DEFINITION

A Caesarean Section is a surgical procedure where a baby is delivered through an incision made in the mother's abdominal wall, and then through the wall of the uterus.

DESCRIPTION

A Caesarean Section is usually performed when it is safer for the mother or the baby than a vaginal delivery. Caesarean deliveries are sometimes necessary when a mother has had diabetes or high blood pressure during pregnancy or when the baby is not positioned normally in the uterus. Emergency Caesarean Sections may be performed when there are abnormal developments during the pregnancy or birth, such as foetal distress, prolonged labour or placenta praevia (when the placenta is blocking the birth canal). Other times, a woman may elect to have a Caesarean Section rather than deliver her baby in the traditional method. It is important that a woman be informed about all of her birthing options and chooses the delivery technique she feels most comfortable with.

Caesarean Sections are generally a very safe procedure, but as they are an invasive type of surgery, they can carry certain risks for both the mother and her baby. There are two types of incisions (cuts) in the wall of the abdomen that can be used to deliver the baby: the classic incision is a vertical cut that is made through the wall of the abdomen through the front wall of the uterus; the lower segment incision is made horizontally at the lower end of the uterus. Classical type incisions are generally used for women with placenta praevia or whose baby is lying transversely in the uterus, whereas lower segment incisions are usually used when a woman is carrying a large baby.

A woman may be given spinal anaesthesia for the Caesarean procedure or she may have a general anaesthetic. Spinal anaesthesia is similar to an epidural, where a needle is inserted into the fluid that surrounds the spinal cord so that there is no sensation from the chest down. The main difference between spinal anaesthesia and an epidural is that the anaesthetic affects more of the body (in an epidural, there is no sensation from the waist down, whereas in spinal anaesthesia there is no sensation from the chest down). Some women may require general Anaesthesia during the Caesarean, which means that they are asleep during the birth. This is sometimes necessary when the baby must be delivered very quickly.

There is a small risk of certain complications arising from a Caesarean Section. The mother may develop infections in her wounds, there may be damage to the bladder and other internal organs and there may be damage to blood vessels. There is a small risk that the surgical instruments may damage the baby and there is an increased chance of the baby experiencing respiratory distress than if it were born via vaginal delivery.

If a woman has a spinal anaesthetic, she will be conscious throughout the operation and may feel a slight dragging sensation as the baby is lifted out of her uterus. Once it is certain that the baby is all right, the mother's baby can be brought straight to her, for her first cuddle. If a woman has a general anaesthetic, she should be able to see her baby once she regains consciousness.
When a woman has a Caesarean Section, she usually has an intravenous drip for the first twenty-four hours or so, just to keep the fluid balance in her body stable, until she is able to eat and drink normally. She may also have a catheter inserted to drain urine from the bladder so there will be no need to get out of bed to go to the toilet.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice.
1) Follow the Diet Hints.
2) If you need any advice on medication, ask your Pharmacist.
3) Your Pharmacy stocks a full range of surgical dressings.
4) Have adequate rest.
5) If you need help to stop smoking ask your Pharmacist for some suggestions.
6) If you are in any pain and need a pain killer, ask your Pharmacist for the most suitable type.
7) If the diet is inadequate consider some supplements. Echinacea and zinc are two supplements suggested to increase the natural immune system of the body.

DIET HINTS

You usually start to eat lightly very soon after your operation. When you pass "wind' for the first time after your operation, be sure to tell the health professional looking after you. You may need a gentle laxative to help your bowels get back to normal, and you will be given one if necessary. In the meantime, extra fibre in your diet will help.
If you are in any pain, do not hesitate to ask for medication. It is important to feel comfortable especially when feeding your baby.

VITAMINS/MINERALS/HERBS

Some herbs are not recommended in the weeks before and after surgery due to the direct effects they may have on the body and/or the possibility that they may interact with other medications. You should tell your Surgeon and/or Doctor well before surgery if you are taking ANY supplements. The American Society of anesthesiologists recommends that people stop taking herbal medicines at least two to three weeks before surgery. Ask your Surgeon and/or Doctor for advice.

POST OPERATIVE NOTES

During a woman's recovery from a Caesarean Section, she will require intravenous fluids via a drip to maintain her body's fluid levels. A urinary catheter is also inserted. This is a tube that goes into the bladder to drain urine. There may also be a tube to drain fluid from the wound. These devices will generally be removed within 12 to 24 hours of the operation. A woman can start drinking fluids as soon as she feels able, although she must pass wind before she can start eating again. This is because the surgical procedure and anaesthetics temporarily stop the normal movements of the intestines. Passing wind is a sign that the intestines have begun to function normally again. Within about 8 to 12 hours after her surgery, a woman should get out of bed and attempt to walk around, as movement soon after the procedure speeds up recovery and helps to prevent certain complications.

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