A Cesarean Delivery
A Cesarean Delivery
A cesarean section is also known as a c-section, which is sometimes also written as c/s. This type of birth is done by a surgical incision in the abdomen and uterus to allow a baby or babies to be born safely when a vaginal birth is not the safest route. The current cesarean rate in the United States is over 30%.
The surgery is relatively safe for mother and baby. Still, it is major surgery and carries risks. It also takes longer to recover from a C-section than from vaginal birth. After healing, the incision may leave a weak spot in the wall of the uterus. This could cause problems with an attempted vaginal birth later. However, more than half of women who have a C-section can give vaginal birth later.
A C-section may be planned or unplanned. In most cases, doctors do cesarean sections because of problems that arise during labor. Reasons you might need an unplanned C-section include labor is slow and hard or stops completely; the baby shows signs of distress, such as a very fast or slow heart rate; a problem with the placenta or umbilical cord puts the baby at risk or the baby is too big to be delivered vaginally this is called fetopelvic disproportion.
When doctors know about a problem ahead of time, they may schedule a C -section. Reasons you might have a planned C-section include the baby is not in a head-down position close to your due date; you have a problem such as heart disease that could be ma de worse by the stress of labor; you have an infection that you could pass to the baby during a vaginal birth; you are carrying more than one baby (multiple pregnancy) or you had a C-section before, and you have the same problems this time or your doctor thinks labor might cause your scar to tear (uterine rupture).
In some cases, a woman who had a C-section in the past may be able to deliver her next baby through the birth canal. This is called vaginal birth after cesarean (VBAC). If you have had a previous C-section, ask your doctor if VBAC might be an option this time.
In the past 40 years, the rate of cesarean deliveries has jumped from about 1 out of 20 births to about 1 out of 4 births. This trend has caused experts to worry that C -section is being done more often than it is needed. Because of the risks, experts feel that C -section should only be done for medical reasons. Before a C-section, a needle called an IV is put in one of the mother's veins to give fluids and medicine (if needed) during the surgery. She will then get medicine (either epidural or spinal anesthesia) to numb her belly and legs. Fast-acting general anesthesia, which makes the mother sleep during the surgery, is only used in an emergency.
Once the anesthesia is working, the doctor makes the incision. Usually it is made low across the belly, just above the pubic hair line. This may be called a "bikini cut." Sometimes the incision is made from the navel down to the pubic area.. After lifting the baby out, the doctor removes the placenta and closes the incision with stitches.
After a routine cesarean section, expect to be monitored closely for the next 24 hours to make sure that you don't develop any problems. You will receive pain medicine and will likely be encouraged to begin walking short distances within 24 hours of surgery. Walking can help relieve gas buildup in the abdomen. It is usually very uncomfortable to begin walking, but the pain will decrease in the days after the delivery. Nursing interventions would include: monitor and document vital signs and FHR; maintain good aseptic technique during vaginal examinations, catheterization, and preoperative skin preparation; monitor blood loss and white blood cell count; monitor and encourage fluid intake and administer antibiotics as order. The nurse will want to evaluate the patient’s self-esteem related to changes in the birth plan and discuss the reason for the changes with the patient. Encourage the patient to verbalize her...
References: Christensen, B.L. & Kockrow, E.O. (2011) Foundations of Nursing (6 th ed.) St. Louis: Mosby
"Cesarean Section – A Brief History: Part 1"
Bewley S, Cockburn J. (2002). "The unfacts of 'request ' Caesarean section". BCOG 109 (6): 597–605.
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