Alternative Names caesarean section, abdominal delivery, abdominal birth
Definition A caesarean section is the delivery of a baby through an incision in the mother's abdomen. Caesarean sections are done when the health of a mother or baby is at risk or at maternal request.
Who is a candidate for the procedure? A caesarean section may be done to help the mother if:
the baby's head is too large to pass through her pelvis
labour has gone on too long without enough progress
the baby is in a position that will make birth very difficult
the mother is having problems such as kidney failure or very high blood pressure that may signal a dangerous health problem called pre-eclampsia
the mother is bleeding internally from a traumatic accident
the mother has a history of infertility, especially a woman over 40
an earlier baby was stillborn
serious health problems, such as cancer or a coma, make it doubtful that a mother can withstand the stress of labor
a mother's pelvis is not shaped normally
a mother has had two earlier caesarean sections
a mother's water breaks and her baby is not in a head-down position for delivery (breech)
a mother prefers this method of delivery over a vaginal birth
A caesarean section may be done to help the baby if:
the baby is not getting enough oxygen.
the heart rate goes too high due to problems like a fever in the mother or infection in the baby.
the heart rate goes too low, possibly because the umbilical cord is wrapped around the baby's neck.
there are twins, triplets or more babies.
the placenta tears away from the uterus too early, known as placenta abruptio or if the placenta is touching or covering the cervix, known as placenta praevia.
the baby has defects or health problems that may cause distress during labor.
the baby has not been growing normally, which is called intrauterine growth retardation.
the mother has an active herpes outbreak in or near her vagina. In this case, a caesarean section may be done to protect the baby from a herpes infection.
How is the procedure performed? The woman is usually awake for the procedure. Spinal or epidural anaesthesia may be used to prevents any painful sensation from the waist down to the legs.
The surgeon makes an incision just above the pubic hair or cuts through a previous abdominal incision. He or she must cut through many layers of the mother's tissues to get to the uterus. Then the lower portion of the uterus close to the bladder is opened. The baby's head is brought out through this incision. Before the baby's body and the placenta are removed from the uterus, the baby's mouth is wiped clean of amniotic fluid. The uterus and all the layers of tissue on top of it are then closed with stitches, and the skin is closed with stitches or staples.
What happens right after the procedure? After the caesarean section, the mother:
may try to breastfeed in the recovery room if she and the baby are doing well.
will probably get antibiotics and intravenous (IV) fluids +/-antibiotics for 24 hours.
will be encouraged to walk as soon as possible.
may be given pain relievers through an IV pump or Injections. Once the mother can eat food, she can take pills instead.
usually stays in the hospital for at least 48 hours, depending on whether she or the baby has any more problems.
What happens later at home? It takes longer to recover from a caesarean section than from a vaginal birth. Once she is home, a woman should:
try to get some help, from friends and relatives or from paid employees, for the first few days
try to use the stairs very little for the first week
walk daily to keep blood clots from forming in her legs
keep taking antenatal vitamins
eat a balanced diet with plenty of fluids to prevent constipation
What are the potential complications after the procedure? Problems are possible with any surgery that requires anaesthesia. These include:
problems with the anaesthetic, such as breathing problems or drug reactions
reactions to medications, such as antibiotics or pain relievers
bleeding
a higher risk that blood transfusions will be needed
a pelvic or wound infection
bladder infection or trauma to the bladder
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
