relieve the pain completely, then he is greatly mistaken. The effect of anesthesia will end, after which the “pleasant” sensations will begin. Discomfort will be observed for several weeks after the operation. Yes, anesthetics will reduce the pain for a while, but in any case, it will not be possible to fully live at this time. After a caesarean section, the body recovers much longer than after a natural birth;
• The risk of infection. As with any operation, on the eve of a caesarean section, pregnant women are prescribed antibiotics to avoid infection, but the risk still exists. If you have a fever, foul-smelling discharge, or heavy bleeding, immediately inform your doctor or obstetrician about this;
• Threat of blood clots. Blood thinners are usually prescribed to reduce the chance of clots forming before surgery. In addition, after a cesarean, doctors advise starting to move as soon as possible in order to restore blood circulation. It is also useful to wear compression stockings;
• The likelihood of adhesion formation. A fairly common consequence of caesarean section for the mother is the occurrence of internal adhesions. Experts say that this is a specific defensive reaction body for surgery. Any wound recovers on its own, regardless of your or medical desire, and scars often form in its place. Moreover, their occurrence is possible not only at the site of the wound itself, but also in nearby organs. So, adhesions between intestinal loops or other organs of the small pelvis are a frequent consequence of a caesarean section. As a result, the woman experiences painful and discomfort, there is a risk of developing intestinal obstruction, possibly infertility;
• Minimum physical activity. You can get out of bed and approach your baby only six hours after the operation, and in the next few months the body will need to be protected;
• The ban on putting the baby to the breast. All bright prospects for painless childbirth are shattered when you realize that your baby will not be able to get such useful colostrum in the first minutes of his life. In women who have undergone a caesarean section, lactation occurs at the same time as in those who have given birth naturally, but it is not allowed to apply a newborn to the breast due to the action of drugs administered to the mother during anesthesia. At first, the baby is fed from a bottle, and if a woman in labor wants to establish breastfeeding, she will have to wait until the anesthetic substances are completely eliminated from the body;
• Psychological discomfort. A factor that cannot be discounted. Frequent Consequence caesarean section - difficulties in awakening the maternal instinct, that is, at first the mother does not manage to feel a connection with her baby.

Do not forget that anesthesia has its own side effects. future mommy before the planned operation caesarean section can choose the method of pain relief - epidural anesthesia or general anesthesia. Any of them affects both the mother and the child. But since several drugs are injected into a woman’s body during general anesthesia, its consequences are much more tangible. May be observed headache and dizziness, nausea, muscle pain and clouded consciousness, which, you see, is not very pleasant.

If you opt for an epidural, be prepared for back pain and tremors in your legs. If a mistake is made during the administration of the drug, it is possible traumatic injury spinal cord. Yes, the probability is minimal, but still it is.

The consequences of a caesarean section for a child

The child gives birth to the birth process. The cherished moment comes only when the baby is completely ready for birth. The cesarean section operation violates all the laws of nature, and this cannot pass without a trace for the crumbs:

• According to scientists, children born as a result of caesarean section adapt much worse to the conditions of extrauterine life;
• With this method of birth, in many babies, amniotic fluid remains in the lungs, which, in babies born naturally, is pushed out during passage through the birth canal. The presence of fluid in the lungs further provokes various disorders of the respiratory system;
• Anesthetic drugs that enter the child's bloodstream adversely affect his nervous system;
• Increased excitability and muscle hypertonicity in cesareans are diagnosed more often than in children born as a result of natural childbirth.

The psychological consequences of a cesarean section for a child do not have direct evidence, however, experts have noticed that such children grow up infantile and dependent, they are uncharacteristically persistent in achieving goals and striving to overcome difficulties, it is very difficult for them to make decisions. Yes, children born natural way, similar qualities may also be inherent, but much depends on the upbringing and attention of parents.

Caesarean section is not such a rare procedure: according to statistics, the proportion of children born in this way is about 15%. Future mom she simply must know what she needs to be prepared for, since it is impossible to fully insure against such an operation and be sure that the child will be born on her own.

