C-section. Caesarean section is a severe psychological trauma. When is surgical delivery indicated?

C-section is an operation in which a child is born not through the natural birth canal, but through an incision in the anterior abdominal wall.

Almost every 3 women have to face it. Knowing the indications for surgery will not be superfluous, but even useful. This will allow you to thoroughly prepare and tune in mentally.

With the approach of the cherished birthday of your baby, expectant mothers think about childbirth. It will not be superfluous to know in what cases a caesarean section is performed.

Reasons for surgery may be:

relative, when the refusal of the operation borders on a high risk for the health of the mother and child.
absolute. There are not so many of them. These are cases where vaginal delivery is not possible or can lead to the death of mother and child.

Recently, more and more often, the operation is performed due to a combination of several factors. When each of them in itself is not a reason to undergo surgery.

But a combination of 2 or more causes an operation. For example: a primigravida woman over 30 years old and a large fetus weighing more than 4 kg. Neither a large fetus nor age alone is the reason for the operation. But together this is already an argument.

There are planned and unplanned cesarean or emergency. With a planned operation, indications for it arise in advance, even during pregnancy. For example, high myopia. The woman and the doctor have time to prepare. Complications in such cases are rare.

Emergency surgery can be performed at any time and even during natural childbirth. For example, with fetal hypoxia, placental abruption.

When is a caesarean section performed?

Placental abruption. This starts bleeding. It doesn't always bleed out. It can accumulate between the uterus and the placenta. The placenta exfoliates even more. The child suffers from hypoxia - oxygen starvation. Woman due to blood loss. It is necessary to urgently remove the child and stop the bleeding.
Placenta previa. The placenta blocks the entrance to the uterus. Therefore, natural childbirth is not possible. When contractions begin, the cervix opens, the placenta in this place peels off and bleeding begins. Therefore, they try to operate on such women on the appointed day before the onset of labor.
Loss of umbilical cord loops. Sometimes the umbilical cord loops fall out of the uterus during childbirth before it is completely open. They find themselves sandwiched between the pelvic bones and the head or buttocks of the fetus. Oxygen stops flowing to the child, he may die. It is necessary to complete the birth within a few minutes.
Discrepancy between the pelvic sizes of mother and child. If the baby is too large, then he will not be able to be born on his own. As they say, it won’t get through. Here, a caesarean section would be the best way to help the woman without harming the baby. Sometimes this circumstance can only be clarified during childbirth. Women begin to give birth themselves, but when there are signs of a size mismatch, they are given a caesarean section.
Transverse position of the fetus. During a normal birth, the baby should lie head down. If it lies across the uterus. That kind of birth is not possible. After the outflow of amniotic fluid, there is a risk of prolapse of the fetal handle, leg or umbilical cord. It is dangerous for his life. In such situations, they try to plan the operation before the onset of labor.
Eclampsia and preeclampsia. This condition is a serious complication of pregnancy. In difficult cases, the functioning of internal organs is disrupted, and blood pressure rises to critical levels. The risk of hemorrhage in internal organs increases: the retina, brain, liver, adrenal glands, etc. To help the woman, it is necessary to perform an emergency cesarean delivery.
After operations on the cervix. Why? Because natural childbirth will damage the cervix.
Obstacles that prevent childbirth through the natural birth canal. Tumors of the uterus, bladder, pelvic bones. Significant narrowing of the pelvis, as well as its deformation.
Fistulas between the vagina and rectum or bladder. As well as rectal ruptures in previous births.
Chronic diseases of women. These are diseases of the eyes, heart, nervous system, endocrine system, joints and bones, as well as chronic infectious diseases hepatitis C and B, HIV infection. The decision in this case is made by doctors of other specialties: ophthalmologists, surgeons, infectious disease specialists. The approach here is planned. The woman knows in advance about the upcoming operation and prepares for it.
Breech presentation of the fetus. Natural childbirth is possible. But since there is a risk of injury to the child and mother, they often resort to caesarean section.
Extension insertions of the head. During childbirth, the head should bend as much as possible. To pass through the mother's narrow pelvis. But there are times when something prevents her from doing this. The head is bent. In such cases, its size turns out to be too large.
Scar on the uterus. It can remain both after a cesarean section and after operations on the uterus to remove myomatous nodes and others. Natural childbirth is possible with one scar on the uterus. 2 or more scars are an indication for cesarean section. Natural birth after cesarean is possible only if the scar is strong according to ultrasound. And the woman does not have nagging pain in the lower abdomen or bleeding.
Fetal hypoxia or oxygen starvation. The child receives insufficient nutrition and oxygen. This condition can occur acutely, for example with placental abruption or umbilical cord prolapse. Or develop gradually. Umbilical cord entanglement around the neck, cysts and placental infarctions. Membranous attachment of the placenta. Sometimes a child, due to chronic hypoxia, is stunted and is born low birth weight.
If indications for childbirth occur between 28 and 34 weeks, a cesarean section should be performed. Since childbirth for a premature baby can be fatal.
identical twins, as well as triplets.
fraternal twins, if the first child is in a breech position or lies transversely in the uterus.
Weakness of generic forces. When the cervix refuses to open during labor, despite treatment.
Pregnancy after IVF, as well as long-term infertility treatment in combination with other factors.
The woman's age is over 30 years old in combination with other factors.
Post-term pregnancy in combination with other reasons.

Important! Caesarean section is not performed at the request of the woman. Since this is a very serious intervention with many complications.

However, there are no contraindications to this operation if refusing it would have negative consequences for the woman. But it is undesirable to perform it if there is an infection of any localization in the body, or if the child has died.

When a cesarean section is prescribed, the doctor decides. The task of the expectant mother is to trust the doctor and tune in to a successful outcome of the birth.

Myths about indications for caesarean section

Caesarean section is performed optionally

In our country, fortunately, at will C-section do not comply. Surgical intervention is resorted to when it is really necessary, when natural childbirth is impossible or can cause harm to the health of the woman and child. Like any other operation, a caesarean section is a certain risk and is carried out only after carefully weighing all the pros and cons.

For those who give birth for the first time after 30 years, a caesarean section is the best option.

Age is not an indication for caesarean section. Another thing is that over time, a woman’s body accumulates various diseases that can affect the course of pregnancy and childbirth, and be an indication for a caesarean section. These are all statistics, not the specific condition of each woman. It is necessary to focus on the state of health and characteristics of the course of pregnancy, and not on calendar age.

If a pregnant woman is myopic, she will definitely undergo a caesarean section.

