Cesarean on demand, what experts call elective cesarean, is growing increasingly more popular in a culture known for getting what it wants when it wants it. Still, most cesarean births today are for medical reasons – not by choice. This is because by far, vaginal deliveries are considered safer than cesarean birth as they don’t involve major surgery. Yet most major health organizations leave this decision up to the mother and her healthcare provider. The American College of Obstetricians and Gynecologists consider elective cesarean an “ethical” decision to be made between the patient and her provider. An international survey conducted by the World Health Organization (WHO) and released in January showed that while medically indicated cesarean births reduced risks for moms and babies, elective cesarean births actually did the opposite, putting mom and baby at increased risks.

Medical reasons for cesarean include a previous cesarean birth, maternal or fetal distress, and simply when it’s feared that the baby’s head will not fit through the mother’s pelvic opening (cephalopelvic disproportion).

When cesarean birth is necessary

Perhaps you’ve been told that your baby is breech—either head up or transverse and that you must birth by cesarean. You might be wondering what this means and what to expect. First, be reassured that today’s hospitals and birthing centers have made tremendous strides in keeping you, your partner, and your baby together as much as possible. Schedule a tour where you plan to birth your baby to ask specifically about their practices, such as:

  • How long will I be apart from my baby?
  • How soon after surgery can I begin breastfeeding my baby?
  • When will skin-to-skin contact with my baby be possible?
  • The entire process takes about an hour, and you may feel pressure on your abdomen when the baby is delivered. Then as long as the baby and you are both doing okay, you’ll go to the recovery room together where you will continue to have your vital signs monitored. If you’re breastfeeding, the nurse will assist you in getting the baby on the breast. During this hour, your family will be welcome to join you. In the hours that follow you’ll be able to eat, feed your baby, and have help getting out of bed the first few times. Your nurses will be monitoring your urine for the next 48 hours, so a plastic type container will be placed under the toilet seat to collect the urine. Latex-free products are available if you have a latex allergy.

    Most moms are discharged 48 to 72 hours after birth. Keep your incision clean and dry and report any redness, swelling, tenderness, or if it’s warm to the touch. Remember, although you just gave birth, you did have major surgery. Ask for help and sleep when your baby sleeps. Talk to your healthcare provider about any abdominal wraps or other therapies you can use to help support your recovery post-birth.

    Undergoing cesarean birth

    Preparing for a cesarean:

    • No eating after midnight the night before surgery.
    • Check-in at least two hours ahead of your surgery.
    • Bring everything you’ll need for a two- to four-day hospital stay.
    • Undergoing cesarean:

      • You’ll begin in the room you’ll be staying in post-birth.
      • An IV will be started so that you can receive antibiotics and fluids.
      • If you’re needle phobic or have a low pain tolerance, ask for Lidocaine to first numb any injection areas. Save yourself an extra needle stick, and ask your nurse to draw your lab work when your IV is inserted.
      • To keep your bladder empty during surgery, your nurse will insert a Foley catheter through your urethra and into your bladder. It will stay in until the next morning, when you can get up out of bed and use the toilet.
      • Epidural or spinal anesthesia will be done in the surgical suite. The incision area will be shaved and your abdomen cleansed with an antiseptic solution.
      • A strap will be placed across your thighs and across your outstretched arms to hold you steady on the table, and you’ll also have a blood pressure cuff on your arm, and a finger probe to measure your oxygen level.
      • Sterile drapes will be hung between your upper body and the incision site, and your physician will perform the surgery, which takes about 10 minutes.
      • Your partner will be seated at your head, as desired. Following the birth, it will take another 30-40 minutes for your doctor to close your incisions.

Joanne Goldbort, PhD, MSN, RN, is an assistant professor in the College of Nursing at Michigan State University and an expert nurse adviser to Healthy Mom&Baby.

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