The reasons for a caesarean section can be both on the part of the woman in labor and on the part of the fetus. Indications are divided into absolute (when childbirth is physically impossible naturally) and relative (in which childbirth is possible, but with a threat to the life and health of the mother or child).

The condition of the woman in labor

• Irregular placenta previa children's place) and other disorders of placentation. When the placenta is attached low - so that it blocks the entrance to the uterus from outside- there is a risk of bleeding and miscarriage. Premature aging placenta and its detachment are dangerous with hidden and obvious bleeding, inability to breathe and feed the fetus.
• Absolutely narrow pelvis. The situation when the pelvis of the woman in labor is anatomically and clinically narrowed, and the passage of the child through the birth canal is impossible.
• Multiple uterine fibroids and other malignant neoplastic diseases internal genital organs.
• The threat of rupture of the thinned wall of the uterus after multiple births or the divergence of the seam during repeated caesarean section.
• Complete absence labor activity, not amenable to medical correction.
• The narrowness of the pelvis is clinical. It turns out on the patronage of a gynecologist during pregnancy.
• Age over 35 in a nulliparous woman.
• Diseases of the mother severe violations vision, presence artificial organs, genital herpes in the progressive phase, bronchial asthma, diabetes, hypertension, pubic bone divergence, varicose veins veins). It's about about serious illnesses in which the pregnant woman is observed by the relevant specialists.
• Complications of pregnancy, not amenable to treatment.
• Severe perineal tears after previous births.
• IVF, long-term infertility, a history of fetal fading in combination with other pathologies.
• Previous caesarean sections.

Fetal condition

• Severe violation of placental nutrition, lack of oxygen (hypoxia). It is found out with the help of ultrasound and CTG diagnostics.
• Placental abruption at any stage of pregnancy.
• The transverse position of one or more fetuses is almost always the basis for surgical intervention.
• Prolapse of the umbilical cord (leads to blocking the oxygen supply to the child).
• Incorrect entry of the baby's head into the birth canal.
• Hypotrophy, FGR of the 2nd and 3rd degree.
• Excessively large (more than 4 kg) or small (less than 2 kg) fruit.
• Breech presentation of the fetus, especially male.
• Rh-conflict of the blood of mother and child, in which it can develop hemolytic disease fetus (destruction). The child's body gets poisoned by decay products, which results in the occurrence of jaundice in newborns.
• Defects in the development of the fetus.

Stitches after surgery

After this procedure, the woman is guaranteed to have a seam. It will most likely last a lifetime.

What are the seams

According to how the incision is made, the seams are divided into:

A vertical incision (from the navel to the pubic bone) is made during the so-called corporal surgery. They are carried out when an urgent (emergency) delivery is needed. For example, when:

• bleeding;
• acute hypoxia in the fetus;
• varicose veins in the lower abdomen;
• low attachment of the placenta;
• presence of a vertical seam.

The vertical seam after caesarean section looks very untidy, through certain time it becomes thicker, more noticeable.

The reason for this is the imposition of interrupted sutures, which are necessary for a stronger connection of tissues.

When performing a Pfannestiel laparotomy, an incision is made in the transverse direction above pubic bone. The scar is almost invisible, since the incision is located inside skin fold. Yes, and impose here cosmetic seam, which after a while will resolve on its own, without requiring removal.

How to process a seam

After the operation, the doctor stitches all layers of the abdominal wall. The skin after a caesarean section is sutured with a non-absorbable (insoluble) suture, which is usually removed on the eighth day after the operation. On the first day, a bandage is applied, which promotes wound healing after cesarean. You can’t soak it, so if you want to take a shower, of course, you need to cover the seam with a towel. When dressed, you should take care that the wound and the surrounding area are perfectly clean. Otherwise, it can lead to infection, inflammation, and even rupture of the suture after a cesarean.

The skin should be washed with water and gel for intimate hygiene at least three times a day. You can also use unscented liquid soap. After washing, the seam is gently wiped dry with a disposable towel (there are too many germs on cotton, even if they are freshly washed). Then you can rub it with alcohol or salicylic acid or a ready swab dipped in alcohol.

