Cesarean Deliveries at St. Vincent’s
Many women wonder about cesarean operations and whether or not they'll need a cesarean. At St. Vincent’s Medical Center, we are here to answer your questions regarding the operation, which is performed in our operating room under sterile conditions.
About Cesarean Operations
Sometimes your doctor knows the answer before labor even begins – if you have a placenta previa (a complication of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix), for example, or if the baby is in a transverse lie (that is the baby is lying sideways within the uterus rather than head-down).
However, neither you nor your doctor can always know whether you'll need a cesarean until you see how your labor progresses and how your baby tolerates labor.
Most often, the incision is low, just above the pubic bone, in a transverse direction (perpendicular to the torso). This cut is known as a Pfannenstiel incision or, more commonly, a bikini cut. Less often, the incision is vertical, along the midline of the abdomen. A cesarean delivery takes approximately one hour to perform.
Anesthesia for a cesarean delivery
The most common forms of anesthesia used for cesarean deliveries are epidural and spinal. Both kinds of anesthesia numb you from lower ribs to toes, but also allow you to remain awake so that you can experience the birth of your child. You may feel some tugging and pulling during the operation, but you do not feel pain. Sometimes the anesthesiologist injects a slow-release pain medication into the epidural or spinal catheter before removing it in order to prevent or greatly minimize pain after the operation.
If the baby has to be delivered in an emergency and there's no time to place an epidural or spinal, general anesthesia may be needed. In that case, you are asleep during the cesarean and totally unaware of the procedure. Also, general anesthesia may be needed in some cases because of complications in pregnancy that make it unwise to place epidurals or spinals.
Reasons for cesarean delivery
The baby is in an abnormal position (breech or transverse)
You've had extensive prior surgery on the uterus, including previous cesarean deliveries or removal of uterine fibroids
Delivery of multiples
The baby is too large in relation to the women's pelvis to be delivered safely through the vagina – a condition known as cephalopelvic disproportion (CPD), or the position of the baby's head makes vaginal delivery unlikely
Signs indicate that the baby is not tolerating labor
Maternal conditions preclude safe vaginal delivery, such as severe cardiac disease
Normal labor comes to a standstill
Bleeding is excessive
The baby's umbilical cord pushes through the cervix when the membranes rupture (known as prolapsed cord)
Prolonged slowing of the baby's heart rate
Recovery from a cesarean delivery
After the surgery, you are taken to a recovery area, where you stay for a few hours, until your condition is stable. Your baby will be with you during this time.
During the first day after having a cesarean, you will spend a lot of time in bed. After that, you will gradually increase your activity so you can build the strength you need to take care of yourself and the baby at home. The recovery time from a cesarean delivery is usually longer than from a vaginal delivery, because the procedure is a surgical one. Typically you stay in the hospital for three days, sometimes longer if complications arise.