Sandy Van

February 20, 2014

Cesarean Section
A cesarean section is the surgical
delivery of a baby that involves
making an incision in the mothers
abdominal wall and uterus. It can
be planned (scheduled) or
unplanned (emergency).

Labor and Delivery

Is this procedure safe?
A cesarean section is a relatively
safe procedure for the mother
and her baby, however, since it is
a major surgery, there are some
risks that goes along with it. The
risks are higher for a cesarean
section than if you were to have a
vaginal delivery. Recovery will
take longer than it would from a
vaginal birth and after healing,
the incision may leave a weak
spot in the wall of the uterus,
which could cause problems in
future pregnancies with an
attempted vaginal birth. Such
problems could include uterine
rupture, when the scar from your
cesarean section tears open,
although this is rare. The benefits
of a C-section usually far
outweighs the risks.

Why is the procedure performed?

The purpose of a cesarean section is to preserve the life or
health of the mother and her fetus. It may be the best choice for
birth when there is evidence of complications and unexpected
problems that occur during delivery. Some reasons for having a
cesarean section instead of a vaginal delivery include the
following.

Where are the incisions made?

The skin incision will be either vertical or transverse in the lower
abdomen. The transverse incision, sometimes called the bikini
incision, is performed more often than the vertical incision, although
sometimes the skin incision is generally determined by the urgency of
the surgery and the presence of any prior skin incisions.

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How is the procedure done?

Here is a quick look at what usually happens during a cesarean section.

To prepare for the C-section:

You will be given anesthesia. Most people will be
awake and aware of the birth experience.
A catheter will be inserted into your bladder to keep
it empty.
You will have various monitors in place to keep an
eye on your heart rate, breathing, and blood pressure.
You may have an oxygen mask or nasal cannula to
give you oxygen.
You will have an IV in your arm.

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Your abdomen will be washed and any hair

between the bellybutton and pubic bone will be
shaved.
A privacy screen will be placed.
Your partner or support person will be by your side.

During the procedure:

The doctor will make an incision in the abdomen
either vertically or horizontally.
The doctor then gently part the abdominal muscles
to get to the uterus where he or she will make another
incision in the uterus itself.
Once the uterine incision is made, the baby is gently
pulled out.
The doctor then removes the placenta from the
uterus, closes the uterus with dissolvable stitches, and
closes the abdominal incision with stitches or surgical
staples that are usually removed, painlessly, a few
days later.

How will it feel?

You will not feel any pain during the C-section, although
you may feel sensations such as pulling and pressure.
Women who receive regional anesthesia (epidural or spinal
block) will be numbed from the waist down and are awake
during the C-section.

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The Recovery Period

After the surgery, there is usually
some degree of pain and discomfort
after a C-section. The recovery period
is also a little longer than for vaginal
births and you will usually remain in
the hospital for about 3 or 4 days and
need to stay in bed for at least a day
after the delivery.

For the first few days,

you might:

When to call your

doctor:

Feel tired and groggy

Elevated temperature

Nauseous

Signs of infection around your

incision (swelling, redness,
warmth, or pus)

Have soreness around the incision

Be constipated and gassy
Have a hard time getting around
and/or lifting your baby

What you can do:

Take prescribed pain medications
or over-the-counter pain relievers.
Ambulate frequently to help ease
some pain and discomfort and
prevent blood clots and constipation.
Support your abdomen near the
incision when you sneeze, cough, or
laugh.

What you should avoid

doing:

Pain around your incision or in

your abdomen that comes on
suddenly or gets worse
Foul-smelling vaginal
discharge

How will the incision

look like after the
surgery?
The incision will form a scar,
which will fade over time. It
will start to decrease in size
and become a natural skin
color in the weeks and
months after delivery and
because incisions are often
made in the bikini area,
many C-section scars arent
even noticeable.

Pain with urination

Heavy vaginal bleeding
Leg pains or swelling or
redness of your legs
Difficulty breathing or chest
pain
Pain in one or both breasts
Feelings of depression

Avoid driving or lifting anything

heavy so that you dont put any
unnecessary pressure on your incision.
Refrain from having sex until about 6
weeks after delivery or when your
doctor allows it.

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References
Lowdermilk, D. & Perry S. (2013). Maternity & Womens Health Care (8th ed.). St. Louis: Mosby.

MedlinePlus. (2014). Cesarean Section. Retrieved February 19, 2014 from

http://www.nlm.nih.gov/medlineplus/ency/article/002911.htm

ATI Maternal Newborn Nursing: Chapter 15