C-Sections

 A C-section is a surgical procedure in which a baby is delivered through a mother's abdomen. Nearly one in three women in the U.S. deliver their babies by C-section, either for elective reasons, or because of a risk to mother or child.

• Risks of C-Section:

A C-Section is a major surgery, so of course there are risks involved, as with all surgical procedures. The procedure involves an incision through the skin, abdomen, muscle, and then into the uterus. From start to finish, including pre- and post-op, a typical C-section lasts 3-4 hours. As a result, there could be damage to the surrounding organs, excessive bleeding, or an infection. For women who have had more than 3 C-Sections, risks are significantly higher. The placenta could be deeply attached to the uterus because of scarring from previous C-sections, and it could be difficult to get out, which means heavy bleeding, therefore a higher chance of needing a blood transfusion, or needing hysterectomy just to save the mother's life. That is why it is extremely important to only have them if it is medically necessary. 

Risks to Mother:
1. Inflammation and infection of the membrane lining the uterus. 
This condition — known as endometritis — can cause fever, foul-smelling vaginal discharge and uterine pain.

2. Increased bleeding. 
You're likely to lose more blood with a C-section than with a vaginal birth. Transfusions are rarely needed, however.

3. Reactions to anesthesia. 
Adverse reactions to any type of anesthesia are possible. After an epidural or spinal block — common types of anesthesia for C-sections — it's rare, but possible, to experience a severe headache when you're upright in the days after delivery.

4. Blood clots. 
The risk of developing a blood clot inside a vein — especially in the legs or pelvic organs — is greater after a C-section than after a vaginal delivery. If a blood clot travels to your lungs (pulmonary embolism), the damage can be life-threatening. Your health care team will take steps to prevent blood clots. You can help, too, by walking frequently soon after surgery.

5. Wound infection. 
An infection at or around the incision site is possible.

6. Surgical injury. 
Although rare, surgical injuries to nearby organs — such as the bladder — can occur during a C-section. If this happens, additional surgery might be needed.

7. Increased risks during future pregnancies. 
After a C-section, you face a higher risk of potentially serious complications in a subsequent pregnancy — including bleeding and problems with the placenta — than you would after a vaginal delivery. The risk of uterine rupture is also higher. With uterine rupture, the uterus tears open along the scar line from the prior C-section. Uterine rupture is a life-threatening emergency.

Serious complications are unlikely, but include:

• Admission to intensive care, which happens to about nine in every 1,000 women.
• An emergency operation to remove the uterus (hysterectomy), which happens to about eight in 1,000 women.
• The need for further surgery at a later date, which happens to about five in 1,000 women.
• Injury to the bladder, the tubes connecting the kidneys to the bladder (ureters), or to the bowel. Though this is rare, and happens to about one woman in 1,000.

If you've had a serious complication during the caesarean, you may need a blood transfusion. Some of the rarer complications of a caesarean can be life-threatening, but the risk of this is very small. 


Risks to Baby:
1. Breathing problems. 
Babies born by C-section are more likely to develop transient tachypnea — a breathing problem marked by abnormally fast breathing during the first few days after birth. C-sections done before 39 weeks of pregnancy or without proof of the baby's lung maturity might increase the risk of other breathing problems, including respiratory distress syndrome — a condition that makes it difficult for the baby to breathe.

2. Surgical injury. 
Although rare, accidental nicks to the baby's skin can occur during surgery.

• Benefits of C-Sections

Having a planned caesarean means you know when your baby will be born. You won't have the contractions, or feel the pain between your vagina and back passage (perineum) that happens with a vaginal birth. For some time afterwards you will have a very sore wound and tummy, but this can be managed effectively with pain relief. 

• Recovery after a C-Section

The typical hospital stay for a C-section is four days, compared to the two that new moms need after a vaginal birth. Immediately after the procedure is over, you'll still have a catheter in, the effects from the regional anesthesia will linger for a few hours -- which means you'll be numb from the waist down -- and you'll need narcotics for the pain. By the next day, the catheter will come out and you will have regained feeling in your legs, but you will still need the narcotics for pain. Recovery does not end once you leave the hospital. Once you're out of the hospital, you can't lift anything heavier than baby for the first couple of weeks, no driving for about two weeks, no exercise for 4-6 weeks, and no sex for six weeks. You shouldn't expect any great miracles before 3-4 weeks, and many women will go up to three months to be 100% back to normal.

