How long does a caesarean section last? What is a caesarean section and how is this operation carried out in stages? Is natural childbirth possible after cesarean?

Timing, duration and progress of the operation

All pregnant women experience fear before childbirth. And it’s even worse if childbirth doesn’t take place. naturally, but by caesarean section. But to make it not so scary, let's figure out why a caesarean section is performed, at what time the operation is usually performed, how long it takes and consider the entire course of the operation.

During pregnancy monitoring, the doctor makes a recommendation on how the birth should proceed. If a woman’s pregnancy is progressing normally, then most likely the birth will take place naturally. If there are any abnormalities during pregnancy or during the birth itself, then doctors may decide to perform the birth by cesarean section.

There are emergency and planned caesarean sections:

prescribed during pregnancy. In this case, the woman in labor prepares for the operation in advance, goes through everything necessary examinations and at a predetermined stage of pregnancy is admitted to the pathology department. The most common indications for elective caesarean section are:

premature placental abruption;
hemolytic disease fetus;
multiple pregnancy;
severe form of gestosis;
absolutely narrow pelvis;
transverse position of the fetus, etc.

Emergency caesarean section carried out in case of unforeseen complications directly during childbirth that threaten the health of the mother or child. The health of both the child and the mother may depend on the timeliness of the decision to perform the operation. In such situations, the qualifications of the doctor and the determination of the woman in labor are very important (after all, the operation cannot be performed without her consent).

Optimal timing

A planned caesarean section is usually performed at 40 weeks of pregnancy. This optimal time for the operation - if the fetus is of sufficient weight, it is already considered full-term, and the child’s lungs are developed enough for him to breathe independently.

With a repeat caesarean section, the timing of the operation is shifted downwards - it is done a couple of weeks earlier than the planned date of birth, usually the 38th week of pregnancy.

This approach avoids the onset of contractions, which reduces the risk various complications during the operation. Remember that only a doctor can correctly determine at what time to perform a cesarean section in each specific case.

Preparing for surgery

A woman in labor who is scheduled for a planned cesarean section is usually sent to the hospital about a week before the operation. If a woman wants to stay at home, she can come to the hospital on the day the operation will take place. But this is permissible only in the absence of severe complications and when good health mother and child.

Postoperative period

After surgery, painkillers are usually prescribed because the woman experiences severe painful sensations after caesarean section. Also, depending on the woman’s condition, the doctor may prescribe different medications, such as antibiotics, or supplements that improve performance gastrointestinal tract.

You can get up after surgery no earlier than six hours later. It is also recommended to buy a postoperative bandage, which will greatly improve the condition when walking.

Nutrition after surgery must be special - on the first day after a caesarean section, you can only drink plain water.

On the second day, a woman can try soups, cereals and other liquid foods.

On the third day, at proper recovery, you can eat any food that is allowed during lactation.

If you are still scheduled for a planned caesarean section, then you should not be afraid. Most often, fear of cesarean section occurs due to insufficient awareness of the operation. Knowing exactly what she has to go through, it is much easier for a woman to psychologically prepare herself for the upcoming events.

Sometimes to complete labor activity it is necessary to remove the child through the dissected abdominal wall. Future mom should know what a caesarean section is, how long the intervention lasts, what the risks are for the child and complications for the woman.

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Indications for caesarean section

When the passage of the fetus through birth canal in a natural way either impossible pose a danger to the child and mother, perform a caesarean section. The following indications are absolute for the operation:

narrow pelvis;
premature birth;
multiple births;
uterine bleeding;
pregnancy complications;
severe myopia;
heart pathologies;
lateral position of the child when contractions begin;
the head comes with an extension insert;
fetal hypoxia.

During caesarean section, newborn extracted through the dissected abdominal and uterine walls.

There are planned interventions, which are carried out according to absolute indications and carefully prepared, and emergency.

Its necessity arises during difficult labor.

Surgery is impossible without anesthesia, otherwise the mother may die due to traumatic shock.

The duration of the operation depends on the type of anesthesia. C-section carried out when labor is completed traditional way impossible.

Types of anesthesia

Depending on the situation surgical intervention carry out under general or local (local) anesthesia. TO elective surgery the woman in labor is prepared 7–14 days before the expected birth. She is hospitalized and monitored for the progress of her pregnancy. Preoperative preparation is carried out, saline solution is injected dripwise to saturate the tissues with moisture in order to compensate for possible blood loss.

