Cesarean section - pros and cons. What to do after a caesarean section. Caesarean section: pros and cons. Natural birth or caesarean? Cons of a caesarean section for a child and mother

Hello everyone, dear readers and guests of the site. I think today's topic will cause a lot of controversy and discussion. My 20-something friend, having become pregnant, firmly decided: she is not ready to give birth herself. “It’s a hell of a pain, and sex life after natural childbirth gets worse,“ there ”because it will be wider,” she explained to me.

As a result, she agreed "on the shore" about a planned caesarean and "gave birth" to a healthy boy. Now he is one and a half years old, and he suffers from severe headaches, does not sleep at night, and his parents along with him. This is how the whim of the expectant mother turned against her.

Like any operation, a caesarean section, the pros and cons for the child of which we will consider today, should be performed strictly for medical reasons. Alas, lately, this is not a necessary measure, but a whim. We must know what it can threaten the baby with before deciding on such a birth.

Caesarean section: debunking the myths

The myth about the safety of caesarean and, moreover, its painlessness has no basis! This is a full-fledged, very dangerous operation, in which the doctor first carefully dissects the peritoneum, then the uterus and takes out the newborn from it. Then the uterus is carefully cleaned, the child's place is removed and the tissues are sutured. Antiseptic treatment at the final stage is required.

Reviews of mothers who survived cesarean say that the pain after the operation is terrible. The seam aches, the stomach seems to be bursting from the inside. But at the same time, you also need to carry a crumb on your hands! So you cost "little blood".

And it’s okay if natural childbirth was impossible for medical reasons. And when mothers themselves choose this supposedly easy path?

When surgery is inevitable

The decision on caesarean section should be made only by a doctor, based on the condition of the future mother and indications, absolute or relative.

The absolute ones are:

Detachment of the placenta;

Complications of preeclampsia;

Presumably large fetus (more than 4.5 kg);

Anatomically narrow pelvis or its deformation;

Operations on the uterus in the past, scars;

Fetal weight over 3.5 kg in breech presentation;

The transverse position of the baby;

Breech presentation of one of the fetuses with twins;

· Multiple pregnancy;

Uterine fibroids and other neoplasms.

If you have at least one of these indications, then you are almost 100% likely to have a caesarean section.

Relative rates are some of the signs that can cause complications and a negative outcome in natural childbirth. Your doctor will recommend a caesarean section if you have:

Significantly delayed pregnancy;

Infections in the genital tract;

Age over 35 years (especially at first birth);

Pathology of blood vessels and heart, diabetes, genital herpes;

· Varicose veins of the walls of the vagina and uterus;

· Miscarriages, stillbirths in the past.

The doctor decides on a planned cesarean if there is 1 absolute and at least 2 relative indicators. Doctors are obliged to evaluate all possible outcomes and risks of the operation so that everything goes with minimal losses.

Scheduled or emergency

In addition to the planned one, there is also the concept of an emergency caesarean, when complications arise in the process of natural delivery that threaten the life and health of the baby and mother.

By the way, the very name of the operation - Caesarean section, came to us from Ancient Rome. The mother of Julius Caesar (Caesar) was exhausted, giving birth to the future commander and emperor. The contractions exhausted her, and the healers decided to open the womb and take out the baby.

The gynecologist agrees on a planned operation with the woman in labor in advance, as soon as he finds indications for her. The date is set approximately 1-2 weeks before the due date (estimated date of delivery). At this time, the fetus is already fully full-term and ready to be born, and the birth canal is still closed.

Caesarean section, pros and cons for a child

Like any surgical operation, a caesarean section is performed under anesthesia. About 20 years ago, women were “sedated” completely, and they could see the baby only when they moved away from general anesthesia. Now epidural (spinal) anesthesia has appeared, which “turns off” the sensitivity of the mother’s body below the waist. That is, she is conscious of the whole process of childbirth and sees her baby immediately.

Caesarean section has its advantages for both mother and baby.

In women, the genitals remain intact, they are not threatened with any incisions and ruptures that occur during the natural process. Although the seam after the incision of the abdominal cavity causes no less trouble. Yes, and, according to psychologists, natural childbirth is necessary for a woman in order to fully realize her new role. As many moms say, "everyone has to go through this."

Another disadvantage for a woman in labor is problems with breastfeeding. In order for it to be complete, the pregnancy must end naturally, so the “caesarites” often become artificial, and are forced to eat milk formula from birth.

In addition, a mother is usually prescribed a course of antibiotics after childbirth to prevent inflammation in the area of the suture. You have to pump so as not to poison the child with medicines, and many mothers can not stand it. And in the end, the innocent child suffers.

About cuts and dislocations in babies

So we come to the pros and cons of the operation for the crumbs.

First about the good.

· Hypoxia, which occurs in the process of protracted contractions and attempts, does not threaten "Caesarites". Doctors remove the baby quite quickly and accurately. Some mothers tell "horror stories" about the baby's rugged body, but this is far from the truth. The whole process is carefully controlled and the baby, as a rule, does not suffer.

· Do not be afraid of other injuries (dislocations and other injuries), which are so common in natural childbirth and sometimes lead to irreparable consequences.