Ways to help recovery go smoother:

1. Take it easy. 
Rest when possible. Try to keep everything that you and your baby might need within reach. For the first couple of weeks, avoid lifting anything heavier than your baby.

2. Support your abdomen. 
Use good posture when you stand and walk. Hold your abdomen near the incision during sudden movements, such as coughing, sneezing or laughing.

3. Seek pain relief. 
Your health care provider might recommend a heating pad, ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or other medications to relieve pain. Most pain relief medications are safe for breast-feeding women.

4. Drink plenty of fluids. 
Drinking lots of fluids can help replace those lost during delivery and breast-feeding, as well as help prevent constipation.

5. Look for signs of infection.

Check your C-section incision for signs of infection. Contact your health care provider if:

• The incision is red, swollen or leaking discharge
• You have a fever higher than 100.4 F (38 C)
• You experience increasing pain around your incision

While you're recovering from your C-section, remember that you're also recovering from pregnancy. Here's what to expect:
• Vaginal discharge (lochia). Expect a bright red, heavy flow of blood for the first few days after the C-section. It might contain a few small clots. The discharge will gradually taper off during the first month postpartum, becoming watery and changing from pink or brown to yellow or white. Contact your health care provider if you have heavy vaginal bleeding, discharge with a foul odor, or you have a fever of 100.4 F (38 C) or higher.
• Contractions. You might feel contractions, sometimes called afterpains, during the first few days after the C-section. These contractions — which often resemble menstrual cramps — help prevent excessive bleeding by compressing the blood vessels in the uterus. Your health care provider might recommend an over-the-counter pain reliever. Contact your health care provider if you have a fever or if your abdomen is tender to the touch. This could indicate a uterine infection.
• Sore breasts. Several days after the C-section, your breasts might become firm, swollen and tender (engorgement). To ease discomfort, nurse, use a breast pump, apply warm washcloths or take a warm shower to express milk. Between feedings, place cold washcloths or ice packs on your breasts. Over-the-counter pain relievers might help, too.
  If you're not breast-feeding, wear a firm, supportive bra, such as a sports bra, to help stop milk production. Don't pump or rub your breasts, which will cause your breasts to produce more milk.
• Leaking milk. If your breasts leak between feedings, wear nursing pads inside your bra to help keep your shirt dry. Change pads after each feeding and whenever they get wet.
• Hair loss and skin changes. During pregnancy, elevated hormone levels increase hair growth and put normal hair loss on hold, creating an extra-lush head of hair. After delivery, however, hair growth decreases and your body begins to shed the excess hair all at once. Hair loss typically stops within six months. At the same time, stretch marks typically fade from red to silver. Skin darkening that can occur during pregnancy, such as dark patches on your face, will also slowly fade.
• Mood changes. Childbirth can trigger mood swings, irritability and anxiety. Many new moms experience mild depression, sometimes called the baby blues, which typically subsides within a week or two. In the meantime, take care of yourself. Ask for help and support. If your depression deepens or you feel hopeless and sad most of the time, contact your health care provider.
• Postpartum depression. If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your health care provider if you think you might be depressed, especially if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
• Weight loss. After your C-section, you'll probably feel out of shape. You might even look like you're still pregnant. This is normal. Most women lose more than 10 pounds during birth, including the weight of the baby, placenta and amniotic fluid. During your recovery, you'll drop more weight as your body gets rid of excess fluids. After that, a healthy diet and regular exercise can help you return to your pre-pregnancy weight.

This blog entry is not intended to scare you in any way. It is simply intended to inform you of the risks, benefits and recovery dealing with a C-Section. Ideally, everyone would be able to have a vaginal delivery, but sometimes that is not medically possible which is why C-Sections are there. Please always do what your physician feels is best and safest medically for you and your little one. 

Sources: Web MD, What To Expect

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