Make a cesarean section of the cylinder. What is a cesarean section and how does this operation go in stages? Lactation after surgery

For many decades, this operation - cesarean section - allows you to save the life and health of the mother and her baby. In the old days, such surgical intervention was extremely rare and only if something threatened the life of the mother in order to save the child. However, now cesarean section is used more and more often. Therefore, many specialists have already set themselves the task of reducing the percentage of births carried out by surgical intervention.

Who should have surgery?

First of all, you need to figure out how to have a cesarean section and what consequences await a young mother. Surgery alone is safe enough. However, in some cases, operations are simply not practical. After all, no one is protected from risk. Many future mothers are asked to have a cesarean section only because of fear of severe pain. In this case, modern medicine offers epidural anesthesia, which allows a woman to give birth without pain.

Such deliveries are performed - cesarean section - by a whole team of medical workers, which includes specialists of a narrow profile:

• Obstetrician-gynecologist - directly removes the baby from the uterus.
• Surgeon - performs an incision of the soft tissues and muscles of the abdominal cavity to reach the uterus.
• A neonatologist pediatrician is a doctor who takes a newborn baby and examines him. If necessary, a specialist in this profile can provide the child with first aid, as well as prescribe treatment.
• Anesthetist - performs analgesia.
• Anesthetist sister - helps to conduct anesthesia.
• Surgical nurse - if necessary, assists doctors.

The anesthesiologist should talk with a pregnant woman before the operation begins to clarify which type of anesthesia is preferable for her.

Types of Caesarean section

Indications for cesarean section can be completely different, and the operation is carried out in certain cases in different ways. To date, there are two types of childbirth performed with surgical intervention:

Emergency surgery is performed if any complication occurs during childbirth that requires urgent removal of the baby from the uterus. A planned cesarean section is performed in situations where the doctor is concerned about the course of childbirth due to complications during pregnancy. Let's take a closer look at the differences between the two types of operations.

Planned Caesarean section

A planned operation (cesarean section) is performed with epidural anesthesia. Thanks to this method, a young mother has the opportunity to see her newborn baby immediately after the operation. When conducting such a surgical intervention, the doctor makes a transverse incision. A child usually does not experience hypoxia.

Emergency Cesarean Section

As for emergency caesarean section, general anesthesia is usually used during the operation, as the woman may still have contractions, and they will not allow a puncture to be performed for epidural anesthesia. The incision during such surgery is mainly longitudinal. This allows you to remove the baby much faster from the uterine cavity.

It is worth noting that during emergency surgery, the child may already experience severe hypoxia. At the end of the cesarean section, the mother cannot immediately see her baby, since they do a cesarean section in this case, as already mentioned, most often under general anesthesia.

Types of sections for cesarean section

In 90% of cases, a transverse incision is made during the operation. As for the longitudinal, they are currently trying to do it less often, since the walls of the uterus are greatly weakened. In subsequent pregnancies, they can simply tear. A transverse incision made in the lower part of the uterus heals much faster, and the sutures do not tear.

A longitudinal incision is made along the midline of the abdominal cavity from the bottom up. To be more precise, then to a level slightly lower than the navel from the pubic bone. Making such an incision is much easier and faster. Therefore, it is usually used for emergency cesarean section in order to quickly remove a newborn baby. The scar from such an incision is much more noticeable. If doctors have the time and opportunity, then during the operation, a transverse incision can be made slightly above the pubic bone. It is practically invisible and heals perfectly.

As for the repeated operation, the seam from the previous one is simply excised.
  As a result, only one seam remains visible on the woman’s body.

How does the operation proceed?

If the anesthesiologist conducts epidural anesthesia, then the site of the operation (incision) is hidden from the woman by a septum. But let's see how they do a cesarean section. The surgeon makes an incision in the uterine wall, and then opens the fetal bladder. After which the child is removed. Almost immediately, the newborn begins to cry a lot. The pediatrician cuts the umbilical cord, and then carries out with the child all the necessary procedures.

If the young mother is conscious, then the doctor immediately shows her the baby and can even give her a hold. After this, the child is taken to a separate room for further observation. The shortest period of surgery is the incision and removal of the child. It takes only 10 minutes. These are the main advantages of Caesarean section.

After this, doctors should remove the placenta, while qualitatively processing all the necessary vessels so that bleeding does not begin. Then the surgeon sutures the cut tissue. A woman is given droppers, giving a solution of oxytocin, which accelerates the process of uterine contraction. This phase of the operation is the longest. From the moment the baby is born until the end of the operation, approximately 30 minutes pass. In time, this operation, a cesarean section, takes about 40 minutes.

What happens after childbirth?

After the operation, the newly minted mother is transferred from the operation unit to the intensive care unit or the intensive care unit, as they do a cesarean section quickly and with anesthesia. The mother should be under the watchful eye of doctors. At the same time, she constantly measures blood pressure, respiratory rate, and pulse. The doctor should also monitor at what pace the uterus contracts, how many secretions and what character they have. Mandatory monitoring of the urethra.

