Caesarean Delivery: Process, Benefits, & Risks


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What is caesarean delivery? 

Caesarean delivery also known as caesarean section or c-section is the surgery performed to deliver one or more babies.

 A caesarean delivery or c-section is advised by doctors due to many medical reasons such as:

  • The baby is emerging buttocks/feet first (breech position)
  • The baby is emerging shoulder first
  • There is more than one baby and if the first one is in breech position
  • There is more than one baby
  • The size of the baby is big
  • The baby is in a sideways position and cannot be turned by the doctor
  • The baby has a serious health condition, including developmental conditions
  • The mother has had a caesarean for the previous baby
  • The baby’s head is too big to emerge through the birth canal
  • The labour is extremely stressful and not on schedule or stalled
  • Any form of early pregnancy complications
  • The mother suffers from health conditions such as high blood pressure, diabetes etc
  • The mother suffers from infections such as genital herpes which could infect the baby
  • Reduced oxygen supply to the baby
  • Problems related to the placenta such as placental abruption or placenta previa
  • Umbilical cord problems
  • If the placenta is partly/completely covering the cervix
  • If you have a large fibroid obstructing the birth canal
  • A severely displaced pelvic fracture

A c-section, therefore, can be planned or unplanned (emergency). A c-section despite being a major surgery is relatively safe for both the mother and the baby. It takes longer for the mother to recover from a c-section than from a vaginal delivery. After undergoing a c-section first time round, a woman may face risks later while attempting a vaginal delivery for the next baby. Though, some women are able to have normal vaginal delivery after undergoing a c-section the first time round. A caesarean delivery can be planned in advance if the mother shows signs of pregnancy-related complications or the doctor may decide to have an emergency c-section if the mother’s condition becomes serious during labour. 

How is the caesarean procedure performed? 

The following steps are involved in a caesarean surgery:

1. At the outset, anesthesia is administered to the expecting mother. The anesthesia administered during a c-section is of three types:

  • Spinal block: a safe and effective alternative to general anesthesia that is directly injected directly into the sac surrounding the spinal cord, numbing the lower part of the body
  • Epidural: a regional anesthesia (that blocks pain in a particular region of the body) is injected into the lower back outside the sac of the spinal cord
  • General anesthesia: which renders the patient completely unconscious

If the first two types of anesthesia are used the mother will be aware throughout the surgery. The third type, i.e. general anesthesia, is reserved for complicated conditions and emergency situations.

2. Intravenous tubes are inserted into the arm of the mother to deliver fluids and medicines.

3. The mother’s abdomen is washed and cleaned and her pubic hair may be shaved or trimmed.

4. The obstetrician then makes an incision through the wall of the abdomen, horizontally (often called a bikini cut) near the pubic hair line or pubic bone. Alternatively, if it is a case of emergency when the baby needs to be delivered quickly, a vertical incision is made from below the belly button to the pubic area.

5. The obstetrician gently pulls apart the muscles in the abdomen to gain access to the uterus.

6. He/she then makes an incision into the uterus, horizontally or vertically. It need not necessarily be the same type of incision that was made in the abdomen.

7. Thereafter the obstetrician suctions out the amniotic fluid.

8. Finally, the baby is delivered head first, so that its mouth and nose can be cleaned of fluids to enable it to breathe.

9. Once the whole body of the baby emerges, the obstetrician clamps and cuts the umbilical cord and lifts up the baby to show it to the mother. He/she then passes the baby on to the nurse for evaluation.

10. Once the baby is delivered the doctor, then removes the placenta from the uterus through the incision.

11. Thereafter, the obstetrician sutures the incisions made in the uterus and the abdomen.

What are the benefits of a c-section?

The benefits of a cesarean section or c-section are:

  • no fear of perineal tearing
  • bleeding is less in the first few days after a c-section delivery compared to a normal delivery
  • no urinary leakage with sudden coughing, laughing or sneezing
  • less sexual problems as there are no cuts and stitches in the perineum and the vagina.
  • less chance of damage to the pelvic floor
  • the baby does not face any trauma during a cesarean as sometime in vaginal delivery, forceps may be used in which process the baby may get hurt.

