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

Timing, duration and course of the operation

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

While monitoring the pregnancy, the doctor gives advice on how the childbirth should proceed. If a woman's pregnancy is proceeding normally, then most likely the birth will take place naturally. If there are any abnormalities during pregnancy or during the delivery itself, then doctors may decide to carry out childbirth using a caesarean section.

Distinguish between emergency and planned cesarean section:

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 period of pregnancy goes to the pathology department. The most common indications for a planned cesarean section are:

premature placental abruption;
hemolytic disease fetus;
multiple pregnancy;
severe form of preeclampsia;
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 on the operation. In such situations, the qualifications of the doctor and the decisiveness of the woman in labor are very important (after all, the operation cannot be carried out without her consent).

Optimal timing

A planned caesarean section is usually done at the 40th week of pregnancy... This optimal time for the operation - with sufficient weight, the fetus is already considered full-term, and the child's lungs are sufficiently developed so that he can breathe on his own.

With a second cesarean section, the timing of the operation shifts downward - 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 do a cesarean section in each case.

Preparing for surgery

A woman in labor who is scheduled for a planned cesarean is usually admitted to the hospital about a week before surgery. If a woman wants to stay at home, then 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 with good health mother and child.

Postoperative period

Pain relievers are usually prescribed after surgery because the woman is experiencing severe pain after cesarean section. Also, depending on the condition of the woman, the doctor may prescribe various medications such as antibiotics, or supplements that improve performance gastrointestinal tract.

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

The food after the operation should be special - on the first day after the cesarean 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 correct recovery, you can eat any food that is allowed during lactation.

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

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

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Indications for cesarean section

When the passage of the fetus through birth canal in a natural way impossible either pose a danger to the child and mother are doing a cesarean section. The indications listed below are absolute for the operation:

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

For a caesarean section, a newborn removed through the dissected abdominal and uterine walls.

Distinguish between planned intervention, which is carried out according to absolute readings and carefully prepared, and emergency.

Its need arises in the process of difficult labor.

Surgical intervention 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 the labor is completed the traditional way impossible.

Types of anesthesia

Depending on the situation surgical intervention spend under general or local (local) anesthesia... TO planned surgery a woman in labor is prepared 7-14 days before the intended permission. She is hospitalized and monitored over the course of her pregnancy. Preoperative preparation is carried out, saline is injected drip to saturate tissues with moisture in order to compensate for possible blood loss.

The day before, a woman is advised to give up dinner, put an enema so that, under the influence of anesthetics, she does not provoke vomiting. Under what anesthesia is a caesarean section performed during planned operations? Prepared patients are given local anesthesia. In the surgical obstetric practice an epidural or spinal method of anesthesia is in demand.

Epidural anesthesia

Caesarean section with epidural anesthesia differs in that the woman is conscious... The anesthetic is injected into the spinal canal cavity 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. Suturing and antiseptic treatment may take 1 / 3–2 / 3 hours.

How long does a cesarean section take? It takes 60–90 minutes from the beginning of the drug injection to the application of the last suture.

Caesarean section with epidural anesthesia has the following advantages:

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

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

Spinal anesthesia

Differs in that the anesthetic is injected deeper- into the subarachnoid cavity exactly between the second and third dorsal vertebrae. Therefore, pain relief comes faster. The rest of the analgesic effect is similar to that of the epidural method.

The differences between the methods of anesthesia are shown in the table.

Indicator	Pain relief method
Indicator	Spinal	Epidural
Tool	Thick needle	Thin needle
Place of introduction	The interval between the 2nd and 3rd dorsal vertebrae	Any place
Advantages	Rapid pain relief. The point of injection of the drug is known. The patients walk away soon after anesthesia. Absence toxic effect pain relievers.	Not contraindicated in patients with heart disease. There are no headaches. The effect of anesthesia can be prolonged.
Flaws	Short-term anesthesia, there is no possibility of prolongation. During the operation, a drop in pressure is not excluded, bradycardia occurs.	It is not easy to locate the injection site. Anesthesia occurs in 20 ... 30 minutes.
Complications	Headaches, hypersensitive reaction to drugs, nausea, vomiting, meningitis is possible.	Allergy, development of an 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 remaining scars on the abdomen, the need to suspend for several months intimate life, limit locomotor activity and physical exercise.

