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CESAREANS
Every pregnant woman has a chance of needing to have a cesarean. The most important recommendation is that if you are pregnant - then educate yourself. Read, read, read, read. Read all you can about pregnancy and childbirth, both natural (vaginal) and cesarean. Attend birth classes. They are well worth the time and effort. Talk to other women who have been there. The worse thing you can do is to go blindly into pregnancy and childbirth and not know what's going on, or what your options are.Sue Ann went through her first two pregnancies without a thought about cesarean delivery. To her, cesareans weren't even an option. She would deliver vaginally just as her mother did, her grandmothers did, her aunts did, and her older sister, so why couldn't she?
Truth is each pregnancy is different and occasionally things come up that require medical intervention in order to save the baby and or mother's life. Just because no body else in your family has never had a cesarean, doesn't mean you won't possibly need one.When Sue Ann gave birth to her daughter, she had her naturally and assumed that her next baby would be the same way. She attended Bradley Method Childbirth Classes and a HypnoBirthing course in preparation for her birth. She talked with her midwife and her backup health care provider at the hospital at length about her birth plan about having no IV's, no drugs and all natural. That was her plan until her 34th week of pregnancy when her midwife discovered two distinct fetal heart beats and had an ultrasound. The ultrasound confirmed she was expecting twins and one was breech. Since her midwife felt that the risk was too great to deliver her babies at home, she was referred on to her backup health care provider. Sue Ann felt that all of her well intended plans of an all natural birth flew out the door. Then she began to read whatever she could find and to learn all she could about cesareans, just in case her health care provider felt that a cesarean would be necessary.
The fact that there is a chance of needing a cesarean, though how small or large a chance depends on how your pregnancy is progressing and what problems may arise, necessitates the need for knowing about cesareans.
Possible reasons for a cesarean include:1. Failure to progress in labor. This is when the cervix will not dilate completely, or the labor stops altogether.
2. Fetal distress - concerns about the baby's health during labor. Usually the baby is not getting enough oxygen, either because the umbilical cord is being compressed or because the placenta is no longer functioning properly.
3. Malposition of the baby - breech positions are the cause of 15% of cesareans. Sometimes the midwife or other health care provider can successfully move the baby and sometimes the baby won't move at all. Few physicians will allow a woman to deliver a complete or frank breech - however it's not without risks to the newborn. Soft neurological damage can occur in the baby. Footling and transverse (sideways) always have to be delivered cesarean. Some experienced midwives will deliver a breech if everything else is normal.
4. Not enough room for the baby - sometimes the baby simply won't fit through the mother's pelvis - either because the mother is too small or the baby too big - or the baby is turned sunny side up (face facing forward, called posterior presentation).
5. Maternal health conditions - these include:a. Gestational Diabetes - this condition can cause macrosomia - or excessive weight at birth in the baby. Most physicians define macrosomia at 9 pounds 14 ounces or more.
b. Heart or pulmonary disease.
c. High blood pressure.
d. Genital Herpes.
6. Multiple births - this is when there is more than one baby present.
7. Obstetrical emergencies - placental abruption, placenta previa, uterine rupture or cord prolapse almost always requires an emergency cesarean birth.
8. Repeat cesareans - 1/3 of all cesareans performed are repeat. This number is decreasing, however, because women are electing to try VBAC (vaginal birth after cesarean).
In preparation for the c-section, visit your hospital for a tour and find out the procedures that are used. You will have an IV inserted in your arm and a catheter put in to catch your urine. You will either be given a spinal, epidural or a combination of the two. In some extreme emergencies general anesthesia is used. Most always a labor support person/partner is allowed to be with you during the procedure. It takes up to an hour and you will feel little to no pain. You will then spend another hour in the recovery room. After you go back to your room, you will be given a liquid diet for a couple of days and will slowly be allowed to get up and move around.
Altogether, recovery time for a cesarean is about 6 weeks where as recovery from a vaginal birth is about 2 weeks. It will take several months to gain back the muscle tone just to be able to sit up without help. And let's face it, once those muscles are cut, you never fully gain back all that tone.
MoonDragon's Pregnancy Information: Cesarean Pictorial
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