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Cesarean Sections

Most labors result in vaginal delivery.  However, there are circumstances beyond our control that arise in pregnancy and labor that require an alternative route to delivery.  A cesarean delivery is the birth of a fetus through a cut (incision ) made by a surgeon in the belly (abdomen) and womb (uterus).  Cesarean delivery is also known as C-Section. 

There are two kinds of cesarean deliveries.  Most commonly, a transverse incision is made on the uterus.  In other instances, it is necessary to make a vertical incision to deliver the baby safely.  The incision on the abdomen does not always indicate the type of incision needed for the uterus. 

Common reasons for having a cesarean delivery include:

  • You have had a c-section previously
  • The baby is breech (buttocks or feet first) or transverse (sideways) position
  • You have a twin pregnancy
  • Failure to progress in labor i.e. the cervix doesn't open or dilate or the head doesn't come down
  • Concern for the mother or fetus in labor
  • Fetal Intolerance - some babies do not tolerate labor and can not maintain normal heart rates during contractions
  • Placenta Previa - the placenta is covering the cervix
  • Active Herpes infection
  • The baby is large and estimated to weigh more than 9lbs

What Happens in a C-Section

Most of the time, the father of the baby is in the room to attend the birth unless it is an emergency c-section.  You will have an IV in your arm and the pubic hair is shaved a little to prevent infection in the incision site.  You will be given an antacid medicine to drink to prevent stomach acid from going into your lungs if you have to vomit.  A Foley catheter is placed in the bladder.  The anesthesiologist will place an epidural unless it can not be done safely.  Very rarely, women have to be put to sleep for the c-section.  After you have received anesthesia, an incision is made in the lower abdomen and then in your uterus to remove the baby.  You are usually awake with an epidural and can see the baby right away.  After the c-section, you will be reunited with the father and your baby in the recovery room.  Breastfeeding, if desired, can still happen immediately after the surgery is complete. 

After C-Section

If a c-section is needed for delivery, be prepared to stay in the hospital for 3 days after delivery.  The Foley catheter is usally removed in 12-24 hours after delivery.  You will be given pain medications that are safe in breastfeeding to use as long as needed.  Women who have had a cesarean delivery may elect to have a cesarean in the future or discuss options for vaginal birth after cesarean (VBAC).  After two cesarean deliveries, and no prior vaginal births, it is recommended to have all cesearean deliveries in the future. 

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