General anesthesia

Systemic anesthesia is used in the following situations:

the woman refuses to undergo an operation under local anesthesia;
epidural and spinal methods are contraindicated;
develop pathological childbirth, an emergency operation is required.

Before surgery, the stomach of a woman in labor is cleared of food masses using a probe. At intravenous administration drugs anesthesia works quickly.

How long does a cesarean section take, if used? general anesthesia? V optimal conditions the operation takes 25-40 minutes.

However, the duration of the procedure can be delayed with a second cesarean section. After the previous intervention, adhesions are formed that impede access to the uterus.

They have to be carefully dissected. Obstetricians recommend performing the intervention under local anesthesia, because systemic anesthesia can harm 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;
an increase in blood pressure;
oppression nervous system and violation respiratory function in a newborn.

Stark modification

A woman can undergo surgery under systemic anesthesia according to the Stark modification. How long does this procedure last? Experienced surgeon 1 / 4–1 / 3 hour is enough to complete it... The child is removed 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 by the method of a suprapubic cross-section;
open the uterus, remove the fetus along with the afterbirth;
suture defects, restore the integrity of the abdominal wall.

The method has the following advantages:

the time allotted for the operation and associated blood loss is reduced;
the need for pain medications decreases;
women quickly withdraw after anesthesia, they can apply the baby to the breast after 2 hours;
it becomes possible to do without taking antimicrobial agents;
it is allowed to get up after 6-8 hours.

The main disadvantage of this method is scar on the abdomen located above the bikini line.

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

A woman after a cesarean section comes out of half-sleep for 2-4 hours. But the observation of the anesthesiologist lasts a day.

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

headache for three days;
nausea, vomiting;
cough;
insomnia;
sense of anxiety;
irritability.

Postoperative recovery

Before the operation, a woman in labor should know how to behave during rehabilitation. It takes months. In this period the uterus is reduced, returning to its original size, the seams are scarred. Attention should be paid to the following rules of conduct:

the first day shows fasting and non-carbonated drinking;
from the second day, sweet tea, porridge, yoghurts, boiled lean meat are allowed;
the transition to regular meals lasts a week;
to prevent constipation, you should purchase probiotics in advance, after consulting an obstetrician;
the soreness of the scarring suture is quenched with analgesics;
need to follow 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! With a caesarean section physical exercise allowed after at least nine weeks, and sports - six months after surgery.

Useful video: a review of the caesarean section operation

Conclusion

From the beginning of the introduction of the anesthetic until the application of the last suture with epidural anesthesia, it takes 60–90 minutes. Spinal method shortens the operation by a third of an hour. With general anesthesia in the traditional version, the caesarean section lasts 45 minutes, and in the Stark version - 22-25 minutes.

At about 35 weeks of gestation, the chances of giving birth on their own came to naught, our daughter refused to turn to the "exit" face, like all decent children. As a result: mixed breech presentation (with a leg) with clear doctor's recommendations to prepare for surgical delivery by performing a caesarean section.

Future mothers are very curious personalities, they want to know everything in advance and for sure, and I am no exception. So many thoughts were spinning in my head about the upcoming birth, I wanted to be ready for anything, so I was actively interested in how long the caesarean lasted. As it turned out, the duration of the operation depends on many factors, and some of them cannot be influenced by either the woman or the surgeon.

How long does a cesarean take? "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 of eight births ends with a caesarean section, which increases the risk of developing postpartum complications by about 12 times.

IMPORTANT! Despite the "inspired" by Western countries, the tendency to perform a caesarean section at the request of a woman, surgical intervention is more dangerous for the mother and fetus in comparison with natural childbirth, therefore, it should be carried out only for medical reasons.

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

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

At the present time, a pregnant woman can independently choose not only the place of delivery, 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 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 gives birth every day and spends hours in the operating room, therefore Caesarean time will last almost the same.

How long does a cesarean take? When not everything goes according to plan.

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

Indications for an urgent cesarean section are:

prolapse from the uterus of the umbilical cord or parts of the fetus during the discharge of amniotic fluid;
premature placental abruption with the development of uterine bleeding;
rupture of the uterus during labor;
a sharp deterioration in the condition of the mother or fetus (acute hypoxia during childbirth, which occurs when the umbilical cord is entwined, incorrect insertion of the head, a long anhydrous period);
the development of severe preeclampsia in the mother (late gestosis), etc.

How long can a cesarean take? Complications during a planned operation.