About cons:

· From the point of view of neurology, "forced" childbirth does not bring anything good with it. Doctors believe that the baby must pass through the birth canal in order to develop normally. Some children are developmentally delayed after a caesarean.

· Artificial feeding, which we talked about above, is also a definite disadvantage. The child is deprived of nutritious breast milk, and with it the mother's antibodies, which means the lion's share of immunity. Hence again the lag in development, and the physical as well.

· During normal childbirth according to the "contractions-attempts-delivery" scheme, the bones of the skull are slightly displaced in the crumbs. This process is correct and even necessary. A caesarean section does not allow the baby's head to come into contact with the mother's pelvic bones, as a result of which the baby may experience increased intracranial pressure and headache at an early age.

Both mom and her daughter or son will have a long recovery period, psychological and physiological, after the operation. Postpartum depression, problems with breastfeeding, scarring of the suture will require significant strength from the woman. Therefore, I ask you again, do not choose a caesarean section only because of your unwillingness and fear to give birth on your own. Childbirth, one might say, is our direct duty, and we must fulfill it steadfastly.

If the doctor prescribed the operation for you, then get ready for difficulties, including during subsequent pregnancies (if any are planned). How long can you get pregnant after a cesarean, many mothers are interested. Answer: no need to hurry!

The seam is scarred not earlier than 3 months after childbirth. Until this time, you can not carry a lot of crumbs in your arms, expose yourself to physical exertion, have sex. What can we say about bearing a child!

Gynecologists recommend planning the next conception no earlier than a year later. The optimal interval is from one to three years, but no later than after 10 years. Then the scar tissues will lose their elasticity, and there will be no opportunity to bear the baby. In any case, the doctor will carefully monitor the condition of the suture throughout the pregnancy, especially its last months.

In many cases, even after a caesarean section, natural childbirth is possible if the condition of the expectant mother allows, and there are no contraindications.

And I hasten to say goodbye to you, see you soon, do not get sick and do not be bored!

The share of abdominal delivery has grown, and today one in five pregnancies ends with a caesarean section, rather than a natural birth. The operation has its definite pluses and minuses. We will talk about the advantages and disadvantages of surgical childbirth, how likely it is to develop complications after them, in this article.

To whom is the operation indicated?

A caesarean section is an alternative delivery method in which the baby is born not in the traditional way, but through incisions in the anterior abdominal wall and uterus. The operation, despite its apparent simplicity and wide distribution, belongs to the category of complex surgical abdominal interventions. That is why in Russia it is not carried out at will, in any case, in state maternity hospitals, perinatal centers and clinics. Only a few private clinics provide for the possibility of an elective caesarean (surgery at the woman's own request). In these clinics, such a service costs about half a million rubles.

The list of situations in which it is safer and more reasonable to give birth surgically is specified and approved by the Ministry of Health of Russia (Letter of the Ministry of Health of 2014 No. 15-4/10/2-3190). So, a caesarean section is scheduled in a planned manner in the following situations.

low location of the placenta with complete overlap of the internal os or incomplete overlap, as well as presentation with signs of detachment and bleeding;
premature detachment of the "children's place" from the uterine wall, while the location of the placenta does not play a role;
two births carried out by caesarean section in the past, as well as any operations on the uterus, if scars remain after them;
the weight of the fetus is more than 3.6 kg with an incorrect position of the child in the uterine cavity (sitting, located across);
incorrect location of one baby from twins;
multiple (often singleton) pregnancy after IVF;
post-term pregnancy (at 41-42 weeks of gestation), if other methods of inducing labor have not had an effect;
any mechanical obstacles to the passage of the child through the birth canal - tumors, large groups of polyps, scars after cervical ruptures;
the state of a severe form of preeclampsia (with edema, large weight gain, signs of increased blood pressure);
a ban on attempts (for myopia, some diseases of the cardiovascular system, a transplanted donor kidney, etc.);
the state of acute oxygen starvation of the fetus (of any origin);
prolapse of the umbilical cord;
genital herpes of the primary type;
HIV infection in the mother, if during pregnancy the woman for some reason did not receive supportive treatment;
narrow pelvis, in which independent childbirth will be difficult;
blood clotting disorders of the mother, fetus;
malformations of the baby - omphalocele, gastroschisis, etc.

As for emergency surgery, there are other indications for it. An unplanned operation will be urgently performed on a woman in labor, whose contractions suddenly weakened during childbirth, the cervix does not open, secondary weakness of attempts is observed, the placenta exfoliates, bleeding has opened. It will be an operation to save the lives of the mother and her long-awaited baby.

Technique

The operation is performed under anesthesia. The patient has every right to choose general anesthesia, in which she will sleep soundly during all surgical procedures. But most surgical births in Russia today are performed under epidural or spinal anesthesia, in which anesthetic drugs are injected into the epidural or subarachnoid space of the spine using a lumbar puncture. With an emergency caesarean section, when every minute counts, general anesthesia is usually given, since there are practically no contraindications to it, and the state of unconsciousness comes faster.

