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Statistically almost every third Polish woman gives birth to a child by caesarean section, although the "cesarean" is theoretically performed only for medical indications. What are the indications for a caesarean section and when should it be performed, even if it was not planned, to avoid complications during delivery?

Caesarean sectiontochildbirthsurgical - the baby is born as a result of a surgical incision of the abdomen and uterus. Most obstetricians agree: This is major surgery, and no one should view it as an easier option to deliver. However, in some cases, a caesarean section is a safer way for a baby to leave the womb.

When is a caesarean section needed?

There are many situations in which it is advisable or necessary to perform an operation. Some indications can be found before the due date and the surgery is scheduled, others appear only during the delivery. What could bean indication for a caesarean section ?

  • Incorrect position of the child, i.e. other than the head position. The front part, i.e. the one that comes out first, in addition to the head, can be the buttocks or feet of the toddler, it can also lie transversely. In the pelvic position (when the buttocks are the leading part), a vaginal delivery is possible - in the past, women often gave birth - but it is very burdensome for the mother and the child, so nowadays a caesarean section is usually performed.
  • Placenta previa - this is where the placenta is positioned right at the mouth of the cervix, obscuring it. The child's pathway in the birth canal is then blocked and must be removed surgically.
  • Multiple pregnancy, also twin. In such a case, a lot depends on the position of the children: when in a pair of twins, both children are in the longitudinal position of the head - then there is a chance for natural delivery. However, it happens that after the birth of the first baby, the second one is so unfortunate that it is difficult to give birth to him normally.
  • High blood pressure or mother's heart disease - in this case, a physiological birth may be too much of an effort for the woman giving birth.
  • Childbirth disproportionate, i.e. a situation when the baby is large and the mother's pelvis is too narrow. Stem itmaybe due to improper construction of the pelvis or too large size of the child (e.g. due to maternal diabetes).
  • Infection of the mother with HIV or genital herpes virus - vaginal delivery then poses a risk of transmission of the virus from mother to child.

C-section on request

Theoretically, there is no such possibility, because caesarean section is performed only for medical indications. However, some doctors believe that in certain situations it is advisable to perform an incision, for example when a woman feels a terrible fear of giving birth by nature, caused by a previous traumatic experience. That is why some doctors agree to such a solution, entering some fictitious "medical indications" in the documentation. It is easier to have such a birth in a private hospital - there are even such centers that openly write on their website that they do not deliver other births - but it costs at least several thousand zlotys.

What is an elective cesarean section

This is the term that obstetricians call a caesarean section, which is planned in advance - then it can be prepared, including the appointment of an exact date. Most often, a baby is born around the 39th week of pregnancy. Unconditional indications for an elective cesarean section are: placenta previa, transverse position of the fetus and double obstetric cesarean section.

What is a cesarean? Look! [TOWIDEO]

When an emergency cut is necessary

Childbirth is a dynamic event - the situation changes from minute to minute and you can never predict how it will end. Even if the pregnancy was exemplary, and the woman in labor is fully he althy and functional, it can never be ruled out that her delivery will end in caesarean section. Why? There are several situations where the decision to operate is made suddenly, already in the course of physiological labor, because the he alth of the child or mother is at risk. Such a situation is the risk of hypoxia (asphyxia), which may be the result of a looped or compressed umbilical cord (the way a child breathes is indicated by a CTG test recording his heart activity). An indication for surgery may also be heavy bleeding as a symptom of detachment of the placenta, as well as disturbances of uterine contractions resulting in inhibition of the progress of labor.

Pain and scar after surgery

Immediately after the surgery you will feel the cut wound quite painfully - for 2-3 days you can take painkillers (e.g. paracetamol tablets). As soon as the anesthesia wears off and you are able to get up - you will be encouraged to move.Get out of bed for the first time with the help of another person and slowly walk around the hall or corridor. Moving as early as possible is very important to prevent dangerous deep vein thrombosis. However, avoid walking up the stairs. Be very careful with what you lift - you must not lift anything that weighs more than your baby. You may feel sore for 4-5 days, but within a few weeks of puerperium, everything should be back to normal. The abdominal incision is usually horizontal, at the top of the pubic hairline. After 6 weeks of puerperium, the wound should heal completely and turn pale shortly thereafter. Some women, however, may experience numbness at this point for a long time.

According to an expertPaweł Kubik, MD, PhD, specialist in obstetrician gynecology, Institute of Mother and Child in Warsaw

Who is present in the operating room during the Caesarean section?

Currently, the vast majority of Caesarean section operations are performed under regional anesthesia while the patient is conscious. Who can expect in the operating room? A caesarean section requires the presence of two gynecologists - one is the operator and the other is his assistant. They are assisted by an instrument nurse who gives and controls the surgical instruments. Of course, an anesthesiologist is required all the time, whose task is anesthesia before the procedure and constant monitoring of the patient's condition during and after the operation. The anaesthesiologist has an anesthesiology nurse to help. Immediately after the newborn is born, it is examined by a neonatologist. Currently, in many hospitals, the child's father may be in the operating room.

Consequences and side effects of cesarean section

Surgical delivery carries a greater risk of haemorrhage, infection and deep vein thrombosis than vaginal delivery. Babies born this way are more likely to have difficulty breathing. In a few cases (1 in 50 births) the baby's skin is incised during surgery. It is worth remembering that one caesarean section significantly increases the risk that the next delivery will also take place in the same way. It also increases the risk of problems with the placenta in subsequent pregnancies, especially uterine ruptures (if the incision wound dissociates). You should be aware of all these consequences, but also remember that the vast majority of these operations run smoothly and without any serious consequences.

Can I give birth naturally after cesarean?

The good news is that one caesarean section does not automatically mean that all subsequent pregnancies will end the same. Biggestwhat matters here is the reason for the termination of the previous pregnancy by caesarean section. If the first time the cesarean was caused by the pelvic position of the fetus, threatening fetal asphyxia, lack of labor progress or pathology of the placenta (prematurely detached or advanced) - the second time, an attempt may be made to deliver vaginally. It is managed by 60-70 percent. women in such a situation. If, on the other hand, the mother's illness was the reason for the previous section, the next pregnancy usually ends with an elective cesarean section.

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