As for the planned operative delivery, that is, the cesarean section is performed according to the following indications:

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

Complications during a planned cesarean section can be difficult operational access in view of the expressed adhesive process v abdominal cavity against the background of previously performed surgical interventions. The time of the operation can take much longer than usual, but the health risks of the woman in labor and the fetus remain the same.

How long does a cesarean take with 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 the 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 afterbirth are removed from the uterine cavity through an incision in its wall - was named, according to one version, by the name of Gaius Julius Caesar, who appeared in the world in this way. Among the many obstetric operations, cesarean section is in the lead.

A fraction of a second was snatched by our photojournalist from eternity, from which a tiny alien appeared (a boy? A girl? We do not yet know exactly at this moment the fourth - temporary - dimension!). An instant, not perceptible in its smallness for us, for him something unimaginable, incomprehensible (maybe terrible? We will never know - what!) This child did not get out into the world, gradually adapting to new sensations, did not fight for existence, pushing through the bosom, 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 late to scream right away, because the anesthesia taken by his mother got a little bit for him too ... Strong hands the surgeon was there, 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 from weightlessness to appear in the blink of an eye into this world.

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

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

And that operation will take about half an hour. Professor Evgeny Alekseevich Chernukha, one of the aces of Caesarean, is applying stitches. An ordinary 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 birth pain is. In the United States, this is one fifth of all women in labor. Is it good or not? What Every Woman Preparing to Become a Mother Should Know About Caesarean Section? After reading to the end, you will understand why everyone ...

Honored Scientist, Professor Evgeny Alekseevich CHERNUKHA answers.

Why are there many more caesarean sections now than before?

Because it became easier to diagnose obstetric complications and the condition of an unborn child in advance. Ultrasound will determine the weight of the fetus, its position, "see" malformations, show where the placenta is located, and make it clear about its premature detachment. With the help of ultrasound, you can learn about serious complication- whether the fetus is entwined with an umbilical cord.

Science has also succeeded in methods for assessing the size of a woman's pelvis, you can even "simulate" whether a child's head will pass 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 finally became a mother, a shadow of risk in the birth of a healthy and healthy baby cannot be allowed.

Indications for cesarean section

Which women are routinely, that is, before the onset of independent childbirth, have a cesarean section? What are the indications for a cesarean section?

With an anatomically narrow pelvis and tumors of its bones;
if bleeding was found during placenta previa or if the normally located placenta began to exfoliate prematurely;
if in bad shape postoperative scar on the uterus;
if the fetus is experiencing an acute lack of oxygen;
if the mother suffers from severe toxicosis that does not respond to treatment;
if a woman has a heart defect, severe hypertonic disease, bronchial asthma, kidney problems;
if the expectant mother has myopia high degree(more than 5 diopters) and there is a danger of a serious complication - retinal detachment and blindness (in this case, it is important to exclude attempts).

Very often, a planned cesarean section is performed according to the so-called combined indications. What does it mean?

Suppose the first birth is due to a woman, according to obstetric canons, “elderly” - from 30 years old and older. Age itself is not the reason: many “elderly primiparous” cope on their own, although not as easily as it happens, besides, the pregnancy is still postponed, the fetus is large, here, in the “appendage” to the age, troubles are quite likely during childbirth! They can be protracted, the child will suffer and even die. So that these complications are not taken by surprise, and surgery is recommended.

And the background of such a woman in labor is often difficult. Many 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 you managed to keep and carry to the end? Then the question "Should this woman be a mother or not?" depends entirely on the method of delivery ...

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

Cesarean section time

How long does a cesarean 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 are the types of caesarean anesthesia?

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

Intubation (endotracheal): in windpipe a tube is introduced through which oxygen is supplied with nitrous oxide.

Epidural anesthesia: An anesthetic is injected into the so-called epidural space spinal cord v lumbar and the pain is relieved. And you can even talk to a 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, with 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 anesthesia sparingly, with the smallest doses. Only when the child is separated is she given deep anesthesia - after all, the surgical field has yet to be closed. A newborn under the weak influence of anesthesia may not cry right away.

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 the kids are sure to cry - only if there are no complications, a little later.

- How long does anesthesia leave from a cesserev section?

After a cesarean section, the newly-made mom is placed in a special postpartum ward for the first day, where she is recovering from anesthesia, during this time she is monitored by an anesthetist nurse and an anesthesiologist himself. From spinal anesthesia move away more easily than from the general, but exact time It cannot be said, since each woman has her own characteristics, but within a day a woman should already move away from anesthesia and adapt to postoperative existence.