Until the wound is completely healed, wear light, breathable underwear. Pants can injure the seam after a caesarean. The best are loose trousers made of cotton, with a fairly high waist. You should also remember to take good care of your intimate hygiene and wash your hands after every use of the toilet. Fecal bacteria multiply rapidly and can easily move into the area of ​​the wound, causing the suture to become inflamed.

Consequences for the mother

Certain risks and consequences are associated with a caesarean section:

• 1/3 of women after caesarean section have operational complications.
• Risk of infections of internal organs (uterus and neighboring organs).
• Danger of large blood loss with the need for a blood transfusion.
• Unforeseen reactions of the body to anesthesia (for example, a rapid drop in pressure).
• Weakening of the intestines.
• Recovery, even with a successful postoperative course, is slower than after natural childbirth.
• Allocations, minor bleeding will last 4-6 weeks after surgery.
• Soreness of the suture may persist for several weeks after surgery.

If a pain very strong, you can discuss with your doctor the advisability of using painkillers - choose those medications that will be safe for breastfeeding.

Risks for the child

Is it possible to give birth normally after a cesarean?

Whether a woman wants to give birth next child naturally or ready for reoperation, anyway the first two-three years it is necessary to be protected. Contraceptive methods can be discussed in antenatal clinic(usually this is hormonal pills, spiral or condoms).

It should be remembered: a new pregnancy is not yet desirable. The minimum break is a year and a half.

But at the same time, one should not think that the more time passes after a cesarean section, the better the suture will heal. The scar is formed within a year, and then nothing qualitatively new happens to it. If, for example, the scar is thinned, then it will remain so. And too long break between pregnancies (10 years or more) is also undesirable - with more late age patients, doctors will prefer not to take risks and, perhaps, just in case, they will do a caesarean. It is necessary to avoid abortions - after all, curettage of the uterus thins the scar and can make it defective.

If after new pregnancy the woman went through necessary examinations and was convinced of the usefulness of the scar, special precautions not required. If a mother wants to try to give birth to a child herself, she should inform the local obstetrician-gynecologist about this. It is better to ask for a referral to a good maternity hospital or a clinic at a scientific institute, where the woman in labor will be examined and prepared for childbirth.

You need to understand that the case is not easy and you should not allow childbirth “on the stream”. In the hospital, shortly before the birth, doctors conduct a final assessment of the situation: they examine the scar and monitor the condition of the birth canal - if the cervix softens and opens according to the timing, this is a favorable indicator. Important role the size of the fetus plays: it is better not to risk it with a very large child.

A woman with a scar on the uterus, as a rule, is satisfied with a planned birth. She is hospitalized in advance, and at a period of about 40 weeks she is pierced amniotic sac and induce childbirth. This is done for maximum safety, so that the patient gives birth in daytime when the entire team is on site. The operating room must be in full combat readiness - at the slightest danger, the woman in labor will be given an emergency caesarean section. What is this danger?

The only and very terrible possible complication- rupture of the uterus along the scar.

This is extremely rare, but it does happen. It is because of this threat that doctors are reluctant to take the risk of spontaneous delivery after a caesarean section.

Nature intended that children be born in a natural way, and not with the help of an incision in the abdomen. In this regard, many oppose cesarean section, including the famous foreign doctor Michel Auden. Cm. " " .

Nevertheless, thanks to caesarean section, many lives were saved, both for children and their mothers. A caesarean section cannot be considered unequivocally evil or unequivocally good, it can both save lives and bring a lot serious consequences for both women and children.

It is not for nothing that WHO recommends that the proportion of caesarean deliveries be no more than 15% of total number childbirth. This makes doctors wonder whether a caesarean section is necessary in each case or if it can be dispensed with. All experts agree on one thing: a caesarean section is an operation and it must be carried out according to strict indications. Cm. " " .

Of course, there are many situations when an operation not performed on time will have much more consequences than complications from it and sometimes a caesarean - the only way save the life of a mother or child.

You can not thoughtlessly refuse the operation, as well as ask to do it only because of your own fear of childbirth. Being aware of the risks will help you make an informed decision.