After cesarean section, mothers are prescribed antibiotics to avoid the inflammatory process, as well as painkillers to relieve discomfort.

Of course, the disadvantages of caesarean section for some may seem significant. However, in some situations, it is precisely such births that allow a healthy and strong baby to be born. It is worth noting that a young mother can only get up after six hours, and walk on the second day.

The consequences of surgery

After the operation, the uterus and abdomen remain sutures. In some situations, diastasis and suture failure may occur. If such consequences occur, then you should immediately consult a doctor. The complex treatment of the discrepancy between the edges of the suture located between the rectus muscles includes a set of exercises specially developed by many specialists that can be performed after cesarean section.

The consequences of this surgical intervention, of course, are. The very first thing to highlight is an ugly seam. You can fix it by visiting a beautician or surgeon. Typically, procedures such as smoothing, grinding, and excision are performed to give the seam an aesthetic appearance. Keloid scars are considered a rather rare occurrence - reddish growths form above the suture. It is worth noting that the treatment of this kind of scars lasts a very long time and has its own characteristics. It should be conducted by a professional in his field.

For a woman, the condition of the suture that is placed on the uterus is much more important. After all, it depends on him how the next pregnancy will pass and by what method the woman will give birth. The suture on the abdomen can be corrected, but the suture on the uterus cannot be corrected.

Menstruation and sex life

If during the operation there are no complications, then the menstrual cycle begins and passes in the same way as after birth in a natural way. If a complication nevertheless arose, then the inflammatory can occur for several months. In some cases, menstruation can go painfully and with copious discharge.

You can begin sexual life after childbirth, performed with a scalpel, after 8 weeks. Of course, if the surgery went without complications. If there were complications, then you can begin sex life only after a thorough examination and consultation with a doctor.

It is worth considering that after a cesarean section, a woman should use the most reliable contraceptives, since she can not become pregnant for about two years. It is undesirable to carry out operations on the uterus for two years, as well as abortions, including vacuum ones, since such an intervention makes the walls of the organ weaker. As a result, there is a risk of rupture during subsequent pregnancy.

Lactation after surgery

Many young mothers who underwent surgery are worried that after cesarean, it is difficult to establish breastfeeding. But this is completely wrong.

Milk in a young mother appears at the same time as women after natural birth. Of course, breastfeeding after surgery is a little more difficult. This is primarily due to the features of such genera.

Many doctors fear that a child may receive part of the antibiotic with their mother’s milk. Therefore, in the first week, the baby is fed with a bottle mixture. As a result, the baby gets used to it and it is much more difficult to accustom it to the chest. Although today babies are often applied to the breast immediately after surgery (on the same day).

If you do not have indications for delivery by cesarean section, then you should not insist on surgery. Indeed, any surgical intervention has its consequences, and it is not for nothing that nature has come up with a different path for the birth of a child.

It may seem that nature has provided everything necessary for children to be born naturally, but, unfortunately, this is far from always the case. There are situations when, for one reason or another, conventional birth is dangerous to the health or even the life of the mother and child. In this case, to reduce possible risks, doctors have to resort to cesarean section.

What it is?

Caesarean section is a surgical operation by which a child is born through an incision in the front wall of the abdomen and uterus. This operation is performed in cases where complications during pregnancy or the state of health of a woman does not allow her to give birth naturally without harm to her own health and condition of the child.

Given that modern technology has made surgery relatively safe, according to the World Health Organization, the number of children born abdominally today is approaching 20%. In developed countries, this figure is almost two times higher, and Russia is no exception. In recent years, doctors have been trying to reverse this trend, as modern medical technologies help women to give birth to healthy children in a natural way, the only solution for which, just 10 years ago, was surgery.

Pros and cons of cesarean section:

In modern society, there are two opposing points of view. Some people think that a cesarean section is convenient, fast, and relatively painless compared to conventional births. Others are confident that if the mother was deprived of the opportunity to give birth on her own, this will have serious psychological consequences for her and the baby, since the emotional connection between them will not be established at the time of birth. If we consider the picture objectively, it is easy to understand that both of these positions are erroneous.

The caesarean section, like the natural childbirth, has its positive and negative sides. To prepare for the operation, it is important to study them in advance.

-pros

The operation takes only about 40 minutes, while natural childbirth, especially for the first time, can last from 12 hours to several days.

Natural childbirth often leads to external and internal ruptures of the genitals, almost every 5th woman is forced to do an episiotomy (perineal incision) to facilitate the appearance of the baby and avoid additional injuries. Both that, and another leads to necessity of suturing, operation allows to avoid it.

Also, due to Caesarean section, it is possible to prevent exacerbation of various diseases not related to pregnancy, since the load on the woman’s body is significantly reduced.

As another small advantage, it can be noted that with a planned cesarean section, in some cases, you can choose a specific day when the baby is born.

- minuses

First of all, you need to understand that any surgical intervention is a risk. Even the most experienced doctor cannot predict the outcome of the operation with 100% certainty.

The recovery process after cesarean section is much longer and painful, the first few days it is hard to walk and get up, discomfort can persist for several weeks.