Suture after cesarean section

- What size will the seam be after a cesarean section, will it disfigure the stomach?

The time of the so-called midline incision - between the pubic articulation and the navel, when there was a noticeable “groove” along the woman's abdomen, has passed. Now they make a transverse suprapubic incision about 12 cm long. Sometimes it is more difficult to work, but such a suture heals better and looks great from a cosmetic point of view. In addition, then it will be completely hidden under the panties, so you will not have to be shy on the beach.

- Which suture material do surgeons use?

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

The consequences of a 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 ended without complications, you can turn in bed, move your legs, and the next day - sit down and walk around the ward. If the mother is not given antibiotics, the baby will be brought in to feed on the third day. But as with any abdominal surgery, these medications are often needed. Then you can feed the baby only after canceling the course of treatment.

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

It is possible that within a month or even several there will be a consequence of a cesarean section for the mother there will be a feeling of insignificant pulling pain in the lower abdomen. Don't be alarmed - it is associated with uterine contraction and scar healing.

Attention! If you suddenly feel sharp pain if bloody, pus-like discharge from the vagina appears, if the temperature rises, immediately contact antenatal clinic... It is possible that endometritis has developed - an inflammation of the mucous membrane of the uterus and urgent treatment is required.

Healing seam on the front abdominal wall passes, as a rule, smoothly and painlessly. Only in very rare cases does it become inflamed, begins to fester. Then urgently to the surgeon - it is impossible that inflammatory process passed into the depths of the abdomen, to the underlying tissues.

Menses and sex after cesarean section

- When does your period start after a cesarean 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, with breastfeeding - after the cessation of lactation. If the woman does not feed - in 2-3 months. But when the operation or postoperative period proceeded with complications, menstruation did not recover for a long time. Then you need a consultation with 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 there have been complications, be sure to visit your gynecologist first.

Children after caesarean section

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

Oh 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 desirable. In the first case, the scar on the enlarging uterus will not be able to form completely, and complications will arise again, and with an abortion there is a danger of uterine perforation where the former incision “lies”.

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

Second birth after cesarean section. Natural childbirth after cesarean section

- How will the second childbirth go after a cesarean section? Are natural childbirth?

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

How many times can you have a caesarean section?

- How many cesarean sections can a woman have?

And two, and three, and four. But it is better if there are two of them - usually this the best option... Although recently we had a mother with a fourth cesarean section.

The consequences of a cesarean section for a child

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

Let's not forget that nature provided for a different way of man's birth. Indeed, operative delivery is more gentle for the fetus - it will not “wade” through the birth canal and, therefore, receive microtrauma, experience pain, and discomfort. However, the adaptability of such a baby to the new environment is reduced. The consequence of a cesarean section for a child can be breathing difficulties, up to and including disturbance.

Which is better than natural childbirth or cesarean section?

- Which is better for a woman to have a natural birth or a cesarean 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 surgical intervention - 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. Do not deceive nature, do not tempt fate. Your baby, born like millions of others, won't get any worse from it. Of course, you can find a doctor willing to operate. By the way, he will definitely write in your medical card that “readings are available”.

But never I, having seen a lot of Caesarean in my life, will not recommend it “just like that”. And I won't.

When natural childbirth is not possible for medical reasons, it is used Alternative option delivery - cesarean section. It should be borne in mind that this is not an easy path that allows you to bypass the pains of natural childbirth, and 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 the abdominal incision. Depending on the development of the pregnancy, the procedure may be scheduled as planned. If during the development of pregnancy no complications were observed, but complications arose during the birth process, then an emergency operation is performed.

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

Indications for elective caesarean section

Planned COP is shown in the following cases:

diabetes mellitus and Rh-conflict;
detachment of the retina and myopia;
physiological characteristics of the mother: a narrow pelvis, malformations of the uterus or vagina;
the presence of scars on the uterus, remaining;
breech presentation of the fetus or other malposition - frequent readings for caesarean section;
with post-term pregnancy, in which the size of the fetus is above 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. Reasons wear psychological character: fear of pain or physiological changes genitals. However, the World Health Organization recommends giving preference to natural childbirth, since the operation lays certain imprints on the health of the baby and mother.