What are the risks involved in the c-section?

The risks during a c-section include:

  • haemorrhage a result of blood vessels being cut
  • surgical injury to other organs
  • breathing problems for the baby in c-sections done before 39 weeks of pregnancy or without proof of the baby's lung maturity increased risks during future pregnancies
  • accidental nicks and cuts to the baby during surgery

The risks after a c-section include:

  • foul-smelling vaginal discharge or vaginal bleeding with large blood clots
  • pain while urinating
  • infection
  • longer recovery time compared with vaginal birth
  • risk of endometritis
  • risk of requiring a hysterectomy during or after c-section birth is greater than vaginal birth
  • anesthesia-related reactions

What are the guidelines I need to follow after undergoing a c-section? 

The post-care guidelines after undergoing a c-section will be given by your doctor and includes:

  • complete bed rest for the first few weeks
  • drink plenty of water and clear fluids, this will also help to keep constipation at bay
  • avoiding sex for upto eight weeks after the surgery
  • how to nurse the baby in a side-lying position so that you do not put pressure on the incision
  • how to cough or do deep breathing exercises to expand your lungs and clear them of any accumulated fluid especially if you were administered general anesthesia
  • how to support your abdomen while sitting or moving around
  • asking for help if you feel you are suffering from postpartum depression

How long does it take to recover from a c-section? 

Complete bed rest is advisable for seven to 10 days. You can resume exercising and leading an active life ( including exercising) after one to two months depending on your health condition and doctor's advice. 

Doing the Kegel Exercises

Kegel exercises, also called pelvic floor exercises,  strengthens the muscles that support the uterus, bladder, and bowels. These exercises also help strengthen vaginal muscles.

It has been observed that pregnant women who perform Kegel exercises often experience an easier birthing process. Strengthening these muscles during pregnancy can aid the mother in the ability to control her muscles during labor and delivery. Toning these muscles also minimizes two common problems during pregnancy: decreased bladder control and hemorrhoids.


The Kegel exercise was named after Dr. Arnold Kegel, who has popularized them in the ‘50s. This exercise was meant to cure patients suffering from urinary incontinence (often after childbirth).

You can easily identify the vaginal muscles which play an active part during sex with this simple exercise. 

Go to the bathroom and urinate a little, then stop the flow of your urine. Then start urinating again, retain the flow of urine, and stop again and then start again. Do so until you have emptied your bladder. 

The muscles which just acted according to your wishes are the same ones involved in dilating and contracting during sex especially during vaginal penetration. 

Once you identify these muscles it is important to exercise them in order to be able to contract and relax these muscles at will. This will help you gain control over the vaginal muscles keeping pain at bay during sexual penetration. This is known as Kegel’s exercise. 

When you are still at the stage of practicing the Kegel exercise do not attempt a sexual intercourse with penetration.


The Kegel Exercise

 Practice the Kegel exercise for a week or two. 

Find a quiet suitable place to do the exercise. You can do it after waking up in the morning and just before bedtime while lying on your bed. 

Follow the steps given below:

  1. Contract your pelvic muscles. Squeeze and hold for 3 seconds
  2.  Then relax for another 3 seconds.
  3. Repeat the exercise for as many as 10 times each session, until you can do around 15 repetitions.

Initially, a certain effort of concentration will be needed to contract the pelvic muscles only, without contracting the abdominal and gluteal muscles. When you get used to it, it will become automatic.

Once you become comfortable doing these sessions quietly in bed, you can do the Kegel exercises anytime while doing some other activities for example, watching TV, working on your computer, in your car, etc. 


Syncing the Kegel Exercises with Breathing Exercises

Once you are comfortable doing Kegel’s exercise anywhere, sync it with breathing exercises: 

  1. Focus on your breathing for a few minutes. Breathe in and out deeply a couple of times to relax yourself.

  2. Then inhale deeply and hold your breath for a few seconds while strongly contracting your pelvic floor muscles.

  3. Then exhale deeply and relax these muscles.

Repeat several series of this exercise. 

