Cesarean delivery: step by step and when indicated

Cesarean section is a type of delivery that consists of making a cut in the abdominal region, under anesthesia applied to the woman’s spine, to remove the baby. This type of delivery can be scheduled by the doctor, together with the woman, or it can be indicated when there is any contraindication for normal delivery, and can be performed before or after the start of labor.

The most common is that the cesarean section is scheduled for before contractions appear, being more comfortable for the woman. However, it can also be performed after contractions have started and drinking shows clear signs that you are ready to be born. 

Cesarean step by step

The first step of a cesarean is the anesthesia that is given to the pregnant woman’s spine, and the woman must be seated for the administration of the anesthesia. Then, a catheter is placed in the epidural space to facilitate the administration of medications and a tube is placed to contain the urine.

After the anesthesia effect starts, the doctor will cut approximately 10 to 12 cm wide in the abdominal region, close to the “bikini line”, and will cut even more 6 layers of fabric until reaching the baby. Then the baby is removed. 

When the baby is removed from the belly the neonatologist pediatrician should assess whether the baby is breathing correctly and then the nurse can already show the baby to the mother, while the doctor also removes the placenta. The baby will be properly cleaned, weighed and measured and only afterwards can it be given to the mother for breastfeeding.

The final part of the surgery is the closing of the cut. At this point the doctor will sew all layers of tissue cut for delivery, which can take an average of 30 minutes.

It is normal that after a cesarean section a scar is formed, however after removing the stitches and reducing the swelling in the region, the woman can resort to massages and creams that must be applied on the spot, as this makes it possible to make the scar more uniform. See how to take care of the cesarean scar.

When cesarean section is indicated

The main indication for cesarean delivery is the mother’s desire to choose this method of birth for the baby, which should be scheduled after the 40th week, but some other situations that demonstrate the need to perform a cesarean are:

  • Maternal disease that prevents normal delivery, such as high and positive HIV, active genital herpes, cancer, severe heart or lung disease;
  • Diseases in the baby that make normal delivery impossible, such as myelomeningocele, hydrocephalus, macrocephaly, heart or liver outside the body;
  • In case of placenta previa or accreta, detachment of the placenta, baby too small for gestational age, heart disease;
  • When the woman has had more than 2 cesarean sections, she removed part of the uterus, needed uterine reconstruction involving the entire endometrium, rupture of the uterus at an earlier time;
  • When the baby does not turn and gets crossed in the woman’s womb;
  • In case of pregnancy of twins or more babies;
  • When normal labor is stopped, being prolonged and without complete dilation.

In these cases, even if the parents want a normal delivery, cesarean section is the safest option, being recommended by doctors.

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