A caesar is an operation where the baby and placenta are delivered through a cut made on the stomach and the womb.
What to expect
A caesar can be quite daunting, mainly because there are so many health professionals with you in theatre. These health professionals work on a range of tasks such as
- Applying or inserting monitors
- Urine catheter
- Positioning you in uncomfortable positions
- Inserting your spinal (anaesthetic to make sure you do not feel pain) and
- Cleaning your body with an antiseptic solution to make sure that there is little chance of infection
A mother will often find that they are separated from their newborn for a long time as the operation is completed and monitored before sending you back to the ward.
Keep in mind that your baby is in safe hands with the midwife and/or your partner and that all the necessary checks are being done.
It is best to ask your doctor, watch videos and read about a caesar before you have one done so that you know what to expect. The most important thing is for you to remain calm during the procedure to have a good experience and so that your baby does not suffer from your stress and anxiety.
Although we take every measure to prevent infections in theatre, it is important for you as a patient to prevent it. This includes taking measures such as following a healthy diet, using clean running water and washing your body with antiseptic wash very well a few days before and for at least one week after the operation.
Why are caesars done?
Caesars are usually performed in an emergency where the baby or mother’s life is at risk.
Common reasons from the baby’s side include problems with the heart rate or if your baby is sick with a medical condition where labour would result in further strain.
Problems from the labour and mother side include
- A very long or blocked labour
- A mother who is too exhausted to push
- Abnormal bleeding from the placenta
- Medical conditions in the mother (especially heart and lung problems)
- Cord prolapse where the umbilical cord comes out before the baby does
- Uterine rupture where the womb bursts open during labour
Sometimes, the caesar can be planned; this is known as an elective caesar and typically happens in the following situations:
- The baby is too big (more than 3.5kg)
- If the mother has had previous operations on the womb, such as a caesarean section or a fibroid removal
- A placenta that covers the opening of the womb (placenta praevia)
- Mothers request. This can be a personal choice to make decisions on what is done on your body. Sometimes from fear of the pain of labour, vaginal tearing and its long term complications.
- Position of the baby. Anything apart from the head that comes out first, such as the buttocks, legs, arm or chin
- Having twins, triplets or more babies. The delivery of so many babies at one time can get complicated. The last baby to come out usually has the highest risk of something going wrong, so a caesar is generally safer.
Benefits and risks of caesars
- If there is a serious risk to the mother or babies life, a caesar can prevent the loss of life
- Reduced chance of vaginal tearing
- Injury to the other organs such as your intestines, bladder and blood vessels
- Injury to the baby with the surgical knife
- Need for a blood transfusion
- Bad reaction to the anaesthetic and medication given
- Pain after the operation and a longer time to heal compared to a vaginal birth
Recovery usually takes a minimum of 6 weeks. This is usually when it is safe to resume normal activities such as driving, housework and sexual intercourse.
You can also start exercise at this time but it should be gradual and listen to your body as you are exercising.
It takes two years for the womb to heal after the operation is done. This is why women are advised to wait at least two years before having the next child.