Consequences of a caesarean section for a woman.

A caesarean section is a major abdominal operation that can have the following consequences for a woman.

surgical consequences. A complication of a caesarean section can be: damage to the uterus and cervix, as well as neighboring organs (intestines, bladder). With CS, there is a high risk of large blood loss (more than 1 liter) and associated complications (need for blood transfusion, anemia).

AT rare cases when the bleeding cannot be stopped, removal of the uterus may be necessary. All complications are more common with emergency caesarean. Also, the frequency of complications is higher in women who have had three or more CSs.

Long-term effects include surgical adhesions and prolonged pain in the pelvic area.

Infectious consequences: endometritis (inflammation of the lining of the uterus), wound infection, bladder infection, very rare serious infections such as sepsis. In this regard, women who have had a caesarean section are much more likely to need antibiotic therapy in the postpartum period.

Psychological consequences. Studies have shown that mothers who have had a caesarean section are less satisfied with their birth experience, they are often disappointed, and they are at increased risk of postpartum depression.

Impact on next pregnancy. Caesarean section increases the risk of infertility and complications of the next pregnancy (placenta previa, placental abruption, ectopic pregnancy). The risk of uterine rupture also increases later dates or during childbirth, especially if next pregnancy occurred shortly after caesarean.

With each caesarean section, the risk of a serious complication of pregnancy - placenta ingrowth - increases. Sometimes the villi of the placenta grow deep into the muscular layer of the uterus and even go beyond it. This pathology most often does not affect the course of pregnancy, but after childbirth it is necessary to undergo serious treatment.

Problems with breastfeeding: delayed start of breastfeeding, difficulty with attachment. Women who have had a caesarean are less likely to breastfeed than women who have had a natural birth.

Increased risk of thromboembolism(blockage of blood vessels by a thrombus).

Longer Recovery after surgery than after natural childbirth.

Longer hospital stay.

Possible Negative influence on the gynecological health women.

Bowel problems, constipation in the postpartum period.
Nausea, vomiting, headache associated with anesthesia.

To prevent infection urinary tract empty on time bladder and drink enough fluids.

Be active after the operation, which will improve blood circulation, avoid congestion in the lungs, thrombosis. Roll over in bed, get up as soon as the doctor allows.

The first weeks after the operation, do not abruptly get up and do not run, do not lift heavy things.

The risk of infection, especially in an emergency caesarean, can be reduced by prophylactic antibiotics.

An important role in the prevention of complications is also played by the qualifications of the surgeon and high-quality suture material.

Consequences of caesarean section for the child.

During a caesarean section, compared to a natural birth, the baby is born too quickly, and therefore there is an increased risk of respiratory distress syndrome (breathing disorders in newborns), especially if a caesarean was performed before the natural onset of labor.

Caesareans often have low Apgar scores and difficulty breathing spontaneously. Immediately after birth, the baby may need intensive care.

If the gestational age has not been calculated correctly, the baby may be born prematurely and have a low birth weight.

Injury to a child during surgery is very rare, but there is a risk, especially if a caesarean is done during labor and if the surgeon is unskilled.

This is how our world works, that a person must overcome many difficulties during his life, especially this applies to the weaker sex. Tests such as pregnancy and childbirth cannot be ruled out. Quite often, situations arise when a child needs to be “extracted” from a woman’s womb by means of a caesarean section.

Many representatives of the weaker sex consider this termination of pregnancy to be more preferable, since they either do not know or forget about the potential threat of complications after cesarean section.

Of course, a woman should also remember how difficult and long it will be postoperative rehabilitation how much patience, perseverance and strength is required.

Negative moments of delivery by caesarean section

Undoubtedly, abdominal delivery is no longer an operation of desperation, when everything was resorted to to facilitate the appearance of a child. possible techniques. Accordingly, the risk of postoperative complications, complications during the operation itself and during rehabilitation.

However, it is not only possible, but necessary, to prevent various hypothetical consequences after surgical delivery. The percentage of consequences after the operation is directly proportional to:

the method of performing the operation;

the time spent on the operation;

antibiotic therapy after surgery;

the quality of the suture material;

qualifications of the surgeon and other factors that may affect the operation in the postoperative period.

