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The C-Section Primer

Baby being born via Caesarean Section
Photo: iStockphoto/Martin Valigursky

Cesarean sections are a hot topic these days and for good reason: according to the National Center for Health Statistics, these procedures account for 29 percent of all deliveries and that number is on the rise.

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Why You Might Need a C-section
There are a number of reasons why you might need a c-section, one being if your baby isn’t tolerating labor well. “We’ll know by the heart rate patterns we’re seeing on the baby’s monitor,” explains Alice Chuang, MD, FACOG, assistant professor in the department of OB/GYN at University of North Carolina, Chapel Hill. “Some patterns are reassuring and some aren’t. If we see a pattern that worries us, that may be a reason for a c-section.”

You also may need a c-section if your cervix doesn’t dilate, your labor isn’t progressing, the baby is in distress, the baby is in a breech position, or if there are other complications.

Opting for a C-section
For many women, a vaginal delivery is too painful and scary to even contemplate. Others fear an emergency c-section. There are women with busy schedules who prefer having a planned delivery date rather than the uncertainty of natural labor. And there are those who wound up having a c-section after hours of labor for their first delivery and hope to avoid the long process for their next baby. Although there are no exact statistics on how many c-sections are being done as elective procedures, estimates range in the tens of thousands per year.

“For most women, a vaginal delivery doesn’t have the long-term effects that many women fear, such as vaginal tears,” Dr. Chuang says. “If a patient comes to me and says, ‘I want a c-section,’ I’m going to explore why and help her understand the risks of both c-sections and vaginal deliveries.”

The Cradle Advisory Board member Dr. Anthony Chin, a Beverly Hills OB/GYN who delivers at Cedars-Sinai Medical Center in Los Angeles, concurs with Dr. Chuang’s advocacy of vaginal deliveries. He also acknowledges the number of people who support primary elective c-sections. “There may be some medical benefits to [this procedure] such as perineal preservation or the avoidance of pelvic organ prolapse and incontinence.” For these reasons, Dr. Chin notes that many urogynecologists recommend elective c-sections. However, while there are reasons why it might make sense for some pregnant women to have a scheduled c-section, Dr. Chin is still a strong proponent of vaginal deliveries whenever possible.

What to Expect 
Unless you’ve scheduled your c-section, you’ll likely be exhausted by the time your doctor decides to perform a c-section and you’re wheeled in for the procedure. “It’s hard when you’ve [already] been in labor for a long time,” Dr. Chuang says. “You haven’t slept, you’re anxious about the delivery, and you’re exhausted from laboring.”

While the procedure itself can take between a half-hour to ninety minutes, it’s still major abdominal surgery. You’ll get a spinal or epidural to block the pain. In most cases, your spouse will be allowed to come into the operating room with you, sitting next to your head. “Your body is draped from the chest down,” Dr. Chuang says. “…so your spouse doesn’t hit the floor.”

As soon as you’ve been sewn up, you’ll be wheeled to the recovery room and you can hold your baby right away. You’ll leave the hospital with dissolvable stitches in your incision, called a “bikini cut,” located either around the hairline or a little bit below.

How Long Until I’m Back to My “Old” Self?
Most women stay in the hospital for two to four days post c-section. Within a week, you should be able to take a short stroll in the neighborhood or a short trip to the grocery store, Dr. Chuang says.

If your pain increases in the days that follow your c-section, call your doctor right away. “We want to hear from our patients,” she says.

By the time you return to your OB for your six-week check-up, you should be back to your routine feeling more yourself again.

In the end, whether you have a c-section or a vaginal delivery, you’ll experience the same wonderful reward for nine months of hard work - your smiling bundle of joy!

– Lambeth Hochwald 

Crib Notes
• A c-section is major abdominal surgery.

• The procedure can take between a half-hour and ninety minutes.

• You’ll have an incision around the hairline called a ‘bikini cut’.

• Most women stay in the hospital 2-4 days post c-section.

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