The day before, the woman is advised to refuse dinner and is given an enema to avoid provoking vomiting under the influence of anesthetics. What anesthesia is used for caesarean section during planned operations? Prepared patients are given local anesthesia. In the surgical obstetric practice epidural or spinal anesthesia is in demand.

Epidural anesthesia

Caesarean section with epidural anesthesia differs in that the woman is conscious. An anesthetic is injected into the cavity of the spinal canal in the lumbar region. How long does it take to inject the anesthetic into the epidural canal? The procedure takes 12–15 minutes.

Complete pain relief in most cases occurs within half an hour.

Then a screen is placed in front of the woman in labor at chest level to deprive her of the opportunity to observe the progress of the operation.

It takes 7–10 minutes to make the necessary incisions and remove the baby. Stitching and antiseptic treatment may take 1/3–2/3 hour.

How long does a caesarean section last? From the start of drug administration to the application of the last suture, 60–90 minutes pass.

Caesarean section with epidural anesthesia has the following advantages:

minimized Negative influence anesthetic for pressure changes and heart function;
there is no risk of vomit getting into the Airways;
duration of the analgesic effect and the possibility of its prolongation;
quick recovery from the narcotic state, a day later you are allowed to get up;
The child can be picked up immediately after the manipulation.

The method has one serious drawback - anesthesia is performed by an inexperienced anesthesiologist fraught with negative consequences. The decision on how to perform the operation - under general or epidural anesthesia - is made by the woman in labor. She may be afraid that during the operation she will feel numbness in half of her body.

Spinal anesthesia

It differs in that the anesthetic is injected deeper- into the subarachnoid cavity exactly between the second and third dorsal vertebrae. Therefore, pain relief occurs faster. Otherwise, the analgesic effect is similar to that of the epidural method.

The differences between anesthesia methods are shown in the table.

Index	Pain relief method
Index	Spinal	Epidural
Tool	thick needle	Thin needle
Injection site	The space between the 2nd and 3rd dorsal vertebrae	Any place
Advantages	Fast pain relief. The point of drug administration is known. Patients recover quickly from anesthesia. Absence toxic effect painkillers.	Not contraindicated in patients with heart disease. No headaches occur. The effect of anesthesia can be prolonged.
Flaws	Anesthesia is short-term, there is no possibility of prolongation. During the operation, a drop in pressure cannot be ruled out; bradycardia occurs.	It is not easy to determine the site for injecting the anesthetic. Pain relief occurs within 20…30 minutes.
Complications	Headaches, hypersensitive reaction to drugs, nausea, vomiting, possible meningitis.	Allergy, development of epidural hematoma or abscess.

Important! The duration of the operation depends on the method of anesthesia, ranging from 1/3 to 3/2 hours. If there is a choice, doctors recommend performing the operation under local anesthesia.

TO unpleasant consequences after cesarean section include scars remaining on the abdomen, the need to suspend for several months intimate life, limit motor activity And physical exercise.

General anesthesia

Systemic anesthesia is used in the following situations:

the woman refuses to undergo surgery under local anesthesia;
epidural and spinal methods are contraindicated;
are developing pathological birth, emergency surgery is required.

Before surgery, the mother's stomach is cleared of food masses using a probe. At intravenous administration Anesthesia medications act quickly.

How long does a caesarean section last, if used? general anesthesia? IN optimal conditions the operation lasts 25–40 minutes.

However, the duration of the procedure may be prolonged with a repeat caesarean section. After the previous intervention, adhesions form, making access to the uterus difficult.

They have to be cut carefully. Obstetricians recommend performing the intervention under local anesthesia, because systemic anesthesia can cause harm to the health of the child and mother.

General anesthesia is characterized by the following disadvantages:

hypoxia of the woman in labor, caused by a decrease in lung volume;
aspiration;
increase in blood pressure;
oppression nervous system and violation respiratory functions in a newborn.

Stark modification

A woman can undergo surgery under systemic anesthesia using the Stark modification. How long does this procedure take? To an experienced surgeon 1/4–1/3 hour is enough to complete it. The child is taken out 2 minutes after the incision of the abdominal wall.