It is worth noting that any caesarean section (even if it is performed perfectly) cannot pass without a trace for the child and mother. Only quantitative indicators of consequences vary.

The consequences of caesarean section for the mother

Suture on the anterior abdominal wall.

The presence of an unaesthetic and rough scar on the anterior abdominal wall carries a lot of negative emotions. I would like such negative point was the only one for a woman, because the main goal is not physical beauty, but healthy mom and baby in the end.

You should not be upset about the “disfigured abdomen”, because today there are methods by which you can make an intradermal suture (suturing the skin) or make an incision in suprapubic region(cross section), which will allow a woman to wear even a swimsuit without fear.

The formation of a skin (wide, convex or inconspicuous) scar depends on the secretion of certain enzymes by the body. Unfortunately, some people produce more of them, while others have less, as a result of which a keloid scar is formed. But even then, there is no need to be upset, because modern medicine offers a lot of ways to get rid of the scar (for example, laser correction, "polishing" of the scar).

Adhesive disease.

After any surgical intervention in the abdominal cavity, adhesions form. Especially high risk development adhesive process in case of ingestion of amniotic water and blood into the abdomen, with traumatic and long operation, as well as complications during rehabilitation period(purulent-septic diseases, peritonitis, development of endometritis).

Connective tissue adhesions and strands lead to tugging of the intestine, as a result of which its functionality is disturbed, and the ligaments that hold the uterus, ovaries, and tubes also suffer. All this can be the reason:

improper location of the uterus (back bend or bend), this affects the menstrual cycle;

tubal infertility;

the development of intestinal obstruction;

permanent constipation.

After performing 2, 3 caesarean sections, the consequences in the form of the most adhesive disease and its complications are more likely.

Postoperative hernia.

Education is not ruled out. postoperative hernia in the area of ​​the surgical scar, which is associated with insufficient comparison of tissues during wound closure (aponeurosis) and the course early period after operation. Sometimes there may be a divergence (diastasis) of the rectus abdominis muscles, a decrease in their tone and loss of functionality:

digestion is disturbed and pain appears in the spine;

formed umbilical hernia(the umbilical ring is the weakest point in the abdominal wall);

as a result of the redistribution of the load on the remaining muscles, they can shift or fall internal organs(vagina, uterus).

The effects of anesthesia.

The decision on the need for anesthesia during caesarean section is made by the anesthetist. Anesthesia can be either intravenous using tracheal intubation or spinal anesthesia. Among the frequent complaints when using endotracheal anesthesia, cough and sore throat are noted, which are explained by the accumulation of mucus in the bronchopulmonary tract and microtrauma of the trachea.

Also exit from general anesthesia quite often accompanied by drowsiness, confusion, vomiting (rarely), nausea. These symptoms disappear within a few hours. Spinal anesthesia can cause headaches, therefore, after such anesthesia, patients are recommended to be in a horizontal position for 12 hours.

With spinal and epidural anesthesia, damage to the roots of the spinal cord can occur, this manifests itself in the form of back pain, trembling and weakness in the limbs.

Scar on the uterus.

After delivery by caesarean section, a scar remains forever on the uterus. The main criterion for the uterine scar is its consistency, which largely depends on the course postoperative period and quality of the operation.

A thinned (insolvent) scar on the uterus can cause a threat of premature termination of pregnancy, and in some cases even uterine rupture, not only during childbirth, but also during pregnancy. That is why doctors advise women who are planning a second birth by caesarean section to perform sterilization. At the third operation, tubal ligation is insisted.

Endometriosis.

Endometriosis is characterized by the fact that there is an accumulation of cells similar in structure to the endometrium in places that are not typical for them. Quite often, after a cesarean section, endometriosis appears on the uterine scar, because in the process of suturing the incision of the uterus, cells from its mucous membrane can get to the outer side, in the future they begin to grow into the muscle and serous layers, endometriosis of the scar appears.