An emergency caesarean section is indicated in the following cases:

Long labor process leading to oxygen starvation fetus. In this case, there is real threat baby's life;
The loss of the strength of the woman in labor. For normal development the generic process is necessary physical strength and psychological determination;
Wrong position of babies with multiple pregnancies;
Childbirth that came before the natural time;
Premature rupture of amniotic fluid. V in this case there is a high risk of contracting infections;
Placental abruption in a woman in labor. This is fraught with bleeding;
Presentation or prolapse of the fetal loop. Threatens with hypoxia and death for the baby;
At ;
Rarely, but still there are cases of uterine rupture.

Each generic process is individual. So this list does not reflect all the complications that may require acceptance emergency measures... A woman in labor should always be under the close supervision of an obstetrician to prevent certain deviations from the birth process.

Algorithm for preparation in the hospital

When carrying out a planned operation, a woman in labor should prepare in advance for the procedure. What week is the planned cesarean section done? In practice, the operation is prescribed at the end - 38–39 weeks of pregnancy. 8-10 days before the appointed date, the gynecologist writes out a referral to the clinic where the operation is planned. A woman should be hospitalized in advance with everyone, as she:

General analysis of blood and urine;
Rh factor analysis;
Cytological smear;
Doppler vessels.

These tests help assess the degree of preparation of the body for delivery.

What is the best anesthesia for CS?

general and regional. General anesthesia has a number of negative consequences, among which we can note respiratory distress mother and child or the ingestion of fluid from the gastrointestinal tract into the respiratory tract. The very substances contained in the composition of anesthesia can have a depressing effect on the neurological system of the baby. The "gold standard" for cesarean section in this case is the spinal and epidural type of pain relief.

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

Each of these types has its own characteristics. The analgesic effect in the first case 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 is initially administered, then general anesthesia is administered. If initially there was an epidural, the operation will be continued by increasing the dose of the drug through the inserted catheter.

According to the consequences, the advantages of spinal anesthesia can be noted. With her, in the postoperative period, mild headaches are possible. are extremely rare, but can be more tangible.

On the eve of the operation

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

Hygienic preparation is also carried out: taking a shower and epilation of the genitals. 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 fluids. A couple of hours before the caesarean section, the intestines are cleansed with an enema.

How is the operation going?

The woman in labor lays down on the operating table in shoe covers and a hygienic cap. The legs of the woman in labor are being pulled elastic bandage. This measure is necessary as 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 anesthetic procedure, a dropper is inserted to compensate for the loss of blood. Cuffs are put on the arms to control pressure and pulse. A catheter is placed in urinary tract... The peritoneum is sterilized and covered with a sterile sheet. The doctor proceeds to the procedure.

How long does a cesarean section take? Itself the operation takes about an hour on average, if there are no additional difficulties during its implementation. But the process of removing the fetus with a cesarean section takes no more than 10 minutes... The umbilical cord is cut and the baby is handed over for postpartum procedures. The process ends with the extraction 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 reduce the muscles of the uterus;
stopping bleeding;
compensation of fluid in the body;
anesthesia.

Despite its apparent simplicity, a cesarean section has a number of risks for both the mother and the baby.

The 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 seams;
Hernia of the vertebra;
Keloid scar is a scar after surgery. Rather, it plays an aesthetic role. The scar 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, intense thirst and general weakness;
During the operation, the woman in labor loses 4 times more blood than during natural childbirth;
Adhesions may form in internal organs;
Upon contact with air, there is a risk of developing endometritis - inflammation of the uterine cavity;
Hematomas may form on the seams or purulent processes may develop;
Rarely, but there may be cases of seam divergence;
Impossibility of caring for a child for several days.

The consequences for the child are also significant.

In the process of natural childbirth, the baby's body must be rebuilt to new form life. In this regard, at the beginning of the birth process in his body, the concentration of the hormone catecholamine sharply increases. It is needed in order to throw fluid out of the lungs and start respiratory system baby as soon as he "comes out". During the operation, the baby's body will not have time to collect the required amount of hormones. The lungs are not ready to breathe, and the heart bears significant stress. This can cause degenerative phenomena in the heart.

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

It has been noticed that children born by cesarean section have and 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 may decide 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 the mother. If natural childbirth is impossible for objective reasons, then one should not persist, thereby endangering two lives.

Pregnancy planning, healthy image life, and sufficient physical activity and a positive attitude towards childbirth helps to minimize the risks of complications and, possibly, help to avoid surgery and give new life in a natural way.
Read some feedback from women who have had CS:

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