Warning: Please do not do this exercise while urinating. 

More OB/GYN Related Topics

People interested in this topic also read: 

References:

1. Nacharaju M, Vellanki V S, Singh S, Verapeneni L, Mandava S. Factors Associated with Successful Vaginal Birth after Caeserean [Internet]. medicalresearchjournal.org. 2018 [cited 13 April 2018]. Available from: https://medicalresearchjournal.org/index.php/GJMR/article/view/448

2. Jeffrey L. Ecker, Fredric D. Frigoletto, Jr., Cesarean Delivery and the Risk–Benefit Calculus [Internet]. http://www.nejm.org/. 2018 [cited 13 April 2018]. Available from: http://www.nejm.org/doi/full/10.1056/NEJMp068290

3. Zhifei He, Zhaohui Cheng,  Tailai Wu,  Yan Zhou,  Junguo Chen,  Qian Fu,  and Feng Z, The Costs and Their Determinant of Cesarean Section and Vaginal Delivery: An Exploratory Study in Chongqing Municipality, China [Internet]. https:/www.ncbi.nlm.nih.gov/. 2018 [cited 13 April 2018]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5138444/ 

Would you like to consult a doctor for Caesarean Delivery ?

Questions answered by trusted doctors

Verified User
I am looking for Post caesarean exercises suggestions from physiotherapist. My caesarean happened 5 weeks back.
Dr. Naiya Talati (PT)
Neuro Physiotherapist, Mumbai
Hi post  c section  there are no. Of excercise known as keigel excercise to increase pelvic muscle strength  which physiotherapist  can guide you better with live session. and apart from that core muscle  strengthening  is required  for abdominal  and back strengthening  ...
Verified User
1 year back I had caesarean delivery and after that I'm having pain on right side abdomen. I'm having pain while turning on bed, standing from bed or chair. Please suggest.
Dr. Prabhjot Manchanda
Obstetrician, Mumbai
its not bcos of section. get a scan done
Verified User
I had previous caesarean in nov.16...ne I m pregnant 14 weeks 2 days ...I want to abort the baby...is any gynaecologist will do that
Dr. Manju Kumari
Obstetrician, Hyderabad
Gynaecologist can do but it is very risky because one and half year back only caesarean section.Still scar is weak again think over it and then decide.
Dr. Astha Agarwal
Obstetrician, Ghaziabad
Any gynaecologist working at a centre  which s registered for a second trimester abortion will do MTP for you.
However you should be aware of the high risks associated with the same.
Verified User
My wife gave birth to baby on 10th april 2018 through caesarean. Today she is having vaginal bleeding very much like periods with symptoms like cramps, abdominal pain etc. Not sure if it is menstruation or sth else. She is breastfeeding d baby without any problems. No formula milk is given to baby only breastmilk. Can periods resume after 8 or 9 weeks from childbirth?
Dr. DHAVAL DHARANI
Gynecologist, Surat
Hi
Ya definitely period can resume nothing to worry
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Did you know?

How did the term c-section or Caesarean section come about?

Apparently Julius Caesar had a hand in coining the term. Under his rule, according to the law an attempt to cut open an expecting woman’s womb to deliver the child could only be made if the woman is already dead or dying and if the woman’s family wishes to save the child. Hence the name Caesarean Surgery. All hail Caesar!

Recovery from c-section

Complete bed rest is advisable for seven to 10 days. You can resume exercising and leading an active life ( including exercising) after one to two months depending on your health condition and doctor's advice.

Risks involved in first time c-section

According to an analysis done over a period of 14 years, compared with women giving birth vaginally, healthy, low-risk women undergoing their first C-section were three times more likely to suffer serious complications—such as severe bleeding, blood clots, heart attack, kidney failure, and major infections.

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