Childbirth can be very unpredictable. Many women have a firm birth plan in mind, only to discover that their labour doesn’t progress as anticipated. And while having an emergency caesarean section – c-section – is never on a new mother’s wish list, it is sometimes necessary in order to prevent further complications for mother and child, and it’s worth knowing ahead of time what is involved, just in case you end up in this situation.
A caesarean section is a major surgical operation in which your baby is born through a cut in your abdomen and uterus. It is usually performed under a spinal or epidural anaesthesia. In some cases, it is necessary to use a general anaesthetic so that you are asleep throughout.
Some caesarean births are planned in advance (elective caesarean) because of existing problems with your pregnancy. In other cases, the decision to perform a caesarean is made during the course of labour. This is called an emergency caesarean.
An emergency caesarean is recommended for the following reasons:
- Concern for your baby’s wellbeing
- Your labour is not progressing
- There are maternal complications, such as severe bleeding or severe pre-eclampsia
- There is a life-threatening emergency for you or your baby.
- What to expect if you need an emergency caesarean
- You will require some form of anaesthesia.
- You may be in the operating theatre for an hour or more.
If you are having a general anaesthetic, there is no added advantage to have your partner with you in the operating room.
If there is enough time, usually an epidural will be used, but if your baby needs to be born quickly, general anaesthetic will be used.
A catheter will be inserted into your bladder so that it remains empty
During the procedure, you will feel some pressure and tugging as your baby is eased out of the uterus.
Most hospitals will have a nurse look after you and your baby in the theatre and the recovery area.
Unless you have had a general anaesthetic, skin-to-skin contact with your baby will be encouraged immediately after the birth, otherwise, you are likely to have skin-to-skin as soon as you are able.
If your baby is unwell or needs to be monitored they may need to go to special or intensive care. In some cases, they may need to go to a different hospital, which has a higher level of care for babies who are very sick.
After surgery, you will be offered a number of different pain-relieving medications, as you need them.
You will be encouraged to express breast milk if your baby is unable to feed on the breast. This will start as soon as possible after the birth and you will need to express about 8 to 10 times every 24 hours.
Risks with a caesarean birth:
C-sections are generally considered safe, but with any type of surgery there are certain risks and complications to be aware of:
- Side effects and complications from anaesthesia including, nausea, drowsiness, dizziness, short-term memory loss and, in rare circumstances, an allergic reaction.
- Pain is very common after surgery. There are several layers of body tissue that are cut and then repaired during a caesarean, so post-surgical pain is to be expected. This can usually be managed well with medications.
- Infection of the wound and bladder will affect a small number of women. This can be treated with antibiotics.
- You may have a fever, which will usually be due to engorged breasts or bladder infection.
- Blood clots can form after surgery. If it is in the lung (pulmonary embolus) it can be very serious.
- You may not be able to hold or feed your baby immediately after the birth, which may have implications for breastfeeding. This is only likely to be a problem if you have had a general anaesthetic. However, you should be able to hold and feed your baby as soon as you are more alert.
- Adhesions or scar tissue can form in your abdomen, which can cause ongoing pain and have implications for future abdominal surgery.
- Hysterectomy is a possible complication with any birth option.
After you have had one caesarean section the risk of complications increases with each caesarean after that. For example, there is an increased chance of the placenta implanting into or over the scar in future pregnancies. This condition is referred to as placenta praevia.
Vaginal birth after a previous caesarean
If you have had a caesarean section it may affect your future pregnancies and births. For future births, you will need to make a choice about whether to have another caesarean section or attempt a vaginal birth. This is called a Vaginal Birth After Caesarean Section (VBAC). Both options carry a level of risk. Having another caesarean carries all of the risks of a normal caesarean section. The main risk for VBAC is that the scar on the uterus will rupture, which can be very painful and, in some cases, life-threatening. Between one and two in 200 women who attempt a VBAC will suffer a ruptured scar.
Most women who attempt a vaginal birth after a caesarean will succeed (70 percent). Thirty percent of women who attempt a vaginal birth will, for any number of reasons, end up having an emergency caesarean.
Many women who have had a previous caesarean section find the prospect of a vaginal birth healing, particularly if the first caesarean was unplanned or traumatic. Unless there are particular health reasons why you would be advised to have another caesarean, the decision is ultimately yours.
Your doctor will usually discuss this with when you are pregnant. It’s a good idea to ask about the speciﬁc risks and beneﬁts for you.
Recovery after a caesarean section is a lot longer than a vaginal birth. There will be some element of pain or discomfort associated with the stitched incision but regular painkillers, as prescribed by your doctor, should provide you with the relief you need.
In the days that follow the procedure, you may feel very tired and sore. You could also suffer from constipation and have difficulty moving around and tending to your baby. For these reasons, you will probably stay in the hospital for 5-6 days.
You won’t be able to lift anything heavy or do any exercise for about 6-8 weeks after the surgery or until your doctor has said it’s OK.
It’s true that there are many things you cannot do after a c-section, but there some things you can do to help with your recovery:
- Get plenty of rest
- Go for short walks
- Eat plenty of fresh, nutritious food
- Get family and friends over to help with household chores
- Look after yourself and if you are concerned about anything, get in touch with your doctor
If you want to learn more regarding emergency c-sections, please feel free to schedule an appointment to see Dr. Gan.
— Dr.Gan Kam Ling
Consultant Obstetrician And Gynaecology