After the woman is given anesthesia or general anesthesia, the surgical team proceeds with the operation. With a planned intervention, they try to make a horizontal incision in the abdomen just above the pubis in the lower uterine segment. During an emergency operation, if the child is in danger of death, a vertical incision can be made in the center of the abdomen through the navel.

After opening the abdominal cavity, the doctor frees up space for himself for further "maneuvers" - he takes the muscle tissue and the bladder aside. After that, an incision is made on the uterus, the fetal sac is pierced and the amniotic fluid is drained. Then the surgeon gently head forward removes the baby through the incision made.

The umbilical cord is cut and the baby is transferred to neonatologists. The woman is gradually restored, first, the uterus, applying internal sutures, then the abdominal cavity, returning the muscles and the bladder to their anatomical initial state and applying sutures or staples to the skin from the outside.

A woman, if she is not under general anesthesia, will be able to see her child immediately. If she is fast asleep, then the meeting will be postponed and will take place only a few hours after the birth.

The newly-made mother stays in the intensive care unit for several hours after the operation, after which she is transferred to the postpartum ward in a regular ward, where already 8-10 hours after the intervention she can begin to sit down, get up, walk.

Advantages

The undoubted advantage of caesarean section can be considered a relatively predictable outcome of the intervention. The likelihood of birth injuries for both the child and his mother is minimal. The child does not need to pass through the narrow birth canal, and therefore he also has practically no chance of getting a neck or head injury during surgical delivery. Whereas with a narrow pelvis or a large baby in a breech presentation, injuries to the newborn and his mother during natural childbirth would be much more likely.

Caesarean section makes it possible to become mothers to women who are contraindicated in natural childbirth. And today, the quality of materials for suturing tissues and surgical techniques make it possible to quickly give birth to not one or even two children, but as many as a woman wants.

With a caesarean section, a woman does not feel labor pain, which scares pregnant women the most and memories of which are never erased from memory. Parturient women have some fear of what is happening when using epidural anesthesia, but it is more psychological.

If general anesthesia is used, then the woman simply falls asleep and wakes up already in the status of a mother.

The use of spinal or epidural anesthesia allows you to correct a drawback that has been unremovable for many years - a woman gets the right to see the baby immediately after it is removed from the womb, and it also becomes possible to attach the baby to the breast, which is very important for the early development of lactation and full subsequent breastfeeding.

A caesarean section, if done in a planned manner, does not leave gross disfiguring scars on the patient's abdomen. Doctors do their best to ensure that the suture is neat, unobtrusive, cosmetic, located in an area that is usually well covered by shorts or swimming trunks. Each subsequent operation, if the woman decided not to be limited to one child, is carried out on the previous scar, no new scars appear on the abdomen and uterus.

A caesarean section makes it possible to carry out additional surgical procedures. If there is a need to provide lifelong contraception, then tubal ligation is performed at the same time, tumors in the uterine cavity can be removed.

Duration of surgical childbirth usually does not exceed 45 minutes, while natural childbirth can last up to a day or even more.

Flaws

Caesarean section is not a natural delivery, it is always a gross intervention in the work of the female body. If the operation is carried out in a planned manner, then often the mother’s body is not actually ready for childbirth (the contractions have not begun), therefore, removing the child in the abdominal way is a huge stress for both the mother’s body and the baby’s body.

The drugs that anesthetists use to anesthetize surgical procedures affect not only the woman, but also the baby, even when it comes to spinal anesthesia. A baby born with the help of a surgeon cannot have an Apgar score of 9 in principle, since he is always more inhibited, lethargic - he is affected by anesthetics and muscle relaxants that were introduced to the mother for anesthesia. However, after a few hours this action passes.

The baby is deprived of the opportunity to go the path prepared for him by nature - he does not overcome the resistance of the genital tract in order to be born, and this, according to some experts, is bad and will certainly affect the formation of his character in the future. Thus, it is argued that such children are less initiative, afraid of difficulties, have less stress resistance.

Many issues have not yet been fully studied, but the fact that a baby without passing through the genital tract is deprived of the opportunity to gently adapt to the new conditions in which he will live is undeniable.

The statements of some opponents of caesarean section that children then grow up with a developmental delay, need correction programs, get sick more often, do not correspond to reality, therefore, they cannot be considered as a disadvantage.

A caesarean section is dangerous due to its complications, and their probability, compared with physiological independent childbirth, increases several tens of times. The period of recovery and rehabilitation lasts much longer than after childbirth, breast milk comes a few days later. Tubal ligation, if performed, lengthens both the time of the operation and the recovery time of the woman's body.

After a caesarean section, a woman for more than 2 years is not recommended to become pregnant again, while after a physiological birth there is no such prohibition. It is harmful to lift weights, and in the absence of au pairs, ordinary household chores and caring for a newborn become a very difficult task.

The harm from the operation, of course, does not exceed the benefits, but still you can never be sure that complications and negative consequences will bypass you.

The likelihood of complications

Complications are possible at any stage of the operation, as well as after it. During surgical procedures, bleeding from the vessels of the anterior abdominal wall may occur; if the vascular bundle is injured, mechanical injury to the bladder, ureters, and intestines may also occur. If complications arose during the operation itself, the woman will not be placed in the intensive care unit, but in the intensive care unit, where her condition will be monitored for several days, if necessary, a blood transfusion will be given, and the necessary drugs will be administered. The frequency of such complications does not exceed 0.01%.

