How Is A Cesarean Delivery Done?

About 30% of all babies in the United States are born through cesarean delivery.

Cesarean delivery mostly follows this process:

• You will be positioned on an operating table.
• A urinary catheter may be placed before entering the operating room.
• The physician may start an intravenous (IV) line in your arm or hand.
• The physician will shave the hair around the surgical site. They will clean the surgical site with an antiseptic solution.
• The physician may give you local anesthesia, either an epidural or a spinal block to numb you from the waist down.
• Once the anesthesia has taken its effect, the physician makes a cut above the pubic bone, mostly along the bikini line.
• The surgeon makes a deeper cut through the tissues and separates the abdominal and uterine muscles and then enters the uterine cavity.
• The physician will open the amniotic sac to deliver the child through the opening and cut the umbilical cord.
• The physician will give you medicine through the IV line for a contraction of the uterus and ejection of the placenta.
• The physician may watch for remnants of the placenta and tears in the uterus.
• Finally, the physician closes the muscles and tissue layers with sutures or surgical staples.
• The sutures may be removed on day 7.

What is cesarean delivery?

Cesarean delivery is the surgical delivery of a baby by making an incision in the mother’s abdominal wall and uterus. Although cesarean delivery is generally safe, it should be performed during certain circumstances. About 30% of all babies in the United States are born through cesarean delivery.

There are certain disadvantages of cesarean delivery over vaginal delivery. They are as follows:

• Longer recovery period Prolonged hospitalization
• Uterine scarring, making further pregnancies riskier 

Why is cesarean delivery needed?

Cesarean delivery might be planned due to a medical reason or performed due to any medical emergency. Cesarean delivery might be recommended in

• Cephalopelvic disproportion (a condition where the baby’s head or body is too large to pass through the mother’s pelvis).
• Previous cesarean birth (attempting vaginal birth may cause the uterus to rupture).
• Multiple pregnancies.
• Placenta previa (a condition where the placenta covers partially or fully the opening of the cervix).
• Transverse lie (the baby lies in a horizontal or sideways position of the uterus).
• Breech presentation (the baby is positioned to deliver feet or bottom first).
• Mothers with underlying medical conditions such as diabetes or high blood pressure.
• Mothers with infections such as human immunodeficiency virus (HIV) or herpes.

An emergency cesarean delivery may be indicated in the following situations:

• Fetal distress (a condition where the fetal brain starts experiencing oxygen shortage)
• Failure of labor to progress
• Placental abruption (the placenta separates from the wall of the uterus)
• Cord compression (the umbilical cord is tangled around the baby’s neck or body)
• Prolapsed cord (the umbilical cord comes first before the baby)

Cesarean delivery should be avoided when

• The mother has a severe pulmonary disease.
• There is a defect in the child that may lead to their death.

What are the complications of cesarean delivery?

Cesarean delivery involves some risks that include:

• Infection
• Bleeding
• Embolism (a blood clot that breaks into the bloodstream)
• Fetal injury
• Injury to the bowel or bladder
• Tear in the uterine wall
• Risks from general anesthesia
• Abnormalities of the placenta in the consequent pregnancy
• Infection in the uterus
• Wound infection
• Trouble urinating or urinary tract infection
• Blood clots

Subsequent pregnancies may have an improper placental position due to a uterine scar from cesarean delivery done at present.