Myopia itself is not an indication for cesarean section. Surgery is absolutely necessary for complicated myopia, for example, problems with the retina or increased intraocular pressure. And then we are talking about easing the second (pushing) stage of labor, since tension can lead to decreased or loss of vision. Other methods can also reduce the risk, such as using epidural anesthesia, using obstetric forceps or vacuum extraction of the fetus. First stage of labor, i.e. contractions is not contraindicated for such women.

Natural birth of a fetus in a breech position is impossible

If the fetus “lies” down with the pelvic end, then childbirth is possible. The decision to operate is made when breech presentation is combined with a woman’s narrow pelvis, large fetus size (more than 3.6 kg), or a combination of breech presentation with other pregnancy complications. A caesarean section is preferred during pregnancy with a male fetus (damage to the boy's external genitalia is possible during childbirth).

Myths about the operation

Caesarean section is simple: fall asleep, wake up, and everything is over

Despite the fact that many “horror stories” about caesarean section are nothing more than a myth, we should not forget that, like any surgical intervention, it carries certain risks. No one is immune from complications (bleeding, development of infection, divergence of sutures, allergic reactions to drugs). The scar remaining on the uterus can complicate the course of subsequent pregnancies and become a risk factor in the next birth.

Fear of pain sometimes makes women ask for surgery. However, it should be borne in mind that natural childbirth pain stops immediately after the birth of the fetus. Postoperative pain lasts for several days, increased blood loss and anesthesia lead to weakness, sometimes depriving a woman of the opportunity to care for her child.

After cesarean section there is a scar on the entire abdomen

Previously, during a caesarean section, the abdomen was cut in the middle “from the navel to the pubis” and interrupted sutures were applied. Now a small incision is made along the pubic hairline and a special cosmetic suture is applied. With proper care, a year after the operation, a white scar remains as thin as a thread, which is easily covered even by bikini bottoms. Such an incision does not damage the aponeurosis of the midline, which contributes to the speedy return of physical form.

Caesarean section is always performed under general anesthesia

Many expectant mothers are afraid of anesthesia. In addition to the banal fear of “not waking up”, the expectant mother is worried about the effect of drugs on the baby. These fears are somewhat exaggerated. First, the vast majority of surgeries are now performed under spinal anesthesia rather than general anesthesia. Pain medication is injected into the spinal canal in the lumbar region, while the woman remains conscious, although she does not feel pain below the injection site. The anesthetic drug during spinal anesthesia does not enter the bloodstream and does not reach the child, and a woman can see her child immediately after birth. General anesthesia is used only when there are contraindications to spinal anesthesia, for example, with curvature and injuries of the spine.

During a caesarean section, blood is always transfused.

Modern surgical techniques allow one to avoid significant blood loss. Typically, a woman loses about 500-800 ml of blood during surgery. If she did not suffer from anemia before, the operation was uneventful, and there are no other complications of pregnancy, then this amount of blood loss does not require a transfusion, the woman is able to restore it on her own. Only 5% of patients require blood transfusions during caesarean section.

If the operation is planned in advance, then in some maternity hospitals that have their own blood transfusion department, the pregnant woman may be offered to donate a certain amount of her own plasma (plasma is the liquid part of the blood) after the 20th week of pregnancy. This procedure is safe for a pregnant woman and child; the plasma is restored in the body in a few days. In this case, if a blood transfusion is required during a caesarean section, the woman will be given her own plasma.

Myths about the consequences for women

Caesarean section leads to loss of health

Before the invention of modern methods of preventing infections, stopping bleeding and pain relief, cesarean section, indeed, often led to serious health consequences. Now the risks are much lower. So, to prevent inflammation, antibiotics are often administered during surgery. On the first day after the operation, the woman is in the intensive care unit or intensive care unit, where medical staff closely monitor her condition. After a caesarean section, a woman recovers more slowly than after childbirth; in the first month she needs the help of her family to care for the child, because She is advised to limit physical activity and is prohibited from lifting weights, even her own child. However, after a month and a half, all restrictions are lifted and the body is completely restored.

Pain after cesarean section is associated with a violation of the integrity of the peritoneum - the membrane covering all internal organs. If it is damaged, adhesions can form - adhesions between intestinal loops and other internal organs. In some women, the body is prone to developing an extensive adhesive process, which is manifested by prolonged abdominal pain and constipation. For most, this process is minimal and is not accompanied by any symptoms.

After a caesarean section you cannot become pregnant or give birth

Such a statement is valid only for the first two years after surgery, while the scar is forming. In this case, you need to take care of reliable means of contraception, because abortion is also undesirable. For successful pregnancy and birth of the next child, it is necessary that the postoperative period proceed smoothly, without complications. If a woman becomes pregnant before two years of age, the risk that in the last trimester the suture may not withstand the load and come apart increases. In this case, doctors monitor the pregnant woman more carefully. With a second operation, the risk of complications is higher than with the first, so doctors do not recommend more than 3 cesarean sections, although medical practice has described cases where 5 or more such operations were performed.

Caesarean section once - always cesarean section

The choice of delivery method for a woman who has already had a cesarean section once is not so clear. When resolving this issue, the condition of the postoperative scar is taken into account (its “consistency” is the ability to withstand the stress of childbirth), the course of the postoperative period, the course of the pregnancy, the presence of complications, and the condition of the child. In addition, be sure to find out the indications for the first operation. If the first operation was performed due to incorrect position of the fetus, and now the child is lying correctly, then independent childbirth is quite possible. If the reason for the caesarean section is irreparable, for example, a very narrow pelvis or health problems of the woman in labor, then, of course, a repeat operation will take place. In addition, when choosing a resolution method for a woman with a uterine scar, the wishes of the pregnant woman herself must be taken into account.

Caesarean section is not compatible with breastfeeding

Establishing breastfeeding after a cesarean section is indeed often more difficult than after a natural birth, but these difficulties are surmountable. If a caesarean section is performed as planned, that is, before labor develops, then milk comes later (4-5 days) than during spontaneous labor (3-4 days). This is due to the fact that when a woman goes into labor on her own, certain hormones are released into her blood, which, among other things, stimulate the production of breast milk. The use of antibiotics during surgery does not require cessation of breastfeeding, because in this case, drugs compatible with lactation are used. All drugs that enter the mother’s body during surgery are removed from it within a few hours. By the time milk appears, you can feed your baby completely fearlessly.

Certain difficulties arise with the first breastfeeding. It is known that the ideal start is breastfeeding in the first minutes after birth for 10-20 minutes. In the conditions of modern maternity hospitals, this interval is not respected, the first application lasts a couple of minutes and is more symbolic than physiological. Within a few hours after the operation, you can organize a full-fledged application. It is worse if a woman after an emergency caesarean section, when general anesthesia is used, is in the intensive care unit for the first 2-3 days, not being able to put the baby in her chest. After the transfer of the mother to the postpartum department, most maternity hospitals have created conditions for the joint stay of the mother and child in the ward. If it is still impossible to stay together, you can at least agree that the child is not supplemented with formula, or, if the doctor insists on supplementary feeding, they do it not from a bottle, but from a spoon or from a cup.