Dangerous consequences can also have postoperative bleeding, as well as a violation of the contractility of the uterus (hypotension or atony of the reproductive organ). In this case, medical assistance will be required and removal of the uterus is possible, if its muscles do not respond to the introduction of reducing drugs, the uterus does not decrease.

Severe vital complication of caesarean section - infectious inflammation. It can lead to the death of a new mother. Symptoms of inflammatory infectious complications are high fever, abdominal pain, discharge of an atypical nature, suppuration of the wound, an increase in leukocytes in the blood test. More often than others, inflammation of the endometrium of the uterus (endometriosis) develops after surgery, but other situations are not excluded. The most dangerous of the possible is considered peritonitis. In practice, given the sterility of modern operating rooms and the sophistication of the actions of the surgical team, such complications are not so common - only in 0.7-1% of cases.

The danger for the child lies in the short-term exposure to anesthetics, which can lead to respiratory failure (0.003% of cases). Much more often, respiratory failure develops in newborns if the intervention was performed at 36 weeks of pregnancy and earlier, but it is no longer associated with the operation itself, but with gestational immaturity of the fetal lung tissue.

Much depends on a properly organized postoperative period.

Problem Prevention

To prevent inflammatory processes, if their likelihood is suspected, doctors prescribe antibiotics to a woman in the early postoperative period. Since most complications occur in women with obesity, systemic comorbidities, low social status and bad habits, as well as with impaired blood clotting, it is these women who are in the zone of special attention of medical personnel.

To exclude hypotension or atony of the uterus, early attachment of the child to the breast is recommended, as well as the introduction of reducing and analgesic drugs. If a woman has had 3 or 4 such operations, more careful monitoring of the area of the scar on the uterus during the year is recommended, since it is thinner than in those who have had one or two operations.

A woman should not lift weights, you also need to protect yourself. Sexual life can begin to live only when the discharge from the genital organs stops, not earlier than 2 months after the birth of the baby. It is strongly not recommended to become pregnant within 2 years, the scar on the uterus during this period is in the stage of intensive formation.

During pregnancy 4 months or a year after cesarean, the weak and thin connective tissue in the incision area may not withstand the intensive growth of the uterus, which can lead to rupture of the muscular organ even during gestation.

According to the reviews of women left on thematic forums on the Internet, there were no complications after a caesarean section. Due to the fact that they are not so common, there are almost no reviews describing the negative consequences. Most women note that the recovery went well, the scar on the abdomen healed about 3 weeks after the operation.

Every year, cesarean section is gaining more and more popularity. In Brazil, for example, giving birth by caesarean section is considered good manners. In private clinics, 80% of women are cesareans. But no one has yet invented a panacea. Cesarean section has its advantages and disadvantages.

First of all, it is an operation, and an operation is always a risk. Despite the fact that the caesarean technique and anesthesia are becoming more perfect and safer.

If a caesarean section is performed according to indications, then in many cases it saves the health and life of the expectant mother and child. Indications are planned, i.e. they occur during pregnancy.

The woman and doctors have time to prepare for the operation. And emergency, when the operation must be done immediately in order to save the health of the mother and the life of the child.

Thanks to the widespread use of cesarean section, childbirth today has become safer.

Obstetric forceps and a vacuum extractor are practically no longer used (medical instruments that were applied to the head of the fetus if there were difficulties with the birth of a child).

This often resulted in trauma to the child and severe lacerations in the mother's birth canal. Gone are the births lasting more than a day.

Today, thanks to caesarean section, only those women who have a high chance of giving birth on their own and without serious complications give birth themselves.

Let's look at cases where Caesarean section has undoubted advantages:

Obstacles blocking the birth canal. For example, placenta, tumors of the vagina, bladder, pelvic bones, uterine fibroids.
After cervical surgery childbirth can lead to its rupture, here, too, it is worth choosing a caesarean section.
Incorrect position of the fetus. If the child lies in the uterus with his head and the head is bent, then it is better to conduct such childbirth through the natural birth canal. But there are times when the fetus is laid down with the buttocks or head, but the head is unbent. Such births are possible, but have the risk of ending in trauma to the child. Therefore, caesarean section should be preferred here. Childbirth with a transverse position of the fetus in the uterus is not possible, only caesarean.
When the size of the pelvis of a woman is much smaller than the head of the fetus. It is better to perform a caesarean section so as not to injure the child and mother.
Some maternal illnesses do not allow her to give birth on her own, tk. this will lead to a deterioration in the health of the woman. For example, high myopia, diseases of the nervous system, heart, bones - symphysitis - divergence of the pelvic bones during pregnancy under the influence of hormones. After giving birth with symphysitis, a woman may be bedridden for several months. and etc.
Multiple pregnancy. Identical twins are operated on before labor starts. They have one placenta for two and one vessels through which the twins receive oxygen and nutrition. With the onset of contractions, the vessels spasm and one child receives food in excess, stealing from the second. Both are extremely dangerous for the lives of children. If you are expecting twins, then they look at the situation and evaluate all the risks.
Pregnancy after IVF or if the woman has suffered from infertility for a long time. Such women took hormones during pregnancy, because. the body could not independently ensure the development of pregnancy. There is a high chance that the birth will go badly. And who will agree to risk the health of such a long-awaited baby.
Repeat caesarean after caesarean section. There is a risk of rupture of the uterus along the scar with heavy bleeding. But natural childbirth is possible and can be done easily under medical supervision, especially if the previous caesarean was performed during childbirth.

