Caesarean section – reasons, procedure and tips for the time afterwards

A cesarean section is a dreaded complication during childbirth for many expectant mothers, but other pregnant women expressly want a cesarean section. But what is actually done during a caesarean section, how dangerous is the caesarean section and how long does it take to heal afterwards? Find answers to all these questions in this article.

When is a caesarean section necessary?

In gynaecology, there are different categories into which a caesarean section can be divided.

First of all, a distinction is made between a primary and a secondary caesarean section. The  primary cesarean section  is performed before the onset of labour-promoting labour. Secondary cesarean section, on   the other hand, is performed for complications that arise during childbirth. The mother-to-be is already in labor at this point.

In addition, a caesarean section can be planned or an emergency. There are different reasons for all these scenarios.

Examples of reasons for a  planned caesarean section  are:

  • Placental or uterine malformations
  • previous illnesses of the mother
  • malformations of the child
  • by request
  • a previous cesarean section
  • labor arrest

Incidentally , in the case of an elective caesarean section without medical necessity, the  costs  are not covered by the statutory health insurance companies.

Reasons for an  emergency c-section:

  • heavy vaginal bleeding
  • Undersupply of the newborn (e.g. drop in heartbeat)
  • suspected uterine rupture
  • umbilical cord prolapse

Depending on whether the emergency caesarean section has to be performed before or after the onset of labor, it is a primary or secondary emergency caesarean section.

How does a caesarean section work?

Unless the situation is an emergency, preparation for a caesarean section begins about two hours before the  operation . Even before entering the operating room, the expectant mother is informed about possible risks, given thrombosis stockings and, if necessary, her  intimate area  is shaved.  A CTG (cardiotocography) is also done to check the baby ‘s heartbeat one last time  .

In the operating room, the expectant mother is given an epidural anesthetic (PDA for short) or an  anaesthetic . A PDA is injected near the spinal cord. The big advantage here is that the mother is awake during the operation and only feels little or nothing about the lower half of her body. As soon as her child is born, she can receive it.

A so-called intubation anesthesia, in which the woman giving birth is not conscious, is chosen primarily for emergency caesarean sections. However, it can also be used in certain circumstances for a planned caesarean section, for example if the mother-to-be is very  afraid  of the procedure, although this is rather rare.

In addition, the mother receives a bladder catheter so that the urinary bladder remains empty during the operation. This reduces the risk of bladder injuries. The mother is also given antibiotic prophylaxis to prevent infection.

Procedure for an emergency caesarean section

The emergency caesarean section differs from the normal caesarean section not only in terms of the anesthesia, but also in terms of the procedure. The most important goal here is to keep the time between the decision to have the caesarean section and the delivery of the child as short as possible, in the best case less than 20 minutes. Accordingly, much is dispensed with that is standard with a normal caesarean section. This includes, for example, putting on thrombosis stockings or  shaving .

What is done during a caesarean section?

The operation itself begins with a small incision in the skin in a horizontal direction above the pubic bone. The cut is about eight to 15 centimeters long. The individual abdominal muscle layers are then carefully exposed and severed until the doctor reaches the uterus and opens it with a cross section. If the amniotic sac has not yet ruptured, it is also cut open and the child can be removed from the mother’s womb.

How long does a caesarean usually take?

A caesarean section is not a particularly long operation. The duration is  approximately one hour.  On average, it only takes about 15 minutes for the baby to be born, and in the case of an emergency caesarean it is sometimes as little as five minutes. After the baby is born, it remains to wait for the placenta to detach. This process is accelerated by the drug  oxytocin  .

In the meantime, a midwife and, if necessary, a pediatrician will take care of the newborn’s first aid.
It then takes about half an hour before the uterus and the individual abdominal muscle layers of the new mother are sewn up again.

How dangerous is the caesarean section?

The caesarean section rate in Germany is currently around 30 percent. A caesarean section can save many lives each year, both for mother and child. But of course, a cesarean section also has some risks and disadvantages, which is why the decision to have a cesarean section should not be taken lightly.

The main risks of a cesarean birth include wound healing disorders and infections at the cesarean scar. In addition, the tissue surrounding the uterus can be injured during the operation, especially the urinary bladder. In addition, the risk of  thrombosis is  increased compared to vaginal delivery.