Caesarean section – severe psychological trauma

Indeed, many mothers who have survived a caesarean section feel a sense of dissatisfaction, guilt for the "wrong", in their opinion, childbirth. In many cultures, this feeling is "fueled" by public opinion: "she is insolvent, like a woman, because she could not give birth herself." In such a situation, an important role is played by the emotional attitude of relatives, friends, acquaintances, support of medical personnel. It is easier psychologically for women who know in advance about the upcoming method of childbirth and are confident in its necessity; it is more difficult for women who had to undergo an emergency caesarean section. It is especially difficult for perfectionists who are accustomed to doing everything “perfectly”, for whom any failure in the “program” deals a blow to their pride and leads to dissatisfaction with themselves. In any case, it is necessary to remember that the main goal of the program is the birth of a healthy child, and not the process and method of its birth.

Myths about the Caesars

Caesar babies get sick more often and often lag behind their peers in development

The birth of a child by caesarean section, of course, leaves an imprint on its further development. During such births, the child does not have time to gradually adapt to atmospheric pressure; due to a sharp drop in pressure, there may be problems with blood vessels. If a caesarean section is performed under general anesthesia, the baby, in the first weeks of life, is lethargic, passive, and does not breastfeed well, which is due to the effect of drugs for anesthesia and muscle relaxants. With a planned caesarean section, the baby is not born at its programmed time and therefore it is more difficult for him to adapt to active life in the first days - to active breathing, sucking, screaming. Lack of readiness of the respiratory system to breathe air can manifest itself in the so-called respiratory distress syndrome. The child’s lungs cannot cope with the load and cannot provide the necessary amount of oxygen. This is manifested by superficial, irregular breathing with quickening and slowing down. This increases the risk of developing respiratory diseases. In addition, during cesarean delivery, the child's intestines are not colonized by microorganisms of the mother's genital tract, which creates conditions for the development of dysbacteriosis.

However, the difference in the development of newborns is leveled with age, and after a few weeks, the "caesareans", due to adaptation, do not differ from their peers who were born naturally. This applies to babies born on time, healthy, if the caesarean section went without complications. It is more difficult for those in whom the operation was performed due to severe late toxicosis, fetal hypoxia or premature birth. Those. the condition of the child depends much more on the reasons for which the operation was performed than on the actual method of childbirth. And the impression that "caesareans" are born weaker is largely due to the fact that the baby had health problems even before the birth.

Planned caesarean section is a guarantee of a healthy baby

The appearance of this myth is due to the fact that the operation is often performed according to indications from the fetus, when there is a possibility that a weakened child will not survive a natural birth. This situation can occur during a very premature pregnancy or when the baby suffers from hypoxia (lack of oxygen in the blood). However, it is incorrect to translate this situation to healthy children. And although the likelihood of birth trauma when passing through the vaginal birth canal is higher, the risk remains. A cesarean section operation does not always go absolutely smoothly; during the operation, the baby may be accidentally injured, for example, during difficult removal from the uterus. Such an injury can cause damage to the nervous system with disturbances in motor activity and muscle tone. This factor can also affect the further physical and neuropsychic development of the child. Not to mention the risks that are described in the previous myth.

If the child does not pass through the natural birth canal, then an emotional connection is not formed between him and the mother

In fact, there is no scientifically proven evidence that children born through surgery love and are loved by their mother less than children born naturally. More recently, when today's expectant mothers were born, the newborn child was taken away from the mother immediately after birth, without even being put to the breast. And during the entire time they were in the maternity hospital, children were brought only for feeding, tightly swaddled in thick diapers, excluding any physical contact with the mother. Nevertheless, maternal love was still formed, and the children responded in kind. The bond between mother and child formed during 9 months of pregnancy will never depreciate. Not to mention the fact that thousands of women love adopted children and children born by surrogate mothers. After birth, it is enough to surround the baby with attention, and everything will work out, and it is not so important that this happens in the first minutes or in the first days of life.

There are a lot of myths associated with caesarean section. I would like you to learn the main thing from this article: if you need surgery, you need to do it, without any doubt. There is no need to be afraid of surgery if it will allow your baby to be born with fewer problems, but you should not strive for it, considering it a panacea for pain. If you can do without a caesarean section, it is better to do so.

The birth of a baby is perhaps the most long-awaited, important, trembling moment in the fate of every representative of the fairer sex. The birth of the baby can occur naturally or by caesarean section. The latter type of childbirth is currently becoming increasingly popular. This article will tell you how many times you can have a caesarean section. It is worth considering each side of this issue separately and drawing a conclusion. You will also find out what doctors say about how many times a woman can have a caesarean section.

C-section

This manipulation a few centuries ago led to irreversible consequences and the death of a woman. The whole point is that the doctors did not suture the uterine cavity, but connected only the upper tissues. The new mother died within a few hours from severe blood loss.

Now everything has changed. Medicine has made a leap forward. Many women, even in the absence of indications, want their babies to be born in this way. The procedure is performed under anesthesia, using one of several types of anesthesia. During the procedure, the doctor cuts the lower part of the peritoneum, opens the uterus and removes the baby. Later, all wounds are sutured in layers.

How many times can you have a caesarean section?

The opinion of doctors on this issue is ambiguous. Rather, it all depends on the individual characteristics and state of the body of the expectant mother. Some ladies easily tolerate the procedure and decide to carry out the third, fourth and fifth birth of the baby this way. Other representatives of the fair sex have too much trouble recovering from surgery and realize that once is enough for them. Let's consider different sides of this issue.

Use of anesthesia

An anesthetic is always used during surgery. Anesthesia can be general or epidural. In the first case, the woman is sleeping and sees nothing around. it allows you to understand, see and hear everything, but not feel pain at all. How many times can a caesarean section be performed if we are talking about anesthesia?

Doctors say that no pain relief leaves its mark on human health. On average, one anesthesia takes about five years of life. That is why doctors and anesthesiologists strongly do not recommend using such anesthesia more than 5-6 times throughout your life. The only exceptions are those cases when anesthesia is

From the reproductive organ

How many times can you have a caesarean section? The female uterus is designed in such a way that it is capable of bearing and reproducing about 5 children in its entire life. However, many women have 7-13 babies and safely give birth to all subsequent ones.

Doctors believe that a sixth child is already a big risk for a woman. Over time, the reproductive organ stretches and loses its elasticity. However, with age this happens to all muscles of the human body. Particular danger arises when the uterus has several scars. With each subsequent pregnancy, the risk that the reproductive organ simply ruptures ahead of time increases.