A caesarean section is indispensable if a quick removal of the baby is required, because. delay will lead to his death. First of all, this is bleeding during placental abruption, uterine rupture. Prolapse of the umbilical cord.

When the waters break prematurely, the loops of the umbilical cord, through which the baby receives food, descend into the vagina and are sandwiched between the bones of the pelvis and the presenting part of the child. If the opening of the uterus is not complete, then only a caesarean section can save the life of the child.

Fetal hypoxia - when a child, for various reasons, does not have enough oxygen. Thanks to the caesarean section and the constant monitoring of the condition of the fetus by doctors, it became possible to save the child at the first sign of his suffering in his mother's tummy.

What are the advantages of the operation can hardly be called pluses?

Pain. Many consider the absence of labor pains a plus of a caesarean. This is a deep delusion. To relieve pain during the operation, anesthesia is performed: general anesthesia or spinal anesthesia. But these methods are not very harmless and have consequences for the woman and the child. After childbirth, a cut stomach hurts more than labor pains. In the maternity hospital, anesthesia will be prescribed, but at home you will have to cope on your own and at the same time take care of the child. In addition, getting rid of contractions, you can get chronic pelvic pain due to the formation of adhesions or endometriosis in the pelvis. Pain during childbirth largely depends on the emotional state and psychological mood. If positive emotions prevail, then it will hurt less. And if you are so afraid, then in childbirth you can do spinal anesthesia. As you can see, pain is not a reason to do a cesarean.
Do a caesarean section faster than giving birth on your own.
Caesarean section lasts on average 40 minutes, and the first birth 10-14 hours, the second 7-9 hours. Still others are even faster. But after giving birth, after 6 hours, you will restore strength and be able to take care of the baby on your own. After a cesarean, you will have to lie down for at least 12 hours, or even a day, and it will be difficult to get up. It turns out that the quieter you go, the further you will be. By the way, during childbirth, at first the contractions are rare, short and not intense, but towards the end they become painful. Therefore, no one says that all 14 hours you will be exhausted from pain.
Haemorrhoids. Many mothers think that having a caesarean section will get rid of hemorrhoids. I want to upset you. Attempts are only one of the causes of the disease. Hemorrhoids often occur during pregnancy, in the third trimester. This is facilitated by an enlarged uterus, which puts pressure on the rectum, hormonal levels, constipation, and malnutrition. After cesarean, another factor is added - physical inactivity - insufficient physical activity. Therefore, in the postpartum period, many suffer from hemorrhoids, regardless of how they gave birth.
Ruptures of the cervix, vagina, perineum. Yes, indeed, a cesarean will save you from tearing the birth canal, but you will get a scar on the uterus and on the anterior abdominal wall. Today, a caesarean section is done over a pubic incision in the bikini area, but if the operation is emergency, if you are overweight or have a skin disease in the area of the planned incision, then they can cut the stomach from the navel to the pubis. Many women give birth without breaks. More often they happen if there is a disproportion between the size of the woman's pelvis and the head of the fetus, weak contractions, infection in the vagina, swelling. In the first two cases, doctors may offer you a caesarean section. To prevent infection a week before childbirth, sanitize the vagina with suppositories. By the way, if in previous births you had serious problems, damage to the rectum, then it will be an indication for surgery.
Urinary incontinence, prolapse of the pelvic organs. The tone of the perineum after childbirth is reduced, but it will recover in a few months. To speed up the process, do Kegel exercises - squeezing and unclenching the muscles of the perineum. After the age of 50, urinary incontinence and pelvic organ prolapse are equally common in both those who gave birth by caesarean section and those who gave birth on their own. The reason here is hereditary predisposition - connective tissue dysplasia. If you can reach the inner surface of the forearm with your thumb, then the above problems with age are likely.

Cons of a caesarean section

After caesarean 5 times often endometritis occurs. The uterus contracts with difficulty because of the scar. Blood, clots accumulate in its cavity, which contributes to the reproduction of microorganisms there.
Almost always after caesarean prescribe antibiotics, and after childbirth only in rare cases. Prescribe only drugs that are compatible with breastfeeding, but does your child need to come into contact with antibiotics from infancy.
Recovery after cesarean is slower. We'll have to work hard to remove the stomach.
During a caesarean blood loss is 2-3 times higher than that in childbirth. And if there are complications during the operation, you may need a blood transfusion.

Thanks to caesarean section, babies are born without injuries and damage. It is possible to save those children who could not survive if the birth was carried out through the natural birth canal.

Each of us at least once heard about a caesarean section - an abdominal operation, with the help of which a child is brought into the world through an incision in the abdominal wall and uterus.

