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July 27, 2016

 

With one in four Kiwi babies being born by caesarean, it’s important to know a few facts, what happens on the day, and what to do during c-section recovery time. Here’s obstetrician, Dr. Olivia Stuart, obstetrician and specialist at Auckland’s Fertility Associates, Tamara McLean, and mum Sara Hutchison with their advice on what you could expect.


Regardless of your thoughts (or what anyone close to you thinks!), there’s a chance that this incredible procedure will bring your baby into the world. The thought of a c-section procedure can make some mums-to-be a little uneasy, however, it may not necessarily be a choice as some c-sections occur by necessity.

But what exactly is involved and in what circumstances is a C-section the safest option?

Obstetrician Dr Olivia Stuart explains that a c-section is swift, safe, straightforward and one of the most commonly performed operations in New Zealand hospitals. “They’re an absolutely standard procedure these days, and something surgeons do over and over again with complete confidence,” says Olivia, a specialist at Auckland’s Fertility Associates.

Elective or Emergency C-section

In a caesarean section, the baby is delivered via an incision in the abdominal wall. An elective (planned) c-section is most commonly carried out at the wish of a mum-to-be, usually as a request following a previous c-section. It also occurs when the baby is in the wrong position – usually bottom down or transverse – or the placenta is low-lying, barring the baby from coming out first. “Both of these issues we usually know about long before the birth, so we can plan for them,” Olivia explains.

Emergency (unplanned) c-sections tend to happen because the baby is distressed or labour is not progressing. “If we have a situation where the mother is in labour but the cervix isn’t dilating to allow the baby out then a c-section may very well be advised,” says Olivia.

It could also be ordered if the baby’s unusual position is only noticed at the last minute or there’s a cord prolapse - when the umbilical cord drops through the cervix into the vagina ahead of the baby.

While these are all referred to as “emergency” situations, Olivia says there’s usually nothing frightening or panicky about them. 

“Most of the time it isn’t like what you see on TV,” she says. “Emergency just means it’s organised on the day but it’s still quite cool, calm and unrushed.”

 

c-section - everything you need to know  c-section all you need to know

 

Preparing for the C-section 

Regardless of whether a c-section is elective or emergency, the process is the same. The woman is assessed by her obstetrician who will set the delivery plan before handing her to the surgeon and anaesthetist to explain the risks and ask her to sign consent forms. The theatre is booked and blood tests are ordered to check for anaemia and blood group - just in case blood is required urgently. Then it’s time to get a catheter fitted to the bladder, the top of the bikini line shaved and the gown on. “After that it’s off to theatre and first up they will get two types of anaesthetic: a local into the skin and then a shot into the fluid that surrounds the spinal cord,” says Olivia. Ice is applied to the top of the stomach to ensure she’s thoroughly anaesthetised in her mid-zone before the drapes are raised, and the site is cleaned with antiseptic.

What happens during the Caesarean 

A swift 60-second manoeuvre in which the surgeon cuts through the layers of the tummy wall, pushes the bladder off the front of the uterus and then makes another cut in the uterus to deliver the baby. 

There should be no discomfort throughout the procedure. 

“This part happens very fast and the baby is very quickly out, getting checked over and then given to mum for that all-important skin-to-skin time,” Olivia says.

The C-section recovery 

The whole caesarean procedure takes an hour, with another 30 minutes of close monitoring in recovery to follow. The stitching up can take up to 15 minutes and includes a check to ensure the uterus is contracting nicely and bleeding is limited. The new mum will then spend five to seven days for the c-section recovery in hospital, and six weeks avoiding heavier lifting as the deep abdominal muscles heal. The only physical sign of the c-section procedure, the 12cm-long incision, should be hidden under the bikini line once the hair grows back.

 

     the c-section recovery    the c-section procedure and recovery 

Choosing an Elective Caesarean

Sara Huchison had a beautiful experience giving birth to her third son by elective caesarean.

“I don’t know if it’s better or worse to know exactly when you’re going to have your baby – you have all the same nerves – but for my third child I planned to deliver my baby boy by caesarean.”

“We knew exactly what time we had to be at the hospital and ended by being 20 minutes late because we got caught in traffic. I hate being late for anything – let alone the birth of my baby.  

Once you get there there’s quite a bit of admin; forms to fill out and people to meet. The team talks you through everything before you go into theatre. I felt like it was the only birth they were doing that day – they were making jokes and the vibe was very positive in the room.  Overall, it’s very methodical the way they carry things out. You can only take one person in with you.

As soon as they pulled my son’s head out, before his body was fully out, he was screaming his head off and I was ecstatic because I knew he was okay. Then they lifted him and showed me over the curtain, it was a huge rush of relief and happiness, and amazement that life happens like that. 

“After that, they gave him to me so I could have skin-to-skin contact.”

They have a nurse stand next to you and just hold on to him with one hand to make sure that he’s okay while you’re under anaesthetic. I really wanted to keep him on me the whole time so they had the nurse walk beside the bed while they wheeled us to recovery. They take all your vitals and things then but by the time you’re not taking any notice of what’s happening anymore.

I know some people can’t understand why anyone would elect to have a caesarean, but it was right for me. Just because it was a caesarean doesn’t mean it wasn’t beautiful.”

To find out more about the emotional side of giving birth via c-section, check out our helpful article on the topic here. 

 


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