For women's health

How many times can you have a caesarean section without harming your health? This procedure is a surgical intervention, after which the new mother needs long-term recovery and rehabilitation. Also, a woman needs to gain strength as soon as possible in order to take care of the baby. All this is quite difficult.

With each subsequent operation, the recovery period only increases. This is why it becomes increasingly difficult for a woman to rehabilitate herself and return to her duties. On average, a healthy representative of the fairer sex is able to undergo 3-4 such operations.

What do doctors say?

Regarding how many times obstetricians, surgeons and gynecologists can do this, they report the following: the manipulation should not be performed more than two or three times. All because of the complexity of the operation and the risk for the woman.

The fact is that during a cesarean section, not only the layers of the peritoneum are cut, but also the area of the genital organ in a certain place. Doctors cannot choose a new segment for each operation. Doctors have to carefully open the already stitched hole. All this is a great risk both for the woman herself and for her subsequent children.

Some women undergo suturing after the third operation. This is a reliable method of protection and a guarantee that you will never have to go to the operating table for a caesarean section again.

What can you say about animals?

How many times can a dog have a caesarean section? Veterinarians and surgeons do not give any special restrictions. If the animal is young and has no health problems, then the procedure can be performed if necessary. Most dogs give birth on their own after surgery. There is rarely a need for a repeat cesarean section.

Summarizing

So, from all of the above, what can be concluded? How many times can a woman have a caesarean section?

If there are no specific indications, then it is better to refuse manipulation altogether and give birth naturally. However, there are cases when a woman has health problems and doctors do not allow her to have a natural birth. In this case, it is better to perform the operation no more than two or three times in a lifetime. In this case, a sufficient break between manipulations is a prerequisite. Doctors say that after the operation, pregnancy should occur no earlier than two years later. The longer the break, the stronger the suture on the uterus will be during pregnancy, and therefore, the lower the risk of complications.

Remember that no caesarean section goes without a trace. Always plan your future and keep women's health under control.

Caesarean section (CS) sometimes becomes a big stumbling block between a woman and an obstetrician-gynecologist. An ideal pregnancy can end in an emergency caesarean section. And it happens that from the very first weeks of pregnancy a woman tunes in to this method of delivery. She told us about him Lyudmila Krasilnikova, obstetrician-gynecologist, Perinatal Medical Center

– Lyudmila Nikolaevna, commenting on breech presentation, Michelle Oden says that one should not rush with a CS, since the child often turns around and takes the correct position in the very last hours before birth. If he nevertheless decides to dive like a soldier, then under no circumstances should he give birth lying on his back - only in a squatting position with support. And then, in his opinion, it is possible to minimize the risk of needing a CS.
– They give birth in any position, as long as they have the desire, good labor and a small child. When children are born with a breech presentation, complications occur in children much more often, for example, throwing back their arms. And the likelihood that the butt will pass and the head will get stuck is high. And at the moment when the child is already half born, a CS will not help. To save him, you have to use forceps.

Memo
C-section – carrying out childbirth using abdominal surgery, in which the newborn is removed through an incision in the abdominal wall of the uterus. Previously, caesarean section was performed only for medical reasons, but now increasingly the operation is performed at the request of the woman in labor.

Emergency CS

Caesarean section operations can be performed on a planned or emergency basis.
Beginning uterine rupture . This absolute indication for emergency surgery is determined directly during childbirth. Most often, a rupture occurs along a scar after a previous CS or along a scar after surgery to remove uterine fibroids. Sometimes the scar breaks after perforation of the uterus (a serious complication of abortion; this is the case when, during the operation, the walls of the uterus are damaged by instruments, they are sutured, and a scar remains). The situation of prolonged labor, discrepancy between the sizes of the pelvis and the baby’s head can also lead to uterine rupture. Ideally, these pathologies should be monitored and prevented. Monitoring occurs through vaginal examination and cardiac monitoring of the child's condition. When the uterus begins to rupture, the woman begins to experience severe pain, the child immediately begins to suffer, and here it is necessary to immediately perform a caesarean section.
Premature placental abruption can happen against the background of a woman’s complete health at any stage of pregnancy. The prognosis for premature placental abruption is always serious for both the woman and the fetus. In such cases, the speed of decision-making about caesarean section is very important.
Acute fetal hypoxia (lack of oxygen) most often occurs directly during childbirth, for example, due to the fact that the umbilical cord becomes knotted around the child and he begins to suffer.
Prolapse (dropping out) umbilical cord often happens with breech presentation. When the umbilical cord falls out, the fetus suffers at the moment of pushing, when the umbilical cord is pressed against the child's head. In Russia, if the umbilical cord falls out, a woman immediately undergoes a CS. Giving birth yourself in this situation is too risky.
Transverse position of the fetus . The child comes out either butt first or head first. It cannot exit across the uterus. Transverse position of the fetus often occurs during repeated (second, third, fourth) births, with polyhydramnios, that is, when the uterus is overstretched and the child is in an unstable position throughout pregnancy and at the time of birth. It happens that the water pours out, and the child remains in a fixed transverse position and cannot turn over, since there is no more water. The only option to save him in such a situation is a caesarean section.
Incorrect insertion of the fetus. This situation occurs already during childbirth. The child walks head down, the opening of the cervix is good, but suddenly at some point he straightens his head (normally, a child should be born with a bent head, that is, in the fetal position), as if tilting it back and thus making it difficult to exit the pelvic ring.

– Who makes the decision about an emergency CS – the mother or the doctor?
– Obstetrician-gynecologist. He evaluates the situation as a whole: how is the process going, how much is the fetus suffering, is it advisable to continue the delivery through the natural birth canal? The doctor voices his reasons to the woman, and she can agree with him or not. But the final decision is always up to the woman; a caesarean section is not performed without her consent. If the patient is conscious, she signs the consent. If she is against the COP, then she signs a waiver and takes responsibility for the health and life of the child. In my practice, when vital signs arose and the obstetrician-gynecologist said: “Without a cesarean section, your child will die in three minutes,” all the women agreed to the operation.

Selfishness, fashion or norm?

– And if a healthy woman requires a caesarean section, will the doctors accommodate her?
– Just like that, at the request of the patient, in most maternity hospitals in Moscow, including the Perinatal Center, CS is not performed. If nature has arranged it in such a way that you can give birth yourself, then there is no need to go against nature. A cesarean section is an abdominal operation that carries certain surgical risks. There is even an obstetric sign: if we perform a CS solely at the request of the woman, then the operation usually ends with some kind of complication. This is why we always explain to patients all the disadvantages of a cesarean section. And first of all, we are trying to convey the idea that children after a CS are somewhat different from those born spontaneously.
An operation is stressful for a child, much more so than passing through the birth canal. It is no coincidence that a neurologist observes children after a CS longer than those born naturally. Two hours after a normal birth, a woman can already walk, but after a caesarean she doesn’t get up for a day – she’s in pain. In addition, CS is fraught with surgical injury to the intestine and bladder. And this is not at all uncommon during surgery. Therefore, you should weigh the pros and cons before requesting a CS.