Even if a woman is a supporter of natural childbirth, the doctor can still decide (planned or emergency) to perform a caesarean section, if there are indications for this.

How is the operation carried out? How is recovery going after it? Is natural childbirth possible after a caesarean section? It is important for every woman planning to give birth to know the answers to these questions.

Indications for the operation

Indications for caesarean section can be absolute (when natural childbirth is not physically possible) and relative (when the mother has diseases that are not directly related to pregnancy, but threaten her health).

The most common indications for surgery are the following pathologies:

Unsuccessful presentation of the fetus. The position of the baby in the uterus makes it difficult for him to exit through natural routes. Presentation can be (full or foot), facial, frontal and occipital. Even if the baby is positioned correctly in the womb, but at the same time its head is turned so that it does not fall into the pelvic inlet, this will most likely be an indication for a caesarean section. The gymnastics prescribed by the doctor during pregnancy helps to return the child to the correct position, but, unfortunately, not always.
Craniopelvic disproportion. The large head of the child does not fit into the woman's too narrow pelvis. Quite often, cranio-pelvic disproportion is diagnosed already during childbirth, but during pregnancy this pathology can be detected using ultrasound. In this case, a caesarean section will be a planned operation.
Prolapse of the umbilical cord. The umbilical cord protrudes into the cervix before the baby moves. If the baby's body compresses the umbilical cord when it exits, oxygen access will be severely limited, which will lead to the death of the baby. And then the caesarean section is performed urgently.
Placenta previa or abruption. If the placenta is attached not to the back wall of the uterus, as usual, but above the cervix, blocking the exit for the fetus, this is placenta previa. In the second case, the placenta exfoliates before childbirth, and not after. Both situations threaten severe bleeding for the mother and oxygen deficiency for the fetus.
Prolonged childbirth. Doctors may decide to have a caesarean section if the contractions are weak, there is no progress in dilating the cervix, and the fetus is not descending.
Fetal disease. The most common cause of fetal disease is hypoxia, that is, lack of oxygen. Listening to the child's pulse, the doctor determines by the frequency of strokes how well the baby's body is supplied with oxygen. If the umbilical cord is compressed or there is insufficient blood flow to the placenta, this can cause a lack of oxygen. Acute fetal hypoxia during childbirth is always an indication for caesarean section.
Mother's illnesses. If a woman in labor has chronic diseases of the genital tract (which can be transmitted to the child during normal childbirth), diabetes, myopia, kidney, heart or lung disease, delivery is possible only with a caesarean section.
Multiple pregnancy. Carrying twins or triplets can lead to various complications (prolapse of the umbilical cord, prematurity, hypoxia), because. it is much more difficult for several babies in the womb to coexist. With multiple pregnancies, caesarean sections are done quite often so that the birth of one child does not turn into death for another.

How is the operation going?

In most cases, the operation goes according to this scenario.

In the operating room there is an obstetrician-gynecologist who is assisted by one or two assistants, an anesthetist, an operating nurse, an anesthetist nurse and a neonatologist (who conducts the initial examination of the newborn).

After carrying out hygiene procedures and anesthesia, the woman in labor is connected to a dropper and an apparatus for measuring blood pressure, and a catheter is inserted into the bladder. The operating field itself is closed from the woman in labor with a special screen.

At the beginning of the operation, the doctor makes incisions in the abdominal wall and uterus (vertical or horizontal). To control bleeding, the doctor pinches the ends of the cut blood vessels. With the help of a special pump, amniotic fluid is sucked out.

Then the doctor inserts his hand into the uterine cavity and removes the head first, and then the whole child. After cutting the umbilical cord, the baby is picked up by a nurse and a neonatologist who clean his nose and mouth, assess his condition on the Apgar scale. Usually the baby is born 10-15 minutes after the start of the operation.

After the baby is removed, the doctor removes the placenta, checks the uterus, and begins recovery. The incisions are sutured with dissolvable surgical thread, the skin can be additionally fastened with clamps. Then the wound is treated and a bandage is applied. All this action takes 30-40 minutes. At the end, the woman in labor will be taken to the postoperative department, where she will gradually recover from anesthesia under the supervision of doctors.

Anesthesia is carried out within 2-3 days. The woman in labor will be prescribed drugs that cause uterine contractions (because she does not know that the birth has already ended), and antibiotics may be prescribed at the discretion of the doctor.

The first few hours after the operation, the woman in labor lies. On the first day, you can drink mineral water without gas and water with lemon juice. Vitamins and microelements will be introduced into the body through a dropper. On the second day, you can already eat cereals, light chicken broth, boiled meat.

8-10 days after the birth, the doctor will remove the stitches, do an ultrasound, and send the mother and baby home! 🙂 Unless, of course, there are complications.

Like any other operation, caesarean section has its pros and cons.

The main and indisputable plus is the very birth of a child, especially if natural childbirth threatened the life of the mother or baby. If there are absolute indications for the operation, there is no longer any talk about the pros and cons - it just needs to be done, period.

The second plus of a caesarean section is that after childbirth, the vagina and perineum remain in the same form: there are no tears or sutures. This allows you to avoid problems with sexual life in the future. In addition, the operation does not lead to prolapse of the pelvic organs (bladder), rupture of the cervix and exacerbation of hemorrhoids. In a word, your genitourinary system remains normal.