How is a cesarean operation performed in the Stark modification? The procedure includes the following steps:

the abdominal wall is passed using a suprapubic transverse incision;
the uterus is opened, the fetus is removed along with the placenta;
suturing defects, restoring the integrity of the abdominal wall.

The method has the following advantages:

the time allotted for surgery and associated blood loss is reduced;
the need for painkillers is reduced;
women quickly recover from anesthesia and can put the baby to the breast after 2 hours;
it becomes possible to do without taking antimicrobial agents;
You are allowed to get up after 6–8 hours.

The main disadvantage of this method is stomach scar, located above the bikini line.

How long does it take to recover from anesthesia? There are individual fluctuations.

After a caesarean section, a woman wakes up from half-asleep for 2-4 hours. But the observation of the anesthesiologist continues for 24 hours.

The period of gradual recovery of reflexes is characterized by the following unpleasant symptoms:

You may have a headache for three days;
nausea, vomiting;
cough;
insomnia;
sense of anxiety;
irritability.

Postoperative recovery

Before surgery, a woman in labor should know how to behave during rehabilitation. This takes months. In this period the uterus is reduced, regaining its original size, the seams are scarred. Please pay attention to the following rules of conduct:

the first day, fasting and non-carbonated drinking are indicated;
from the second day, sweet tea, porridge, yogurt, boiled lean meat are allowed;
the transition to normal nutrition lasts a week;
to prevent constipation, you should purchase probiotic products in advance, after consulting with your obstetrician;
the pain of the scarring suture is relieved with analgesics;
need to be monitored vaginal discharge, it is considered normal if, gradually decreasing in volume, they stop after 2–3 weeks;
has a beneficial effect on the healing process;
intimate relationships are resumed after mandatory quarantine (40 days).

Note! During caesarean section physical exercise are allowed after at least nine weeks, and sports – six months after surgery.

Useful video: review of cesarean section surgery

Conclusion

From the beginning of the administration of the anesthetic to the application of the last suture for epidural anesthesia, 60–90 minutes pass. Spinal method shortens the operation by a third of an hour. With general anesthesia in the traditional version, a caesarean section lasts 45 minutes, and in the Stark modification - 22–25 minutes.

At about 35 weeks of pregnancy, the chances of giving birth on her own disappeared, our daughter refused to turn her face to the “exit”, like all decent children. As a result: mixed breech presentation (with a leg) with clear recommendations from the doctor to prepare for surgical delivery by performing a cesarean section.

Future mothers are very curious individuals; they want to know everything in advance and for sure, and I am no exception. There were so many thoughts spinning in my head about the upcoming birth, I wanted to be prepared for anything, so I was actively interested in how long a caesarean section would last. As it turned out, the duration of the operation depends on many factors, and some of them are beyond the control of either the woman or the surgeon.

How long does a caesarean section last? "Standard" standards.

Naturally, any case in medicine, including obstetrics, is endowed with individuality and the risk that something will go wrong, so if the doctor gives you a 100% guarantee of success, you should be wary. According to statistics, one in eight births ends in a cesarean section, which increases the risk of developing postpartum complications by approximately 12 times.

IMPORTANT! Despite the trend “inspired” by Western countries to perform a caesarean section at the woman’s request, surgical intervention is more dangerous for the mother and fetus compared to natural childbirth, and therefore should be carried out only for medical reasons.

A caesarean section is an abdominal operation that involves cutting through the layers of the abdominal wall and uterus to deliver a baby. During the normal course of the operation, the child is born approximately 3-5 minutes from the start. The absence of unforeseen circumstances (complications) does not guarantee, but significantly increases the likelihood of the operation lasting approximately 30-40 minutes.

How long does a caesarean section take? Experience versus youth.

Nowadays, a pregnant woman can independently choose not only the place of birth, but also the surgeon who will perform the operation. Naturally, in most cases the choice falls on more experienced surgeons with “gray hair at the temples” and an excellent reputation, which can be found out on any of the women’s forums. In fact, there is practically no difference between an obstetrician-gynecologist with 20 years of experience and a young specialist with 5 years of experience, if you do not take into account the financial side, because each of them delivers babies every day and spends hours in the operating room, so The duration of a caesarean section will be almost the same.