– But women will tell you a lot of advantages of CS: the vagina does not stretch, there are no stitches on the perineum from an episiotomy, sexual sensations do not change, so there are no problems with sexual life. In addition, hemorrhoids and prolapse of the pelvic organs due to pushing can be avoided. Nowadays, advanced mothers say, only the poor and stupid give birth on their own.
– This is a fundamentally wrong position of mothers, selfishness on their part. If a woman cares most about her figure, then let her hire a surrogate mother and not spoil herself with stretch marks and hemorrhoids, which, by the way, arise not only during childbirth, but also during pregnancy. In addition, the mother takes longer to recover from a CS and is not able to fully care for the child. Usually women are afraid to give birth because of the pain, but today childbirth is well pain relieved.

Absolute indications for CS
These are situations when a woman will not give birth through the natural birth canal under any circumstances.
For example:
1 Placenta previa, which blocks the exit from the cervix, and therefore any onset of labor - rupture of water, bleeding - is fraught with death for the child and mother. Only surgery can help here.
2 Anatomically narrow pelvis of III - IV degree. With this shape of the pelvis, even a small child cannot be born through it.
3 Mechanical obstacles, such as large uterine fibroids, ovarian tumors located below the level of the child’s head.

– While in Europe obstetricians and gynecologists are trying to reduce caesarean sections to a minimum, in Russia the number of these operations is constantly growing. Why is the choice always in favor of the Constitutional Court in any controversial situation?
– Childbirth is an unpredictable process. For example, some children can do without oxygen for 10 minutes, and women give birth to a healthy child with a tight, two or three-fold entanglement of the umbilical cord, while for other children, even one entanglement of the umbilical cord is enough to be born with severe asphyxia. We cannot know what the child’s reserve of vitality is: perhaps he will survive 7-8 minutes of pushing without oxygen, but what if not? Mom will never forgive herself for this experiment later. We have no right to take risks. As for Europe, they have already passed the stage of craze for CS, when operations were performed at the request of the woman in labor and many indications were not justified. Now Europeans are returning to normal developments, when each indication for CS is carefully weighed.
At the Perinatal Center, we also adhere to the tactics of natural childbirth, and in situations where there are relative indications for cesarean section, we always give the patient the opportunity to give birth herself. At the same time, we carefully monitor the condition of the mother and child in order to complete the birth with surgery at a critical moment. That is, we often balance on the line between a CS and natural childbirth.

– Or maybe the number of operations is growing because the new generation of mothers is no longer healthy and is not able to give birth?
– In the mid-80s, in my opinion, women were much healthier, they gave birth to two or three children young. Today, the percentage of women who give birth for the first time after 35 years has increased significantly. Many give birth after 40. It is clear that age does not improve their health; on the contrary, over the years, diseases only accumulate - infertility, severe somatic diseases, vision declines, and blood pressure rises. In the 60s and 70s in the USSR, caesarean sections were performed only according to indications from the woman; in a critical situation, they saved the mother, not the child. Currently, in addition to indications from the mother’s condition, the condition of the fetus is always taken into account. If we initially have a suspicion that the child will not survive childbirth, then a caesarean section is performed according to indications from the fetus. That is why the indications for CS have expanded significantly.

Operation

– What complications can arise during the operation? Is it true that uterine arteries are often damaged during caesarean sections?
– Yes, it happens that large vessels are damaged, including the uterine arteries. This is fraught with massive bleeding, which is difficult to cope with. It is necessary to carry out ligation of the uterine arteries and embolization of blood vessels. When an incision is made on the uterus, the intestines and bladder can be injured, because everything there is sometimes welded together in a conglomerate and it is difficult to distinguish the boundaries of the organs. Then vascular and abdominal surgeons are urgently involved in the operation, depending on which organ is injured. Sometimes after a CS the uterus contracts poorly, which results in massive bleeding. The woman is warned in advance about all these complications. If we compare all surgical operations, a caesarean section is one of the bloodiest. The fact is that the uterus is entangled in a branched vascular network and is abundantly supplied with blood, because it needs to nourish itself, the placenta and the child. Therefore, the surgeon’s task is to get the baby out and then stop the bleeding as quickly as possible. On average, a woman in labor loses 500-600 ml of blood during a CS, and during complex operations, blood loss can be significantly greater.

– And how are these liters replenished later?
– If we expect greater blood loss, for example, with placenta previa there is always more heavy bleeding, then we store blood, plasma, including the plasma of the woman in labor, which she donates during pregnancy. In the Perinatal Center there is a machine that takes the blood of a woman in labor, purifies it and returns it to her. It reduces blood loss to almost a minimum.

CS stages
First, anesthesia is given. In the Perinatal Center, 99% use an epidural (injection in the spine): the woman does not feel pain, but is conscious and participates in the process, she sees the born child, who is applied to her chest. Under general anesthesia, she falls asleep, then a day later she wakes up, and they bring her to see the child. General anesthesia is used in exceptional, emergency situations, for example, the mother has started massive bleeding, and we are talking about saving the life of the child. An injection in the back is not given, since it will begin to act only after 10 minutes, and this is too long. General anesthesia disables the woman in a minute or two, which allows the operation to begin almost immediately.
After anesthesia, the woman is covered with sterile material and a horizontal incision is made in the skin of the abdomen along the bikini line. It is cut vertically during an emergency CS - when there is bleeding, acute fetal hypoxia, or, for example, we know that the woman has a large fibroid and we will need a larger view to remove it. The vertical incision is always consistent with the patient. In all other situations, mainly transverse incisions are made. Then an incision is made on the aponeurosis, followed by the muscles being separated, and finally the doctors get to the uterus. The uterus is also cut transversely in its lower third.
From the moment the operation begins until the child is removed, approximately 5 to 7 minutes pass. The remaining time is spent stitching up, checking everything and stopping the bleeding. On average, a standard operation without complications lasts 30 - 40 minutes. A complex caesarean section, for example, in combination with the removal of fibroids or ovarian cysts, is carried out with the prior consent of the woman. During a caesarean section, at the request of the patient, for example, she already has six children and she does not want to give birth anymore - surgeons can ligate the tubes, that is, perform medical sterilization. At the end of the operation, the woman is sent to the intensive care unit.

