Caesarian Sections
The best piece of advice I had from someone when I was pregnant was not to skip the "caesarian" chapter of my birth book just because I didn't think it applied to me. She had done the same thing and gone on to have an unplanned caesarian and had wished she had been more informed.
Despite my plans for a natural birth, I did read the caesarian chapter, and also paid attention to a good friend of mine's account of her emergency caesarian at a hospital in Malaga. I am so glad that I did as unfortunately I too ended up with an emergency caesarian and what knowledge I had gathered before-hand proved to be a comfort in some way during my surgery...well at the very least it helped me remain a little more calm!
Here is a little more information about the caesarian procedure. Please do check the Birth Experience section of our Forum Community as well for more first-hand accounts of both natural and Caesarian births in Italy.
Elective Caesareans
Elective caesareans are often carried out under a spinal block or epidural. This means the mother will be conscious throughout the procedure and will be able to hold the baby as soon as it is born. Unfortunately the birth partner to date can not be present during the surgery. When the mother is conscious during a caesarean, a screen is put up so that she cannot see what the surgeon is doing.
A catheter is a small tube which runs into your bladder and drains out the urine. You will have to have a catheter fitted if you have a caesarean so the bladder can be emptied preventing it getting in the surgeon’s way. It is also helpful afterwards when your movements will be restricted till you feel strong enough to walk to the toilet on your own again. The catheter is fitted whilst the spinal block is in place so you will not feel a thing. Removal is not painful, just a little uncomfortable.
What happens in a caesarean?
An elective caesarean is when the decision to have a caesarean is made before labour starts. It may help to prepare yourself for a caesarean, so that if you do have one you know what to expect. The most common reasons for babies to be born this way are if the baby is breech, the baby’s head is too big to pass through your pelvis, or if you are pregnant with twins and multiples. You may need a caesarean if you suffer from certain medical conditions like placenta praevia. If you have had a caesarean with a previous baby, you may need another, because there is a small risk of uterine rupture when you go into labour. Your doctor and midwife can advise you on this.
Once you have been injected with the anaesthetic, the effects will be almost immediate. You will be sprayed with an ice-cold spray to confirm the anaesthetic is working. You may feel a tingling sensation in the lower part of your body, and your legs will start to feel heavy. There will be no feeling from your bump downwards and you will feel no pain. (Tell the surgeons if you DO feel any pain or you regain feeling in your legs etc as the operation progresses - although this is very rare)
Once the surgeon is certain the anaesthetic is working, an incision will be made on your lower abdomen (most hospitals these days favour a horizontal bikini cut, just below the top of your pubic hair). You may need to be shaved before the procedure.
A second incision is then made on your uterus and the amniotic sac is opened and drained. The baby is pulled out of your stomach gently, either manually, or by using forceps. Your baby’s airways will be cleared and you will probably hear the first cry. If the screen has been pulled down, you will be able to see your baby entering into the world. As in a vaginal delivery the cord will be clamped and cut, and the doctor will do a quick routine check on your baby, whilst the placenta is being removed.
Your baby will be brought over to you to see. Whether or not your baby stays next to you will depend on your hospital’s own policy whilst you are stitched up – generally the baby will be taken out to be weighed, etc where the birth partner will be able to see the baby for the first time.
How do I prepare myself for a caesarean?
You will be told not to eat or drink for a number of hours before the procedure, and you might need an overnight stay in the hospital beforehand. A consent form needs to be signed before the operation, and you will be talked through the procedure by someone on the medical team. Now is the time to ask any questions if you have any, and flag up any needs you might have, for example, do you want to find out the baby’s sex yourself, or do you want to be told? And do you want to try to breastfeed straight away? Your midwife should be able to help you with any concerns.
The top of your pubic hair will need to be shaved before the caesarean, so it might be a good idea to take care of this yourself at home, if you know when the procedure will be.
Are there other types of caesarean?
Emergency and crash caesareans won’t be planned and will probably take place once labour has started. Emergency caesareans are when the caesarean in unplanned. It usually takes place if the baby is showing signs of distress or if labour is progressing very slowly. Epidurals can still be used in an emergency.
A crash caesarean is an emergency when the baby needs to be delivered quickly, and the mother will probably need a general anaesthetic. A mother might need a crash caesarean if she shows signs of placental abruption, a prolapsed cord, or if the baby is showing severe signs of distress.
Recovery after a Caesarean
Most women will be able to walk again (if slowly and perhaps painfully), the day after they have had a caesarean. The best thing to do is attempt walking as soon as you feel ready too. Each time you walk it will be less painful than before and the strength will slowly return to your lower body. You will probably be given pain relief drugs which will help with the initial stages of recovery. If you still have a catheter inserted, it may make it difficult to be fully mobile and to attend to your baby, but the more mobile you are the quicker your recovery will be. It is also advisable to be mobile to help prevent blood clots forming.
How you will feel emotionally
Lots of women feel disappointed after having a caesarean especially if they didn't even go into labour (if they had an elective caesarean for a medical reason like the baby was breech for example). This is because they feel as if they missed out on the birth experience and feeling their babies come into the world through the traditional route. Studies show that there is no difference in the bonding process between mums and babies who had vaginal births and mums and babies who had caesarean births.
It can also be tough recovering from a major operation at the same time as looking after a helpless newborn baby and many women feel overwhelmed by the two tasks. Remember to make sure your guests know that you need time to recover from the operation too, so keep visits to a minimum so you can recover and get used to your baby. If you are feeling disappointed that you didn't have a vaginal birth, remember that your caesarean happened for a reason. That was the way your baby was meant to come into the world and you will have your own special memories of this time. The scar you receive is likely to be very small and just below your bikini line so you will still get into a tiny bikini (if you are brave enough). Lots of women like their caesarean scars as it is a reminder when you look in the mirror of how your baby was born.
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