How long does a caesarean section last? When not everything goes according to plan.

You can replay the moment of the birth of a child in your head as much as you like, hoping that everything will go perfectly, but fate often presents its own “surprises.” This happens, for example, when the need for a caesarean section becomes known already during childbirth - the operation is performed unscheduled and is called urgent (urgent). Under such circumstances, how long a caesarean section lasts depends on the condition of the fetus, the mother’s well-being and the complications that arose during childbirth.

Indications for emergency caesarean section are:

prolapse of the umbilical cord or parts of the fetus from the uterus when amniotic fluid breaks;
pre-premature placental abruption with the development of uterine bleeding;
uterine rupture during childbirth;
a sharp deterioration in the condition of the mother or fetus (acute hypoxia during childbirth, which occurs when the umbilical cord is entangled, the head is not inserted correctly, or a long period without water);
development of severe preeclampsia in the mother (late gestosis), etc.

How long can a caesarean section last? Complications during planned surgery.

As for planned surgical delivery, that is, cesarean section is performed for the following indications:

complete placenta provision;
anatomically narrow pelvis;
breech presentation of a fetus weighing more than 3500 grams;
malposition;
complicated course of multiple pregnancy, triplets;
severe maternal illness;
two or more scars on the uterus or failure of a postoperative scar, etc.

Complications during a planned caesarean section may include difficulty operational access due to the presence of a pronounced adhesive process V abdominal cavity against the background of previously performed surgical interventions. The operation may take much longer than usual, but the risk to the health of the mother and fetus remains the same.

How long does a cesarean section last for bleeding due to poor uterine contractility? It all depends on the effectiveness of the doctor’s actions, as well as determining the scope of the operation, because in some situations, to save the life of a woman in labor, it may be necessary to expand the operation up to the removal of the atonic uterus.

Caesarean section - a surgical operation in which the fetus and placenta are removed from the uterine cavity through an incision in its wall - was named, according to one version, after Gaius Julius Caesar, who came into the world in this way. Among the numerous obstetric operations, caesarean section is the leader.

A split second was snatched by our photojournalist from eternity, from which a tiny alien appeared (boy? girl? We do not yet know at this very moment the fourth - time - dimension!). A moment, imperceptible in its smallness for us, for him something unimaginable, incomprehensible (maybe terrible? We will never know what!) This child did not come into the world, gradually adapting to new sensations, did not fight for existence, pushing through the maternal the womb is like a sprout, stubbornly piercing the thickness of the earth with its head.

He became earthly with the help of a surgical scalpel and was too late to scream right away, because the anesthesia taken by his mother got to him a little... Strong arms The surgeons were nearby, and he did not even realize that he was breathing. Perhaps only an astronaut, crushed to the grass after landing by the merciless gravity of the earth, is able to understand what it is like to appear from weightlessness in the blink of an eye into this world.

He was born. Look how lucky this wanderer was - he was greeted with a camera flash, and he immediately became famous. But even such an event is incomparable to the feeling of the first independent breath.

And now the newborn (it’s a girl!) screams and screams, opening her tiny mouth wide, protesting against the energetic actions of the midwife. The first ten minutes of life without a mother.

And the operation will take about half an hour. Professor Evgeniy Alekseevich Chernukha, one of the Caesarean aces, applies stitches. A typical day at the Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences.

In Russia for last years There are three times more mothers who do not know what labor pain is. In the United States, this is one fifth of all women giving birth. Is this good or not so good? What should every woman preparing to become a mother know about caesarean section? After reading to the end, you will understand why every...

Answered by Honored Scientist, Professor Evgeniy Alekseevich CHERNUKHA.

Why are there so many more caesarean sections now than before?

Because it has become easier to diagnose obstetric complications and the condition of the unborn child in advance. An ultrasound will determine the weight of the fetus, its position, “see” developmental defects, show where the placenta is located, and make it clear about its premature detachment. Ultrasound can be used to determine serious complication- Is the fetus entwined with an umbilical cord?

Science has also made progress in methods for assessing the size of a woman’s pelvis; it is even possible to “model” whether the baby’s head will fit through it. A modern achievements in the treatment of infertility, in vitro fertilization (when the embryo is transferred into the uterine cavity), artificial conception make a cesarean section necessary: after all, for a woman who has finally become a mother, not even a shadow of risk in the birth of a living, healthy baby should be allowed.