– Most of all, women are afraid of infection of an open wound. According to statistics, the risk of maternal mortality after a CS is four times higher than after a vaginal birth.
– Most often, after a cesarean section, antibiotic therapy is carried out. If the operation went perfectly and quickly, then antibiotics are not prescribed. The risk of infection is high not only during childbirth, but also during abortions, as well as after miscarriages: a gaping wound is created, covered with blood vessels, and this is an open gate for any infection. Therefore, if there is a reason to prescribe antibiotics, then they are prescribed. The risk of infection is especially high in those women who were not examined or treated during pregnancy.

– Let’s say a woman was not seen by you, she just read about the center, found money and came from the region to give birth. Will you accept this?
- Of course, we will accept it.

– In one reference book I found information that the most common causes of death after a CS are pulmonary thromboembolism, amniotic fluid embolism and coagulopathy. What it is?
– Pulmonary embolism is the most common complication after any surgical operation. To avoid large blood loss during a cesarean section, the woman in labor is given medications to stop the bleeding. Accordingly, blood clots form both where it is necessary, that is, in the uterus, and where it is not necessary. To prevent the formation of blood clots, a woman gives birth wearing special anti-varicose stockings that hold the veins. Lying down for a long time (both during the operation and after it) ensures that blood clots that have already formed do not dissolve, but rise higher and can clog the vessels of the heart, lung or brain. Amniotic fluid embolism is an extremely rare and very dangerous complication: the resulting emboli (blood clots from fluid) immediately penetrate the heart and thrombose all vessels. The result is instant death.

– But where does amniotic fluid come from? Isn't the bladder punctured before a caesarean section?
- There is no need for this. The amniotic sac is opened immediately after the incision in the uterus, just before the birth of the child. Coagulopathy is a blood clotting disorder. Occurs in patients prone to thrombosis or, conversely, bleeding. Let's say a woman gave birth three times, and each time the birth was accompanied by bleeding.

– Is it true that the first three days after the operation, a woman in labor lies under an IV?
– Periodically, the woman is given a drip, which compensates for blood loss. To avoid bleeding, the patient must be given reducing agents.

– On online forums, women often complain that after a CS they cannot urinate on their own and they are given a catheter for a day.
– Epidural anesthesia has a complex effect, that is, in addition to the fact that the woman does not feel pain, she still does not fully control her muscles, including those responsible for urination and defecation. If the anesthesia was administered correctly and wears off well, then the woman gets up six hours after the operation and goes to the toilet herself. And it happens that recovery after cesarean is delayed, then a catheter is used.

– On what day are stitches removed?
– In the Perinatal Center, either metal staples are used, which are removed on the 6th – 7th day after the operation, or a cosmetic suture is applied, which is removed on the 6th – 8th day.

– Does the suture on the uterus hurt a lot?
– It’s not the stitch specifically that hurts, but all the tissues that were cut hurt. On average, intense pain lasts two to three days. To relieve them, the woman is given painkillers. After discharge, pain can last from a month to six months.

– How should the seam be cared for? Many people advise washing it only with dark laundry soap.
– This is who believes in what more. In principle, it is enough to wash the seam with ordinary soap, without additives. You can take a shower on the second day after surgery. We recommend special ointments to improve scar healing.

– Does caesarean section affect the quantity and quality of milk?
- No. After extracting a healthy baby, we always place it on the mother’s breast to stimulate milk production, and then, as expected, milk will definitely come on the 3rd – 4th day. With proper breastfeeding, it is very important to put the baby to the breast as early and often as possible, even if there is no milk in it yet. True, after the operation it is physically difficult for a woman to manage the child. She is so weak that she cannot take care of herself, let alone the baby. If a caesarean section is performed under general anesthesia, the baby is delivered to the mother at least 24 hours later. And since she puts it to her breast later, it is believed that milk comes later after the CS. In fact, if you overcome your malaise and competently engage in feeding, then milk will come at the right time and in the required quantity.

– To feed a child, you will have to pick him up, lift him, and put him on your bed. So the seams can come apart.
– We allow you to take the baby out of the cradle only in a sitting position. Usually relatives come to visit the woman and give her the child and help take care of him.

– Is it possible to feed milk during antibacterial therapy?
– There is a certain set of antibiotics that are approved by pediatricians.

– Why are children sluggish after cesarean section, have decreased muscle tone, and do not suck well?
– Often, due to general anesthesia, children are born sleeping and cannot breathe on their own for some time. Sometimes they experience asphyxia, and sometimes they even have to use artificial ventilation so that the baby wakes up, catches his breath and recovers from the effects of anesthesia. With an epidural, the baby is not exposed to pain medications and is born the same as babies born during natural birth. It’s just that for a baby, an instant exit into another space, where there is bright light, everything is different, is a shock. Imagine that they woke you up in the middle of the night, grabbed you, shined a blindingly bright light in your face, and started shaking you. You are in a complete stupor. The baby experiences the same thing after a cesarean section. By the way, children who pass through the birth canal experience a slightly different stress than those who were suddenly taken out of their mother’s belly. Natural childbirth lasts for hours, the child is in pain and hard, so for him the birth is a relief, liberation from suffering. But when he is suddenly pulled out of the ideal conditions of the uterus, he needs much more time to adapt to the new conditions. This is why such children suck poorly and have decreased muscle tone.

– In babies born naturally, excess mucus in the respiratory tract is squeezed out during the passage of the birth canal. It remains in children after a CS. And how to get rid of it?
– It’s okay, then the pediatricians pump her out with a special device.

– On what day is the woman discharged?
- On the sixth. For two months after the operation, you cannot lift weights of more than 3 kg - a discount is given for the child, but you cannot carry him in your arms for a long time. It is forbidden to actively engage in housework, such as washing floors. Any physical activity can cause bleeding. You cannot be sexually active or take hot baths.

