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C-Sections Cubby

C-Sections and What to Expect
by Barbara Parker, RN, ARNP, CNM

Q. I am 39 weeks and just found out today that my baby is breech (confirmed on ultrasound). My doctor says that, although it is possible for baby to turn in the next few days, it is now too late for manual inversion, and he does not want me going into labour with baby in this position. Therefore, I have been booked in for a c-section. I have not done any reading on c-sections, as the pregnancy up to this day has been perfect, and I hadn't even really considered a c-section. I am now feeling anxious and unsure. Can you tell me ANYTHING about c-sections? What I should expect? Risk to baby and/or myself?

A. C-sections are the most common surgery done in the US today. They are very safe. But it is important for you to remember that all surgical procedures have a certain element of risk associated with them. In a C-Section, the major risks (although VERY rare) are bleeding too much, and having the surgeon cut something they don't intend to. If that would happen, they would of course fix whatever it was right then!

When you go into the hospital, you will be "prepped" for the operation. A nurse will start an IV, shave your abdomen and insert a catheter in your bladder. Most women today are given the choice of the type of anesthetic they want. An epidural or spinal will allow you to be awake through the procedure, and see and touch your baby as soon as it's born, although you have no pain and do not feel anything the doctor is doing. In a general anesthetic, you are asleep and wake up when it's all over. Most people feel that the spinal or epidural is much more pleasant, and more comfortable in the long run, since the doctor can put pain medication in the epidural which will last quite a long time, and keep you comfortable.

Most hospitals allow your husband/spouse/partner to be in the operating room with you if he/she wants to. I think it's a great idea for them to be there. They won't see anything bloody or disturbing, and they'll get to hold the baby right away.

The incision in your abdomen is made low and across, just below the hairline, usually. When the pubic hair grows back, you can't even see where the incision was!

The operation itself goes very quickly. Usually within 5 minutes of starting, the baby is born, then they start to put things back together, very carefully, layer by layer. Putting you back together takes about 25-35 minutes.

After the operation, you will spend 1-2 hours in recovery, where your blood pressure and pulse are taken very frequently, and you are closely monitored. Usually the baby can be with you there, and you can nurse (if you plan to breastfeed) and get acquainted with your new baby.

The first day of your operation, you usually spend in bed, and you may get up to stand or walk to the bathroom (with help) in 12-24 hours. The catheter is usually taken out of your bladder in 24 hours, and the nurses will help you walk in the halls. Your tummy will be sore, but you will have pain medication if you need it, which you SHOULD take (no one gets a gold star for being stoic).

Most women stay in the hospital about 3 days after a c-section.

As long as the incision is low and transverse (horizontal), you will probably be able to have a vaginal delivery next time.

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