In a natural delivery, the babies are delivered vaginally. However, when this is not feasible or advisable, the babies are lifted out of the womb by an operation that involves cutting through the abdomen and the womb to lift out the baby. This is called a caesarean or a C-section. The incision is made just below the bikini line and is almost invisible once it heals.
Elective caesarean: When the caesarean delivery is planned before you go into labour, it is called an elective caesarean. It may be recommended by the doctor if it is dangerous for you or the baby to go ahead with a vaginal delivery.
Emergency caesarean: This is required if complications develop and the baby needs to be delivered immediately. This may occur during or even before labour.
You will be encouraged to breastfeed after a caesarean. However, if you had an elective caesarean and were not in labour, it may take a while for your breasts to start producing milk. Also, if you had a general anaesthetic during the operation, you may not feel up to breastfeeding for some hours afterwards and you may be better off waiting for some time.Breastfeeding may put additional strain on your abdomen and your stomach muscles are sore after the operation anyway. Remember to put a pillow under your baby and you can feed him from one side rather than holding him in your lap which will cause you a lot of pain and put strain on your incision. Your midwife will help you find a comfortable position for breastfeeding.
There are many instances where a caesarean may be required:
* You have diabetes
* You are HIV positive
* Your pelvis is very small as compared to the baby's head and a vaginal delivery will not be feasible.
* Placenta is covering the cervix completely (placenta praevia)
* Haemorrhage before onset of labour
* Cord prolapse
* You develop very high blood pressure
* Baby appears to be in great distress
* Your cervix does not dilate and the baby continues to get distressed
* You are carrying twins who are in awkward positions to be delivered vaginally
* Your baby is breech
* A caesarean is preferably carried out under an epidural anaesthetic. However, if there is an emergency and the baby needs to be delivered very quickly, a general anaesthetic may be used.
* If you are already on epidural in the second stage of labour when the caesarean is called for, it will be topped up and you will be ready for the operation.
* If using an epidural, a screen will be set up so that you can't see the operation but will be able to hold your little one as soon as she's born.
* Your pubic hair will be shaved.
* You will have a drip providing you with essential fluids.
* A catheter will be inserted in your bladder to empty it out.
* A side-to-side incision will be made just above the pubic hairline.
* The amniotic fluid is drained off.
* The baby is lifted out of the womb.
* The entire operation takes about half and hour of which about 20 minutes are spent in stitching you.
* If you are awake during the operation, the doctor will inform you of his progress all the time.
* Your partner can be with you during the operation if an epidural is being used.
* If general anaesthetic is used, you will not be conscious during the operation and your partner will not be in the room.
* However, he may be the first one to see the baby before you regain consciousness.
* You will be in the hospital for about 5-6 days following delivery.
* Although walking may hurt but you will be encouraged to move as soon as you can.
* You can have a bath once your wound dressing has been removed(a couple of days).
* Remember to dry the wound with a separate dry towel and contact your midwife if it becomes red or tender as it could be an infection requiring antibiotics.
* The stitches will be removed five days after the operation if they are not soluble ones.
* Keep the area clean and dry.
* Avoid straining and lifting heavy objects for at least six weeks.
* Although you can start gentle pelvic floor exercises almost immediately after the operation, you may not feel upto it for a couple of days.
* Don't try anything more intense till after your post natal check, about 6 weeks after the operation.
* You should not drive a car for six weeks.
* It is important not to put any strain on your abdomen for the prescribed time.
* Although you can't lift your newborn straighaway, you can have a pillow on your side and then place your little one on it. This helps prevent straining the abdomen.