Relative readings
Physically, vaginal birth is possible, but may involve risks to the health of the mother or baby.
Scars on the uterus. If there is a scar on the uterus from a previous cesarean section and the woman wants to give birth herself, then there is a possibility that the birth will be normal. But before choosing a method of delivery, the doctor must take into account many factors. We need to see which scar is thin or thick? Determine the baby's weight: if the baby is overweight, the uterus may rupture. Find out if the waters are clear? The practice is that women with a uterine scar rarely give birth on their own - the risk is too great. After all, if they already had a caesarean section in a previous pregnancy, then there were serious reasons for this.
Extragenital diseases in a severe stage of development are those diseases that are not related to gynecology, for example, dystrophy and retinal detachment. During attempts, the retina may rupture and the woman will go blind. This category also includes severe injuries to the pelvis and spine, in which the patient should not push. In case of severe neurological diseases, for example, epilepsy, it is dangerous for a woman to go into labor, as she may have a seizure.
Breech presentation. If the weight of the fetus is small, if labor is good, then the child can be born healthy and with a breech presentation (that is, he walks forward with his butt or legs). With repeated births with breech presentation, they give birth on their own more often than with the first birth.
Complications of pregnancy, such as severe gestosis that cannot be treated, chronic or acute fetal hypoxia.
A burdened obstetric history (infertility, miscarriage) occurs in women over 30 years of age who suffer from long-term infertility and, as a rule, have undergone IVF treatment. Since pregnancy was difficult for them, because artificial insemination is not done for everyone, but for those who have a history of gynecological pathologies, for example, chronic endometritis, repeated miscarriages, the birth of such women is often abnormal from the very beginning, so it is wiser to do a cesarean section section. But if the patient, despite her complicated medical history, fundamentally wants to give birth herself, we always meet her halfway.
Diabetes. If a woman found out about it shortly before giving birth and did not take any medications, if she has disorders of other organs (for example, disorders of the cardiovascular system), if the child is large, has polyhydramnios - all these factors may become an indication for a CS. In any case, the obstetrician-gynecologist should discuss this situation with the endocrinologist: how much natural childbirth can worsen her condition. If the patient knows about her diabetes, takes medications, and all her tests (hormones and sugars) are compensated by therapy, then in the absence of contraindications from the child, she is quite capable of giving birth naturally. So diabetes itself is not an indication for CS. But diabetes, complicated by severe toxicosis or breech presentation, is already a serious reason for a CS.
Herpes is dangerous for a child only in the acute stage, when the mother has rashes on the genitals a few days before giving birth. To prevent the child from becoming infected while passing through the birth canal, it is necessary to do a CS. And if the last exacerbation occurred several months before childbirth, then there is no need for surgery.
A post-term baby experiences the birth process more difficult. These babies tend to have very dense skull bones, making it more difficult for them to pass through the birth canal. When postmaturity occurs, chronic hypoxia often occurs, cloudy waters occur, and the fetus begins to suffer. If a woman endured it for two days, this is not an indication for a CS. If she is post-term for a week or two, this is a reason to intervene in the process, to prepare the cervix for childbirth, but also not a reason for surgery. Indication for cesarean section is postmaturity in combination with other risk factors.

– How many CS can a woman have during her life?
– If everything heals well for her, then theoretically as much as you want. In my practice, I have met patients who have had five or six operations. The optimal option is two cesarean sections. But if a woman fundamentally wants to give birth herself, then she cannot be prohibited, although a repeat caesarean section is a surgically much more complex operation than the first. The abdomen is cut again along the same suture. And on the uterus, the incision depends on the condition of the previous scar. If it is very thin and can tear, then it is cut so that it can be sutured and made more dense.

– Does the subsequent cesarean section depend on the suture – is it vertical or horizontal?
- No. If the first birth was a cesarean section, then the likelihood of a repeat operation is very high, regardless of the type of suture. For us, the most important thing is the reason for the first CS. If it can happen again this time, then we have an absolute indication for surgery.

– Is it possible to have an abdominoplasty after a cesarean section?
- Can. True, there is a type of this operation after which you cannot get pregnant at all, since this is fraught not just with stretch marks, but with sutures coming apart.

– Now it’s fashionable for husbands to be present at childbirth. I wonder if fathers are allowed to have caesarean sections?
– The husband, naturally, is not present in the operating room itself. Many men faint at the sight of blood. Usually dad waits near the operating room. When the baby is removed, he will be placed on the mother’s chest, then he will be examined by a pediatrician, and only then will the baby be swaddled and taken out to the father, who will spend the rest of the operation (while the woman is being stitched up) with the baby. After a caesarean section, it is the father who takes the baby in his arms first, not the mother, because the mother’s hands are occupied with IVs. And this first contact with the child is very important for men.

– What would be your final advice?
– The trouble with modern women is that they rush from one extreme to another. Some are keen on the idea of giving birth at home, others consider water birth a panacea, and still others advocate cesarean section. You always want a woman to give birth on her own with minimal complications, so that immediately after giving birth she can walk and say that the birth went like a fairy tale, but if there is a risk of getting a sick mother and a crippled child, then you should throw away all your beliefs and trust the doctor, because that he knows best what type of delivery you need. We must approach everything wisely.

Mila Serova

No matter how long caesarean section has existed, there are always debates about it and various myths arise. This probably happens because many women do not perceive a cesarean section as a normal birth option. In fact, this is often the only way to give birth to a child, and all speculation about the “unnaturalness” or “uselessness” of a cesarean section arises from ignorance. So what kind of operation is this, why and when is it done, and is it true that this is also a normal option for childbirth?

When it's needed

A caesarean section (CS) is done if a woman is unable to give birth to a baby naturally. And there may be enough reasons for this. Of course, each expectant mother may have her own situation and her own reasons for the operation, but generally speaking, the indications for cesarean section are absolute and relative. Absolute readings- these are situations in which a woman cannot give birth to a given child on her own under any circumstances. For example, the mother’s pelvis is too narrow for the fetus to pass through. Or the pelvis may seem to be of normal size, but the baby’s head, on the contrary, is too large. Transverse position, placenta previa, some complex illness of the mother - these are also situations in which giving birth can only be done with the help of surgery. In general, everything here is more or less clear regarding the indications - there are no other options other than cesarean section. Is there some more relative readings, when childbirth is possible, but still the risk to the health of the mother or child is quite high. For example, a common situation today: the mother is not young, could not get pregnant for a long time, did IVF (and maybe more than one), and plus twins - here, most likely, there will also be a cesarean section. Although, if one factor were excluded, the woman could give birth herself. Let’s say they give birth to their first child at the age of 40 naturally, and everything goes well. Or how many young women gave birth to twins without surgery! So it all depends on several factors. Another common case: the boy is lying in a breech position; at the beginning of labor he has not turned, which means that it is not his head that will move forward, but his pelvis, and there is a possibility of injury to the scrotum. Yes, no one can say for sure how everything will actually go (before, boys were born in a breech position without a cesarean section), but no one wants to take risks.

Does this mean that since a caesarean section must be performed, then either the mother is “something different” or the child is not very healthy? Of course not.

The reason for the operation may be pathology in both the woman and the baby, but they can be completely healthy, but a caesarean section still needs to be done.