Indications for caesarean section

Which women have a cesarean section planned, that is, before spontaneous labor begins? What are the indications for caesarean section?

With an anatomically narrow pelvis and tumors of its bones;
if bleeding is detected during placenta previa or if the normally located placenta begins to exfoliate prematurely;
if in bad condition postoperative scar on the uterus;
if the fetus experiences an acute lack of oxygen;
if the mother suffers from severe toxicosis that cannot be treated;
if a woman has a heart defect, severe hypertonic disease, bronchial asthma, diseased kidneys;
if the expectant mother is myopic high degree(more than 5 diopters) and there is a danger of serious complications - retinal detachment and blindness (in this case it is important to exclude attempts).

Very often, a planned caesarean section is performed for so-called combined indications. What does it mean?

Let’s say a woman is about to give birth for the first time; according to obstetric canons, she is “elderly” - 30 years and older. Age itself is not the reason: many “elderly primigravidas” cope on their own, although not as easily as it happens. Moreover, the pregnancy is still post-term, the fetus is large, then in addition to age, troubles during childbirth are quite likely! They may be protracted, the child will suffer and even die. To avoid these complications being taken by surprise, surgery is recommended.

And the backstory of such a woman in labor often turns out to be complicated. Many people have already had several abortions by the age of 30. Others have been treated for infertility for a long time. What if this pregnancy is the only one that was saved and carried to completion? Then the question “To be or not to be this woman’s mother?” It depends entirely on the method of delivery...

By the way, a caesarean section is almost always inevitable due to numerous abortions. After them, dystrophic and cicatricial changes form in the uterus, inflammatory processes arise - and a chain of consequences extends into pregnancy: placental insufficiency, weakness of labor, fetal hypoxia...

Cesarean section operation time

How long does a caesarean section take?

Most often about half an hour. If the operation is repeated, it will take longer.

Epidural anesthesia for caesarean section

- What kind of anesthesia does a pregnant woman receive? What types of anesthesia are there for caesarean section?

Anesthesia, as with any abdominal surgery, is necessary. Two types of anesthesia are commonly used.

Intubation (endotracheal): in windpipe a tube is inserted through which oxygen and nitrous oxide flow.

Epidural anesthesia: an anesthetic substance is injected into the so-called epidural space spinal cord V lumbar region, and the pain is relieved. And you can even talk to the woman in labor.

Which anesthesia is preferable? Epidural is popular abroad. It is often practiced in Russian maternity hospitals. We at the Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences “love” endotracheal anesthesia more. It is contraindicated only for women with lung diseases and bronchial asthma.

- Does the child also receive anesthesia?

Yes, as long as the fetus and mother are connected by the umbilical cord. Therefore, before the fetus is removed, the woman is given gentle anesthesia, with the most minimal doses. Only when the child is separated is she given deep anesthesia - after all, the surgical field still has to be closed. A newborn under the weak influence of anesthesia may not cry immediately.

The main thing is to breathe - this is what the neonatologist, who is always present at the operation, and the midwife pay attention to. And babies definitely scream - only a little later if there are no complications.

- How long does anesthesia last for a caesarean section?

After a caesarean section, the new mother is placed in a special postpartum ward for the first day, where she recovers from anesthesia, during which time she is monitored by a nurse anesthetist and the anesthesiologist himself. From spinal anesthesia come away easier than from the general one, but exact time It is impossible to say, since each woman has her own characteristics, but within 24 hours the woman should already recover from anesthesia and adapt to post-operative existence.

Suture after caesarean section

- What size will the suture be after a caesarean section, will it disfigure the abdomen?

The time of the so-called median incision - between the pubic symphysis and the navel, when a noticeable “groove” ran along the woman’s stomach, has passed. Now they make a transverse suprapubic incision about 12 cm long. It happens that the work is more difficult, but such a suture heals better and looks great cosmetically. In addition, it will then be completely hidden under panties, so you won’t have to be shy on the beach.

- Which suture material do surgeons use?