Many pregnant women also fear that after a caesarean section operation, a vaginal birth will no longer be possible for the next child. This is only partially true. In general, a vaginal birth after a caesarean section, even after an emergency caesarean section, is possible. Only with a longitudinal uterine incision can a vaginal delivery no longer be carried out afterwards. This is an incision technique in which the uterus is opened lengthwise instead of in cross section and which only needs to be used very rarely.

What are the dangers for the baby?

There is also a risk of so-called “wet lungs” for the newborn. Because the baby is not constricted in the birth canal, less fluid is forced out of the lungs.

In general, the infant may experience slight adjustment disorders in the first hours of life after a caesarean section. These are probably caused by the fact that caesarean children are born much faster and less stressed than is usually the case with a natural birth. Newborns who are born by caesarean section often need a little longer until they are as alert and alert as children who are born naturally.

In addition, there is evidence that children born by caesarean section are more likely to suffer from  allergies  and other autoimmune diseases.

What comes after the caesarean section?

Postpartum after caesarean delivery is a little different than after vaginal delivery. First, the mother typically stays longer in the hospital. It’s usually around  five to seven days  compared to three to five days after a vaginal delivery.

Most women are more exhausted after a cesarean than after a natural birth. One of the reasons for this is that the body doesn’t release as many hormones that keep the new mom awake and euphoric.

In addition, the surgical wound must be monitored and wound healing supported. A cesarean scar is a small wound in the bikini area about two fingers above the pubic bone, which is only covered with a small plaster in the first few days after birth.

pain after cesarean section

Pain in the area of ​​the operation scar is completely normal in the first few days. After about five days, the stitches can be removed from the scar. It takes about eight to twelve days for the suture to heal.

There are various ointments for the care of the scar that support the healing of the wound and help with the  regression  . Many women are initially ashamed of their fresh scar and their stomach after a caesarean section and  pregnancy , but in the long run only a very small scar remains.

How long does post natal discharge last?

The so-called weekly flow, also known as lochia, also occurs after a caesarean section. This is wound secretion secreted by the uterus. The weekly flow after a caesarean section is usually less pronounced than after a vaginal delivery. It lasts about three to four weeks.

When is sport possible after the caesarean section?

As with vaginal delivery, the woman’s pelvic floor suffers from the stresses of pregnancy, even if the heavy stress of childbirth is removed. Post-natal gymnastics is also highly recommended here. This can usually be started six to eight weeks after the birth.

You may have to wait even longer before doing more strenuous exercise, such as jogging. This depends entirely on the individual wound healing of each woman. It is best to discuss with the doctor treating you whether it is time to start exercising again. In addition, every woman should listen to her own body and only increase her physical training slowly. As soon as she feels pain in her abdomen, she should stop the activity in question.

Even in everyday life, the new mother should be careful and careful with herself. For the first six weeks, she shouldn’t do any heavy lifting or other household chores

When can you shower and bathe after the caesarean section?

The goal after a caesarean operation is to get the new mother mobilized again as quickly as possible. In these first few hours, mobilization means above all light movement: For example, getting up, stretching your legs a little and cleaning and refreshing yourself at the sink. This can usually be done as early as six to eight hours after the operation and speeds up recovery.

A short time later, around the third day,  showering is  possible again. It is advisable to ask the ward for a waterproof patch. The surgical scar should not come into contact with water and soap.

Women should only bathe  again when the weekly flow has dried up to prevent germs from entering the uterus.

When can you breastfeed after a caesarean section?

Breastfeeding is also no problem immediately after the caesarean section. On the contrary: Breastfeeding actually supports the bond between mother and newborn. Many mothers, especially after an emergency caesarean section, are disappointed that their birth experience did not go as they had hoped. They feel like they haven’t bonded as strongly with their newborn as a result. Breastfeeding can help with that.

If the mother wishes to breastfeed the child, it should be placed regularly on the breast from the start. In this way, a rhythm can quickly develop between mother and baby. Another advantage of breastfeeding is that the mother’s body releases many hormones that strengthen the bond with the child and promote uterine involution.

When does the period start after the caesarean section?

The length of time before the first menstrual period after pregnancy varies greatly. After the weekly flow has dried up, menstruation can generally start again and pregnancy is possible again.

If a woman breastfeeds, the onset of her period can be significantly delayed due to the released hormones. However, even breastfeeding does not provide complete contraception. It is recommended that women wait a year before becoming pregnant again after a cesarean section. This guarantees that the uterus and abdomen around the caesarean operation scar can heal completely. Accordingly, couples should resume contraception six to eight weeks after a caesarean section  .

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *