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What is a Caesarean?

by Peg Plumbo

question
My wife and I are concerned about having a caesarean section for the birth of our child. What does a caesarean birth entail?

answer
The surgical technique for a caesarean birth involves a skin incision across and just above the pubic hairline or up and down below the navel. Vessels are cauterised and the membrane over the organs is cut revealing the bladder which is separated from the uterus to expose the uterus itself. The obstetrician feels the baby for position, and to stay away from vessels and the placenta, and makes a scalpel incision, suctions the fluid from the uterus and enlarges the incision with her fingers. The baby's head (or whatever is presenting near the pelvis) is grasped and delivered in much the same way as it is in a vaginal birth. The baby's mouth and nose is suctioned and then he is placed on the mother's abdomen. The cord is cut and the baby is handed to the nurse who dries and warms and suctions the baby. After the baby is dry and stable, the father may bring the baby over for the mother to see and touch. All of this takes just a few minutes.

The placenta is then manually removed and the contents of the uterus (mostly clots) are evacuated and bleeding is minimised. The ovaries, tubes and bladder are inspected and the uterus is checked for lacerations. The repair takes three times longer than the birth, with the doctor taking care to repair the uterus and be sure that the abdominal layers are sewn in the appropriate order until the skin is finally stapled or sutured.

If a caesarean is done for failure to progress and the baby is doing well, time can be taken to administer epidural anaesthesia or a spinal block. If the caesarean is an emergency, general anaesthesia is often given.

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