Cases of development of endometriosis of the skin suture are known.

Endometriosis can cause future infertility, but the disease develops years later.

Women suffer from constant pain in the lower abdomen, the strength of which depends on the phase of the cycle (during menstruation, the pain usually increases).

Problems with lactation.

Many patients after surgery experience problems with the process of lactation. This is especially true for those who had a planned caesarean, before the onset of childbirth. The flow of milk to the glands after caesarean in women who had a natural birth and gave birth naturally occurs on the 3rd-4th day, otherwise it happens on the 5th-9th day.

This is due to the fact that during childbirth, the body synthesizes oxytocin, leading to uterine contractions. This component is also responsible for the production of prolactin, which, in turn, is responsible for the synthesis and release of milk.

It becomes clear that a woman after a planned operation cannot provide the child with milk on her own, she has to supplement the newborn with mixtures, and this is not very good. Often, women after caesarean section develop hypogalactia (lack of milk production) or even agalactia.

Consequences of caesarean section for a newborn

A caesarean section also affects the baby. “Caesarites” quite often have breathing problems.

Firstly, if the operation was performed under intravenous anesthesia, then a certain part of the narcotic drugs penetrates with the bloodstream into the blood of the child, respiratory center oppressed, which can lead to asphyxia. In addition, in the first days and weeks, mothers note lethargy and passivity of the baby, the child does not take the breast well.

Secondly, in the lungs of children who were born by caesarean section, fluid and mucus remain, which are normally pushed out during the passage of the fetus through the birth canal. In the future, the remnants of the fluid are absorbed into the lung tissue, and this is the cause of the development of hyaline-membrane disease. Remaining liquid and mucus are an excellent substrate for reproduction. pathogenic microorganisms, which subsequently leads to respiratory disorders or pneumonia.

During natural delivery, the baby is in a state of sleep. With hypernation physiological processes slow down, which serves to protect the newborn from a pressure drop at the time of birth.

With a caesarean section, the baby immediately enters the external environment from an incision in the uterus, he is not prepared for this pressure drop, as a result - microbleeds in the brain (experts believe that such a pressure drop in an adult would end pain shock and death).

"Kesaryats" adapt much longer and worse to environmental conditions, because they do not experience stress during passage through the birth canal, they do not produce catecholamines - hormones responsible for adapting to completely new conditions of existence.

To long-term consequences include:

frequent development of food allergies;

increased excitability and hyperactivity of cesarean children;

poor weight gain.

There are problems with breastfeeding the baby. The child who ate artificial mixtures while the woman was recovering from anesthesia, taking a course of antibiotic therapy, becomes unmotivated to breastfeeding, he sluggishly takes the breast and does not want to make an effort to get it out of the breast mother's milk(sucking from a bottle is much easier).

The specialist also believes that after a cesarean section there is no psychological connection between the child and the mother, which is normally formed during the natural birth process and is fixed during early attachment to the breast (immediately after birth and dissection of the umbilical cord).

Recovery after caesarean section

Immediately after the operation, the woman is transferred to the department intensive care, where she is during the day under the close supervision of medical personnel. At this time, it is required to apply ice to the abdomen and inject painkillers. After a caesarean section, the recovery of the body should begin immediately:

Physical activity.

The sooner a newly-made mother restores physical activity after the operation, the sooner her usual rhythm of life will be restored.

The first day, especially if spinal anesthesia was used, the woman must observe bed rest, however, it is less strict and you can move.

You need to roll over from one side to another right in bed, do leg exercises:

• bend your legs alternately knee joint and then straighten it;

  press your knees to each other, and then relax them;

  perform rotational movements with the feet in different directions;

  pull your toes towards you.

Each exercise should be performed at least 10 times.

Immediately you need to start doing Kegel exercises (periodic contraction and relaxation of the muscles of the vagina), they help strengthen muscular system pelvic floor and are preventive possible problems with urination.

You can get out of bed after a day. To perform the lift, you need to turn on your side, lower your legs off the bed, then, resting your hands on it, lift upper part torso and sit down.