The most common one, which is used when conducting abdominal operations. It is necessary that the threads be aseptic - non-infected, as well as elastic, elastic and, most importantly, dissolved in the tissues. Previously, they sewed with catgut - a natural material made using complex technology from the intestines of sheep; now they use synthetic threads that are in no way inferior to catgut - vicryl, dexon, monocryl.

Consequences of caesarean section for the mother

- What does a mother need to know about the consequences of a cesarean section in the first days and months after the operation?

After a few hours, if everything is over without complications, you can turn around in bed, move your legs, and the next day you can sit up and walk around the room. If the mother is not given antibiotics, the baby will be brought in to feed on the third day. But as after any abdominal surgery, these medications are often necessary. Then you can feed the baby only after stopping the course of treatment.

On the 6-7th day, the stitches will be removed from the abdominal wall, and on the 8-10th day you will be discharged home under the supervision of a doctor at the antenatal clinic. However, the healing of the sutures on the uterus and abdominal wall continues, and you will have to be careful. Do not remove the baby from a low crib or stroller (you can take it from the changing table and hold it in your arms). In the first 2-3 months, do not lift more than 5 kg from the ground. You can't wash the floors.

It is possible that for a month or even several months, the consequence of a cesarean section for the mother will be a feeling of insignificance. nagging pain in the lower abdomen. Don't be alarmed - it is associated with contraction of the uterus and healing of the scar.

Attention! If you suddenly feel sharp pain if bloody, purulent vaginal discharge appears, if the temperature rises, contact your doctor immediately antenatal clinic. It is possible that endometritis has developed - inflammation of the uterine mucosa and requires immediate treatment.

Healing of the suture on the anterior abdominal wall As a rule, it passes smoothly and painlessly. Only in very rare cases does it become inflamed and begin to fester. Then urgently see a surgeon - you can’t inflammatory process moved deep into the abdomen, to the underlying tissues.

Menstruation and sex after caesarean section

- When do periods start after a caesarean section and when can you start again? sex life and have sex?

Menstruation will come at the same time as after normal childbirth, as a rule, when breastfeeding - after the cessation of lactation. If a woman does not feed, after 2-3 months. But when the operation or postoperative period proceeded with complications, menstruation did not return for a long time. Then you need to consult a gynecologist.

As for sexual activity after a cesarean section, no earlier than 6-8 weeks, provided that after the operation everything went without a hitch. If complications occur, be sure to visit a gynecologist first.

Children after caesarean section

- Is it possible to have more children after a caesarean section?

Yes, sure. But a new pregnancy should occur 2-3 years after the operation - only by this time the formation of a scar on the uterus ends. During this period, neither childbirth nor artificial termination of pregnancy is advisable. In the first case, the scar on the enlarging uterus will not be able to fully form, and complications will arise again, and during an abortion there is a danger of perforation of the uterus where the former incision “lies.”

Therefore, soon after the operation, you need to decide with the gynecologist which method of contraception is best to “adopt.”

Second birth after cesarean section. Natural birth after caesarean section

- How will the second birth proceed after a caesarean section? Are they allowed? natural childbirth?

A narrow pelvis, heart disease, and bronchial asthma do not disappear anywhere - therefore, the inevitability of a repeat delivery operation remains. If the first caesarean section was emergency indications: due to premature abruption of the placenta, for example, the scar on the uterus has healed well, natural childbirth is allowed under strict monitoring control - it is important to carefully monitor the condition of the scar.

How many times can you have a caesarean section?

- How many caesarean sections can a woman have?

And two, and three, and four. But it’s better if there are two of them - usually this is best option. Although quite recently our mother had a fourth caesarean section.

Consequences of caesarean section for a child

- What are the consequences of a caesarean section for a child??

Let's not forget that nature provided for another way for a person to be born. Indeed, operative delivery is more gentle for the fetus - it will not “make its way” through the birth canal and, therefore, receive microtrauma, experience pain, and discomfort. However, the adaptation capabilities of such a baby to the new environment are reduced. The consequence of a caesarean section for a child can be difficulty breathing, even breathing problems.

What is better: natural childbirth or caesarean section?

- What is better for a woman to have a natural birth or a caesarean section?

I want to warn all women - expectant mothers: it is a huge mistake to believe that the operation is simple, almost harmless. Real abdominal surgery - why do you need it unless absolutely necessary?!