But the state of the body as a whole is a complete minus.

Of course, the operation is performed with the help of anesthesia (epidural anesthesia or general anesthesia). However, after the end of the operation, the pain returns and lasts much longer than after natural childbirth. Women who have given birth naturally and by caesarean report that the pain during childbirth and perineal ruptures is much weaker than the pain in the surgical wound.

Childbirth with caesarean section is faster than natural - this seems to be a plus. But the recovery of the body after surgery is much more difficult and is associated with constant restrictions.

First, you move away from anesthesia, then you wait for the wound on your stomach to heal, endure pain, recover from blood loss (which, by the way, is more than during natural childbirth). At the same time, communication with a newborn is practically prohibited, because you cannot get up and take the baby in your arms. In the first month, coping with a baby will be really difficult.

The psychological state of a young mother after a cesarean section also leaves much to be desired. Many women experience a feeling of incompleteness and illogicality of what is happening, do not feel connected with the child, feel "deceived" in their expectations. Even natural childbirth is a strong stress for the psyche, leading to postpartum depression. What can we say about a caesarean section, when it is necessary not only to take care of the child with the last effort, but also to heal the surgical wound.

The same goes for sex. Doctors recommend returning to sexual activity no earlier than 1-1.5 months after the operation, until the stitches are tightened. Even if your general health is normal, discomfort from tight stitches or abdominal pain will prevent you from having an active sex life.

And yet we must not forget that recovery after any operation is a purely individual process. Someone can’t get out of bed for two months, and someone gets behind the wheel in two weeks.

At first glance, a caesarean section is a quick, convenient and painless operation. However, upon closer examination, it becomes clear that a caesarean section significantly increases the risk of problems with anesthesia, infection, bleeding, and the health of the newborn.

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During the bearing of the baby, the expectant mother has many questions, as well as controversial situations. So, many of the fair sex, who are in an interesting position, argue about the pros and cons of a caesarean section. Reviews of 2014 for women in labor are very different. You can look at this course of childbirth from two sides. Let's try to figure out what a caesarean section is, the pros and cons, reviews about this procedure and how it is carried out.

C-section

This operation is considered one of the most difficult. During the procedure, the doctor cuts the lower part of the peritoneum of the pregnant woman, then dissects the uterus and takes out the baby. Next, the toilet of the abdominal cavity is carried out, the separation and removal of the child's place, the cleaning of the reproductive organ. After that, the surgeon carefully stitches all the tissues in layers and treats them with an antiseptic.

Who needs a caesarean section?

To begin with, it is worth saying that this procedure can be both planned and emergency. With a planned cesarean operation, a cesarean is done about one to two weeks before the expected date of birth. Such a period is necessary so that the birth canal has not yet begun to open, but the baby has already been full-term.

In most cases, the indication for the procedure is a multiple pregnancy, the wrong position of the baby, partial or complete, as well as its presentation. In addition, this type of delivery is chosen when a woman cannot give birth on her own due to her own health. If a pregnant lady has already had similar births, then a second caesarean section is almost always performed. Reviews of women suggest that there is a chance to give birth on their own, but few dare to take such a risk.

An emergency caesarean section is performed at any time. In some cases, this manipulation may be required during natural childbirth.

Anesthesia

Each caesarean section has pros and cons. Anesthesia is required during the procedure. If a few decades ago women had no choice, now the method of pain relief can be chosen.

A woman in labor is offered two options: and dorsal. It is worth noting that caesarean section with more has positive than negative. During the procedure, the woman is conscious and can see her baby immediately after his appearance.

Caesarean section: pros and cons

The reviews of most women who have undergone surgery indicate that they would never have decided on a natural birth. The same mothers, whose babies appeared through the classical birth canal, do not want to go under the knife and are ready to endure the pain of contractions. What is still better: a section? The pros and cons for the baby and mother can be different. Let's consider them.

Advantages of the operation

Despite the fact that this process of having a baby is not natural, it has many advantages. Let's dwell on them.

Confidence in the main day

If this procedure is shown to you, then you will know in advance and exactly when your baby will be born. You will not have uncertainty and daily fear of the onset of labor. The doctor will be able to tell you to the nearest minute when you will see your baby.

If such an operation has already been performed once, then the second caesarean section also has positive reviews. A woman already knows what awaits her and can prepare in advance for such a procedure.

No pain

Cesarean section reviews of mothers are positive due to the anesthesia used. The woman in labor does not feel pain from contractions, which can last for a whole day. The expectant mother simply sits on the operating table and waits for her baby to be removed.

It is worth noting that in this case a woman is infringed in her rights. When used, she will also put a baby on her chest after birth. The woman in labor receives everything the same as with the natural appearance of the baby, but does not feel pain.

No incisions in the perineum

After the procedure, the woman will have one reminder of such childbirth - a small seam. However, the undoubted advantage of caesarean section is the absence of damage to the perineum. Many women during natural childbirth push incorrectly or at the wrong time. As a result, there is a rupture of the cervix and perineal tissues. After such a complication, a woman is often shy of her husband and avoids sexual activity. Circumstances that develop in this way can lead to a deterioration in relations, the appearance of complexes and misunderstandings.