Get out of bed only under the supervision of a nurse. Early physical activity stimulating effect on intestinal motility, thereby preventing the formation of adhesions.

Skin sutures are treated daily with antiseptic solutions (potassium permanganate, brilliant green, 70% alcohol), the dressing is changed. Removal of sutures is performed on the 7-10th day after caesarean section (an exception is the intradermal suture, which dissolves on its own after 2-2.5 months).

In order for the scar to dissolve better and avoid keloid, doctors recommend treating the sutures with gels (Kontraktubeks, Curiosin). You can take a shower after removing the stitches and healing the skin scar, after about 7-8 days (it is forbidden to rub the seam with a washcloth), baths and baths should be postponed for 2 months (until the uterine scar heals).

Nutrition and intestinal gases.

Outgassing is one of the important elements restoration of bowel functions. After a caesarean section, you should follow a certain diet. On the first day, only mineral water without gases or water lemon juice. On the second day, you can take chicken or meat broth, kefir, rolled meat, low-fat cottage cheese.

After self-emptying of the intestines, usually this happens on the 4-5th day, the woman is transferred to a normal diet. You should not hold back gases, for their easier discharge, you need to perform stroking movements in a clockwise direction, then roll over on your side, take your leg and relieve yourself. If constipation occurs, you can resort to the use of "Microlax" or glycerin suppositories, they must be approved for use during lactation and breastfeeding.

Bandage.

Wearing a bandage will greatly facilitate the life of a woman in the first days after a cesarean section. But you do not need to abuse this device in order to restore muscle tone of the anterior abdominal wall passed quickly and fully, the bandage must be periodically removed and the periods of being without this device gradually lengthened.

Cough.

After surgery, women often suffer from coughing, especially if endotracheal anesthesia was used. At the same time, the fear that the stitches will open during a cough makes many hold back. In order to strengthen the seams, you can press a pillow against them or perform a dressing with a towel, then take a deep breath and exhale completely, making a sound similar to “woof”.

Physical activity and restoration of elasticity of the anterior abdominal wall.

After delivery by caesarean section, the patient is limited to lifting weights to the limits of 3-4 kg for 3 months. Raising and caring for a child is not prohibited, but rather welcomed. At the same time, all household work that is associated with squats, bends, should be entrusted to another family member.

One month after caesarean section, you can start physical activities from the lungs gymnastic exercises. After the operation to restore the abdomen, you can start pumping the press no earlier than six months later. By and large, a sagging belly will return to normal after 6-12 months (muscles and skin will become elastic, and their tone will be restored).

Sports in order to restore the figure after surgery (yoga, body flex, aerobics, fitness) should be carried out only after consulting a doctor and only under the supervision of an instructor, not earlier than after 6 months. Bodyflex exercises do an excellent job of restoring the figure and abdomen, 15 minutes a day is enough.

Sex life.

You can resume sexual intercourse 1.5-2 months after the operation (the period is the same as with natural childbirth). Such a period of abstinence is required for the healing of the site of attachment of the placenta to the uterus and the uterine suture.

It is important to think about contraception even before the start of an active sexual life. After the operation, the intrauterine device can be installed only after 6 months from the moment of the operation, while the abortion is the strictest contraindication, since the scar is re-traumatized and its failure may develop.

Menstrual cycle.

There are no differences in the restoration of the cycle after caesarean section and childbirth in a natural way. If a newborn is breastfed, menstruation may begin 6 months after birth or even later. If there is no lactation menstrual cycle recovered after 2 months.

next pregnancy.

Obstetricians recommend refraining from a new pregnancy for at least two years, and preferably at least three. During this time period, a woman manages to fully recover both psychologically and physically. Complete healing of the scar on the uterus is also necessary.

Observation at the gynecologist.

All women after caesarean section in without fail are registered in the antenatal clinic, observation is carried out for 2 years. The first visit after a caesarean section must be performed no later than 10 days later. An ultrasound of the uterus is required. After the end of lochia (6-8 weeks), a second visit is performed. A visit at six months is necessary to assess the healing of the scar on the uterus, subsequent visits to the gynecologist should be carried out at least once every six months.