Yes, it has its advantages - when the life of a mother or child is in danger. But there are also disadvantages. Don't deceive nature, don't tempt fate. Your baby, born like millions of others, will not become any worse for this. Of course, you can find a doctor willing to perform the operation. By the way, he will definitely write down in your medical card, that “there is evidence.”

But I, who have seen a lot of Caesareans in my time, will never recommend it “just like that.” And I won't.

When natural childbirth is not possible for medical reasons, Alternative option delivery - caesarean section. It is worth considering that this is not an easy path to bypass the pains of natural childbirth, but a serious procedure that has a number of negative consequences.

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KS is surgery to remove the fetus from the uterus through an abdominal incision. Depending on the development of pregnancy, the procedure may be scheduled. If no complications were observed during the development of pregnancy, but complications arose during the birth process, then emergency surgery is performed.

According to statistics, every ninth baby in Russia is born with the help. Despite the fact that the operation is considered simple and often practiced, the likelihood of complications increases by more than 12 times.

Indications for planned caesarean section

A planned CS is indicated in the following cases:

diabetes mellitus and Rh conflict;
retinal detachment and myopia;
physiological characteristics of the mother: narrow pelvis, malformations of the uterus or vagina;
the presence of scars on the uterus remaining;
breech presentation of the fetus or other abnormal position - frequent readings for caesarean section;
in post-term pregnancy, in which the size of the fetus is higher than normal;
at ;
the presence or exacerbation of genital herpes;
with placenta previa.

Anyway, the operation is performed with the consent of the woman in labor. This consent must be recorded in writing.

In the practice of doctors, there are cases when a woman in labor without medical indications to surgery, decides to give birth by caesarean section. The reasons are psychological character: fear of pain or physiological changes genitals. However, the World Health Organization recommends giving preference to natural childbirth, since the operation leaves certain imprints on the health of the baby and mother.

Emergency caesarean section is indicated in the following cases:

A long labor process leading to oxygen starvation fetus In this case, there is real threat baby's life;
Loss of strength of the woman in labor. For normal development birth process is necessary physical strength and psychological determination;
Incorrect position of babies during multiple pregnancy;
Childbirth occurring before the natural term;
Premature rupture of amniotic fluid. IN in this case high risk of infection;
Placental abruption in a woman in labor. This is fraught with bleeding;
Presentation or prolapse of the fetal loop. Threatens hypoxia and death for the baby;
At ;
Rarely, but still there are cases of uterine rupture.

Each birth process is individual. That's why this list does not reflect all complications that may require treatment emergency measures. A woman in labor should always be under the close supervision of an obstetrician to prevent any deviations from the birth process.

Algorithm for preparation in the maternity hospital

When undergoing a planned operation, the woman in labor must prepare for the procedure in advance. In what week is a planned caesarean section performed? In practice, surgery is scheduled for the end - 38–39 weeks of pregnancy. 8–10 days before the appointed date, the gynecologist writes a referral to the clinic where the operation is planned to be performed. A woman should be hospitalized in advance with everyone, since she:

General blood and urine analysis;
Analysis for Rh factor;
Cytological smear;
Vascular Doppler.

These tests help assess the degree to which the body is prepared for childbirth.

What anesthesia is better for CS?

general and regional. General anesthesia has a number of negative consequences, among which we can note respiratory failure mother and child or ingress of fluid from the gastrointestinal tract into the respiratory tract. The substances themselves contained in anesthesia can have a depressing effect on the baby’s neurological system. The “gold standard” for caesarean section in this case is considered to be spinal and epidural anesthesia.

The spinal method is carried out by a single injection administered into cerebrospinal fluid. Epidural anesthesia is administered through a catheter into the spinal cord. Both types of injections are administered horizontally or sitting position. The procedures are painless, occasionally accompanied unpleasant sensations in the lower part of the peritoneum.

Each of these types has its own characteristics. In the first case, the analgesic effect occurs within 10–15 minutes; for an epidural it will take 20–30 minutes.

Sometimes regional anesthesia may not provide the appropriate level of pain relief. In such cases, if spinal anesthesia was initially administered, then general anesthesia is administered. If epidural anesthesia initially took place, the operation will be continued by increasing the dose of the drug through the inserted catheter.