How often

But what about the talk that caesarean sections are now being performed on everyone, where does this opinion come from? Indeed, there are indeed more surgical births (compared to several decades ago), but this is understandable. Medicine has improved, different research methods are available, and doctors have begun to recognize diseases or obstetric problems that could not be diagnosed before. And some traumatic obstetric manipulations (vacuum extraction and application of forceps), on the contrary, are no longer used almost anywhere; they have been replaced by caesarean section. And one more reason why it seems that there are more operations: nowadays people often give birth after 35 and even 40 years, when, frankly speaking, health does not improve. In addition, pregnancy and childbirth are actively discussed on the Internet: there are all sorts of websites, blogs, magazines, and social networks where the phrase “caesarean section” is heard constantly. This is what, for example, an expectant mother sees under some post of a popular Instagrammer about her cesarean section: a lot of reviews from other young women who also gave birth this way - “I had an operation because...”, “I had an emergency CS.. .”, “I wanted to give birth myself, but they did a caesarean section...”. Information spreads instantly, but in reality it is difficult to understand where, when and why these mothers had surgery. That’s why it seems that if not all, then almost half of women give birth through surgery.

In fact, as soon as obstetrics became modern, the percentage of CS increased, but then it remained constant. So this operation is not performed too often anywhere.

How is this solved?

Another misconception of many people is that a caesarean section can be “ordered”. That is, if a woman is very afraid to give birth on her own or fears for the health of the child during childbirth, then she can ask the doctor to perform a CS. After all, during the operation everything is simple: anesthesia, an incision, and there is a guaranteed healthy child nearby and no labor pains. This is even more possible if childbirth is paid. And people who are far from medicine believe that there are more caesarean sections because it is more convenient for a doctor to perform an operation than to have an independent childbirth. After all, the operation takes only about an hour, and natural childbirth takes up to a day. Well, or the doctor does not want to take responsibility for the outcome of the birth and in case of the slightest doubt he plays it safe - that’s where the operation comes from. But this is not at all true, not a single good doctor (namely a good one) will perform a caesarean section if it is not necessary. After all, the risk to the mother’s health during a CS is much greater than during natural childbirth, postpartum complications are more common, and the postpartum period itself, to be honest, is more difficult. Doctors know all this and do not perform caesarean sections without indications.

Almost as usual

More recently, in obstetrics, the rule was adopted: “One cesarean, always a cesarean,” that is, it was believed that if a woman wants to give birth to another child, she will have to have surgery again. Doctors were afraid that during contractions or pushing there was a risk that the scar would rip apart. But it turned out that the mere presence of a scar on the uterus is not a 100% indication for surgery. It is clear that if the reason for the previous cesarean section was an anatomically narrow pelvis, then the operation cannot be avoided in the next pregnancy - the size of the pelvis will not change. But if there were other indications (for example, breech presentation), and during this pregnancy the baby lies as it should, mother and child feel well, the scar is healthy, then it is quite possible to give birth on your own. So now natural childbirth after cesarean section, if not a common occurrence, is already quite common.

There is one more point: doctors used to say that it was not worth doing more than three caesarean sections, again they were afraid for the scar - whether it would disintegrate during pregnancy. Today, these restrictions have been lifted, and if the scar is good, then at least five children can be born using a caesarean section. So you don’t have to be afraid that there will be one or two children in the family: mothers with many children having a cesarean section are not at all uncommon.

Baby and caesarean

Children after cesarean section are a separate topic of prejudice. Having once heard from doctors that Caesarean babies adapt less well to life after childbirth, zealous lovers of a healthy lifestyle and everything natural immediately classify childbirth using a CS as unnatural and unnecessary. And some doctors, when they cannot explain to the mother the cause of some problem in the baby, tell her the banal: “Well, what do you want, the baby is after a cesarean!” In fact, these are all misconceptions. Of course, CS affects the newborn. During natural childbirth, the child slowly moves along the birth canal; he gradually moves from intrauterine to extrauterine life, which means he also gradually adapts to the new environment. Caesar babies don’t have time for this, so at first, during primary adaptation, it’s a little harder for them. However, this does not last very long; after just a few weeks, caesareans fully adapt and are no different from their peers born naturally. Where does the impression come from that Caesar's children are born weaker? Caesarean section is performed not only planned, but also urgently, for example, suddenly placental abruption or premature birth began, severe toxicosis developed or hypoxia occurred. All these situations also affect the child, especially if the operation must be performed earlier than the planned due date. So the condition and adaptation of the cesarean baby depends much more on the reasons for which the operation was performed, and not on the method of birth.

Mom and caesarean

What else do they come up with about a caesarean section - that milk won’t come after the operation and you won’t be able to breastfeed the baby. It's not like that at all. Naturally, after a caesarean section, the baby can be breastfed. If epidural anesthesia was given during the operation, then the baby can be put to the chest while still in the delivery room; If there was general anesthesia, then feeding can begin within a few hours. And even if after the operation the mother is prescribed antibiotics, in most cases these will be drugs that are compatible with breastfeeding. The first days after the operation, the mother will feed the baby with colostrum, and the milk itself will come on the 3-7th day, that is, a little later than after a natural birth.

Well, the most trumping argument that a caesarean section is not a real birth is what “loving” mothers-in-law and “dear” girlfriends like to give. Of course, they themselves suffered, suffered (and not just, but for several hours), experienced some incredible sensations, but the mother who gave birth using a CS does not have these experiences. There is only one reason for this behavior - self-affirmation and rejection of the fact that for other women everything may be different. In general, when it comes to babies, women like to gather in groups: those who gave birth themselves believe that they have some kind of advantage over those who have had a CS; Those who breastfeed (and if this continues even after one or two years) feel like more real mothers compared to those who fed little or did not feed at all. There can still be a lot of groups - separation is possible in everything: potty, pacifier, joint or separate sleep, early development, hand training - for some mothers this lasts until the child finishes school.

Well, as for caesarean section and natural childbirth, one thing needs to be understood here: the operation gives a woman the opportunity to become a mother, and it doesn’t matter how this happened. The main thing is that now she has a child.

Memo for expectant mothers

1. Not a single good doctor (just a good one) will perform a caesarean section if it is not necessary. After all, the risk to a mother’s health during a CS is much greater than during a natural birth.

2. If the scar is good, then using a caesarean section you can give birth to at least five children. So you don’t have to be afraid that there will be one or two children in the family; mothers with many children having a cesarean section are not at all uncommon.

3. After just a few weeks, caesarean babies fully adapt and are no different from their peers born naturally. The condition and adaptation of the caesarean baby depend much more on the reasons for which the operation was performed, and not on the method of delivery.

4. If epidural anesthesia was given during the operation, then the baby can be applied to the chest while still in the delivery room; If there was general anesthesia, then feeding can begin within a few hours.

So if you have a caesarean section, you need to accept this situation and take it calmly. A caesarean section will not prevent the baby from growing up healthy and happy, and the parents will love him no matter how he was born.