In addition, after vaginal delivery, a complication may occur - prolapse of the uterus. It is worth noting that it happens quite rarely, but the likelihood of such a situation persists for the rest of your life.

Benefits for the child

Despite the fact that a caesarean section has pros and cons, doctors recommend choosing this particular method of delivery. There are many negative consequences and complications that can occur due to natural childbirth if the baby is in the pelvic position.

Of course, some risky ladies give birth on their own in such a situation, but gynecologists strongly do not recommend risking the life of a little man.

Cons of the operation

Has a caesarean section pros and cons. Reviews of women in labor suggest that this procedure still has more disadvantages than positive aspects. Consider the negative effects of manipulation.

Long Recovery

Despite the fact that a caesarean section has pros and cons, doctors' reviews indicate a long recovery after the procedure. Due to the layered suture, a woman cannot move independently for about a day after the operation. For a long time, the mother is forbidden to lift the child because of the danger of wound dehiscence. Even the sick leave in this case is extended by almost one month. All this suggests that after the operation it is more difficult for a woman to return to her usual way of life and restore her body.

Inflammatory processes

After such delivery, there is a high probability of occurrence of inflammatory processes. Since there is a fresh wound on the uterus, into which pathogenic bacteria can enter, a woman after a cesarean section must adhere to special hygiene.

If you experience pain or discharge of an unusual color, consistency and smell, you should immediately contact your local gynecologist. There are times when a woman needs additional procedures to completely cleanse the inner layer of the reproductive organ.

Risk of complications in subsequent pregnancies

Has a caesarean section pros and cons. Reviews of doctors say that after manipulation there is a possibility of pathology during a subsequent pregnancy. It is worth noting that this phenomenon occurs very rarely, however, the surgical suture on the genital organ can simply disperse.

If the placenta forms in the place where the suture is made, then it can simply grow into it. If such a pathology occurs, complete removal of the genital organ may be required. Of course, the rotation of the baby's place can also occur in the first pregnancy, however, with an existing caesarean section in the past, the likelihood of this outcome increases.

Inability to breastfeed

Very many children born by caesarean section are artificial. Why does such a pattern arise?

After the operation, the woman in labor is prescribed a course of antibiotic therapy. This is necessary in order to avoid the occurrence of an inflammatory process in the scar area. Because of some drugs, doctors do not allow a new mother to start breastfeeding. If a woman wants to maintain lactation, then she has to express herself. Many of the fair sex are simply not up to it after the operation.

Aesthetic flaws

Many ladies have complexes associated with a suture left from a caesarean section. Of course, in our time there are many ways to get rid of this shortcoming, but not everyone decides on plastic surgery. Many women simply do not have the financial opportunity to carry out such a correction.

Inability to give birth on their own in the future

After one caesarean section, doctors perform this operation in subsequent pregnancies. Some ladies decide to have a natural childbirth, but there are very few such people who want to.

During the bearing of the baby, the expectant mother needs special supervision. She is often prescribed ultrasound in order to monitor the condition of the scar.

Caesarean section: pros and cons for a child

Pros of the procedure

It is worth noting that during the operation the child does not suffer in any way. Many talk about the negative impact of anesthesia on the baby. When used, the probability of getting the drug into the blood of the newborn is minimal. The doctor starts the operation as soon as the woman has been given the drug.

During a caesarean section, the doctor carefully removes the baby from the reproductive organ. The baby is not exposed to oxygen starvation, which so often occurs during natural childbirth. With a caesarean section, the baby is insured against various injuries that can be obtained when passing through the birth canal. In some cases, such birth injuries can become irreparable or even lead to disability.

With this delivery, the child can be born "in a shirt." Many parents consider this a good sign and hope that good luck will accompany the child throughout his life.

Cons of the procedure

Many neurologists argue that the effect of a caesarean section on a baby can be negative. The baby needs to go through the process of passing through the birth canal. It is worth noting that with a natural appearance, the bones of the skull in a newborn are somewhat displaced. This does not happen at birth by caesarean section. Due to the absence of this process, babies born during surgery are more likely to suffer from headaches and intracranial pressure.

The lack of breastfeeding from the first days of a child's life is also an undoubted minus of such childbirth. Very rarely, but there are cases when the surgeon inflicts injury on the baby with a scalpel. Such cuts heal on their own and quickly.

Expert opinion

In our country, a woman has the right to independently choose the method of delivery. Many ladies resort to caesarean section even in the absence of evidence for this. It is worth noting that doctors condemn this decision.

A caesarean section is a complex operation that is designed for women who are unable to give birth on their own. It is necessary to resort to such manipulation only in extreme cases, if there are certain indications. You should not go under the knife just because you are afraid of pain and contractions. Unpleasant sensations after the operation and soreness of the seam are no less than during natural childbirth.

If you are due to give birth soon, talk to your gynecologist. Ask him about whether you have a chance to give birth on your own or if you need to have an operation. Ask all the questions that concern you. The doctor will talk in detail about the birth process and support you.