Based on the consequences, one can note the advantages of spinal anesthesia. With it, mild headaches are possible in the postoperative period. are extremely rare, but can be more noticeable.

On the eve of the operation

A CS is usually performed in the morning. The night before, the woman in labor should prepare for it. In particular, the anesthesiologist conducts an explanatory conversation. As a result, he must find out the previous facts of taking anesthetics, past illnesses, woman’s weight and other factors. The data obtained will help you select an individual dose of painkillers.

Hygienic preparation is also carried out: showering and genital hair removal. Lunch on this day should be limited to the first course, and dinner should consist of kefir or tea, drunk before 18:00.

On the day of surgery, be sure to refrain from eating and drinking liquids. A couple of hours before a cesarean section, the intestines are cleansed using an enema.

How is the operation performed?

The woman in labor lies down on the operating table wearing shoe covers and a hygienic cap. The legs of a woman in labor are pulled elastic bandage. This measure is necessary as a prevention of thrombosis. The operating area and the woman's face are separated by a screen. It should be borne in mind that in the absence of other indications, it is practiced local anesthesia. After the anesthesia procedure, a drip is inserted to compensate for blood loss. Cuffs are placed on the arms to monitor blood pressure and pulse. A catheter is placed in urinary tract. The peritoneum is sterilized and covered with a sterile sheet. The doctor begins the procedure.

How long does a caesarean section take? Herself The operation takes about an hour on average, unless additional difficulties arise during its implementation. And here the process of fetal extraction during caesarean section takes no more than 10 minutes. The umbilical cord is cut and the baby is transferred for postpartum procedures. The process ends with the removal of the placenta and suturing of the incision.

After the operation, the woman in labor spends about a day in the department intensive care, then transferred to the postpartum department. During the day, a number of measures are taken to restore the woman in labor:

measures to contract the muscles of the uterus;
stopping bleeding;
compensation of fluid in the body;
anesthesia.

Despite its apparent simplicity, a caesarean section has a number of risks affecting both mother and baby.

Consequences for a woman in labor are divided into two types according to the duration of manifestation:

Late;
Postoperative.

Late consequences are expressed:

The formation of ligature fistulas is an inflammatory process around the sutures;
Vertebral hernia;
Keloid scar is a scar after surgery. Rather, it plays an aesthetic role. Tripe is absolutely safe for health.

Postoperative complications include the following factors:

Pain syndrome after surgery. The process of discharge may be accompanied by headaches, dizziness, strong thirst and general weakness;
During surgery, a woman in labor loses 4 times more blood than during natural childbirth;
Adhesions may form in internal organs;
When exposed to air, there is a risk of developing endometritis - inflammation of the uterine cavity;
Hematomas may form at the sutures or purulent processes may develop;
Rarely, but cases of seam divergence may occur;
Inability to care for a child for several days.

The consequences for the child are also significant.

During natural childbirth, the baby’s body must adapt to new uniform life. In this regard, at the beginning of the birth process in his body the concentration of the hormone catecholamine sharply increases. It is necessary to throw out fluid from the lungs and start respiratory system baby as soon as he “comes into the world”. During the operation, the baby’s body will not have time to accumulate the required amount of hormones. The lungs are not ready to breathe, and the heart suffers significant stress. This can cause degenerative phenomena in the heart.

In addition, before the baby enters a period of hibernation, during which all physiological processes slow down. This phenomenon is preparation for the transition to a new environment. Surgical intervention involves a sharp change in pressure drop. This is a gross violation natural process preparing the baby for life and is fraught with minor hemorrhages in the brain. These children often show evidence of minimal brain dysfunction.

It has been noticed that children born by caesarean section have psychological characteristics. This can be expressed in apathy of character, increased dependence on the mother and a pronounced desire to manipulate adults.

Let's summarize:

With an adequate assessment of the risks of surgery, even women in labor with indications can come to the decision to give birth naturally. In this case, the doctor can only warn about possible development events. However, the task of medicine is to preserve the life of the baby and mother. If natural childbirth is impossible for objective reasons, then you should not persist, thereby endangering two lives.

Pregnancy planning, healthy image life, and sufficient physical activity and a positive attitude towards childbirth help to minimize the risks of complications and may help avoid surgery and give new life naturally.
Read some reviews from women who have undergone CS surgery:

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