Caesarean Section

What is a caesarean section?
A caesarean section is an operation to deliver your baby through your tummy (abdomen). The cut is usually made along the bikini line. There are many possible reasons why this operation may be recommended.
An elective caesarean section means that it is a planned operation carried out before labour begins. An emergency caesarean section is one that is carried out as a result of a complication arising during labour. Your obstetrician will have discussed with you the reasons for your caesarean section. Do
ask if you are unsure why you are having the operation or need further information.

Enhanced Recovery Pathway

The Enhanced Recovery Pathway has been developed to help you recover sooner after your caesarean section. The aim is to improve the care that you receive and reduce the time you will need to stay in hospital after the birth. It has been found that the earlier you get out of bed, start walking, eating and drinking after your operation, the shorter your recovery time will be.
Before your caesarean section

Your blood test, taken at 28 weeks, will be checked and you will be encouraged to take iron supplements if it shows low iron levels. Your obstetrician will discuss the reasons why a caesarean section is advised, the risks and benefits of the operation. You will be asked to sign a consent form and given a copy to take
home with you. You will receive a letter confirming the proposed date of your caesarean section.

From 34 weeks, try to increase the amount of physical exercise that you do. For example, a brisk walk for 30 minutes or two 15 minute walks. If this is difficult, remember that any increase in activity will improve your health.
Diet

From 34 weeks, ensure that you eat a healthy diet, high in protein (eg. fish, meat, cheese, beans, pulses) and with plenty of fresh vegetables and fruit.

What are the risks of caesarean section?
Risks to me:
Infection: The uterus or nearby pelvic organ such as the bladder or kidneys can become infected, although the most common site of infection is the wound. Antibiotics are given during your caesarean section to reduce the chance of these infections.
Bleeding: Blood loss on average is about twice as much with caesarean birth as with vaginal birth. Between two and four women in every 100 will need a blood transfusion.
Collection: Accumulation of blood under the skin and soft tissue (haematoma). Injury: This can be to the bladder, bowels or other organs. Adhesions: This is scar tissue that can develop causing organs to
stick together. Thrombosis and pulmonary embolism: These are blood clots that may affect the legs or lungs. This can be a very dangerous complication. You will be asked to wear special socks which
improve blood circulation in your legs. Women who are at higher risk will be given blood thinning injections (clexane) after the operation to reduce the risk. Decreased bowel function: The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and
discomfort. Longer hospital stays and recovery time: The stay and recovery time may be longer than after a vaginal birth where women may go home in six hours. The risk of additional surgery: For example hysterectomy or repair of any damage during the operation. This is rare. Women are more likely to be admitted to an intensive care unit after caesarean section than after vaginal birth, although the risk is
rare. They are more likely to be readmitted with a complication. Risk for future pregnancies: Tearing of the scar on the womb. (uterine rupture) 1:500 and risk of the after birth (placenta) covering the entrance of the womb (Placenta Previa) or sticking to the previous scar or bladder (Placenta Accreta).

Risk to my baby:
Breathing problems: About 35 of every 1,000 babies born by caesarean section have breathing problems just after the birth compared with five of every 1,000 babies after a vaginal birth, particularly if delivered before 39 weeks. Fetal injury: Although rare, the surgeon can accidentally cut the baby’s skin while making the uterine incision. Dislocation: Very rare. Dislocation of the joints may result from
delivery of the body and limbs. Breast feeding: Women who have caesarean section are less
likely to start breast feeding in the first hours after the birth, but if they do start they are just as likely to continue breastfeeding as those who have vaginal delivery.

The day before the caesarean section
Take 30 minutes exercise (or two x 15 minutes). Please ensure that any nail polish, especially gel or acrylic
polish is removed.

Recovery
After your operation you will be moved onto a bed and taken back to your room on labour ward. Regular observation of your blood pressure, pulse and vaginal blood loss will be made. You will be encouraged to sit up and feed your baby. Your baby will be weighed, measured and have an initial full examination by the midwife, who will also check his/her temperature. You will be encouraged to start drinking, and to have a light diet as soon as possible to help your body recover quickly. You and your baby will be transferred to a shared bay.
At home
Please make sure that you have someone with you at home for the first few days.


You should contact your doctor immediately if you have any of the following:
■ Unusual or smelly vaginal discharge
■ Any discharge from the wound
■ A high temperature or you feel feverish
■ Pain in the back of your leg
■ Sudden episode of breathlessness or chest pain
■ New or severe pain

Ali Hospital
support@alihospital.pk