In the postoperative period, there are serious restrictions on weight lifting, physical activity, and sudden movements. Active sports will have to be forgotten for at least six months, and spring cleaning on weekends should be postponed for 2 months or delegated to relatives.

It scares many that an ugly scar will remain after the operation, but a really ugly scar can appear only after an emergency cesarean, when the question is literally between life and death. During a planned operation, a small, even line remains below the level of the laundry, which brightens after a year and becomes invisible.

There are unpleasant consequences for the child, for example, during abdominal labor, unlike natural ones, amniotic fluid may remain in the baby's lungs, which will subsequently lead to the development of inflammation and respiratory diseases. It is worth noting that this happens quite rarely, however, such an opportunity exists.

- popular misconceptions

On the Internet you can often find information that after a cesarean section, due to restrictions on weight lifting, a woman is forbidden to take her own child in her arms. This is not true. Despite the fact that the permissible weight is no more than 3 kg, doctors strongly recommend that young mothers pick up their children and independently take care of them immediately after the effect of anesthesia is completely over. An exception can only be very large babies (more than 4.5 kg). The child gradually gains weight, respectively, and the load on the damaged muscles increases smoothly. This helps to recover after surgery, the main thing is to do everything carefully and not rush.

Another common misconception relates to psychological complications after surgery. It is believed that women who for some reason could not give birth in a natural way, it is more difficult to form an emotional connection with their child. In most cases, an emotional bond with the baby is formed in the mother throughout the entire 9 months of pregnancy. With a planned operation, a woman can see her baby right after he was born. Possible psychological consequences are most often a reflection of the opinions of others or the state of the woman in labor (for example, a symptom of postpartum depression).

There is also no evidence that babies born using Caesarean section develop more slowly, or have any psychological and physical difficulties that babies born naturally do not encounter.

Breast milk for mothers who have undergone surgery comes at about the same time as for ordinary women in labor. With the appropriate desire to establish lactation is not difficult.

And last but not least. In some sources, among the minuses of cesarean section, you can find information that sexual rest will have to be observed for 2 months. This is absolutely true, which applies equally to natural childbirth. To avoid inflammation, infections and other complications, all young mothers, regardless of the method of delivery, should refrain from having sex for at least 8 weeks. The only difference is that women who have undergone surgery need to be more responsible for contraceptive methods, since a new pregnancy is categorically not recommended before 2 years later.

Indications and contraindications for caesarean section

Doing an operation, or choosing a natural birth - this is decided by the doctor, based on the results of examinations of each specific patient, the opinion of the future mother herself, as a rule, does not play a significant role. In rare cases, when the situation is ambiguous and there is no absolute indication for Caesarean, a woman’s desire to give birth on her own or to go to the operating room can tip the scales in one direction or another. But to ask for an operation if there is no indication for it, or to give birth naturally, when there is a risk, definitely will not work.

All indications for Caesarean section are divided into absolute and relative (natural childbirth is possible, but there is a risk of negative consequences).

Absolute indications:

• insolvent suture on the uterus after a previous cesarean or other operations;
• ovarian tumors, uterine fibroids, placenta previa and other obstacles to the passage of the child through the birth canal;
• a narrow mother's pelvis and a large fetus;
• multiple pregnancy with complications;
• transverse presentation of the fetus;
• the occurrence of situations that threaten the life and health of the mother and child (detachment of the placenta, bleeding, fetal hypoxia).

Relative indications

• high myopia (poor vision), diseases of the cardiovascular and nervous system, kidney disease, cancer, diabetes and a number of other problems with maternal health;
• pelvic or gluteal presentation of the fetus in combination with its large size;
• post-term pregnancy (more than 41 weeks);
• infections of the birth canal and genitals (dangerous, as they can be transmitted to the child);
• high blood pressure and severe swelling;
• weak or stopped labor, a long anhydrous period;
• late childbirth, poor history (miscarriages, abortions, missed pregnancies).

There are also other indications that the doctor determines individually. Sometimes complications arise directly during childbirth, in which case an emergency operation is prescribed.

Contraindications to Caesarean section include:

• the risk of developing inflammatory processes and sepsis in the mother (serious infectious diseases, HIV, gestosis, significant blood loss, etc.);
• fetal death of the fetus;
• defects and abnormalities in the development of the fetus, incompatible with life;

Under such conditions, caesarean section is done only in the most extreme case, since the risk of developing peritonitis and other infectious processes is too great.

How many weeks do they have cesarean?

In each case, the date of the operation is assigned individually. The optimal time for carrying out a planned cesarean section is the moment of the beginning of the first fights. In any case, doctors are trying to focus on PDR and, if possible, do not perform surgery before 37 weeks.

How does the operation go:

As mentioned earlier, cesarean section is planned and emergency. In the latter case, it is impossible to prepare for the operation in any way, since the woman in labor is on the operating table immediately after a possible threat is identified. But with planned caesarean, in order to reduce the possible negative consequences, some preparation is necessary.

- preliminary stage

Since cesarean section is abdominal surgery, it is not recommended to eat 12 hours before it begins. Immediately before the woman goes to the operating room, hygiene procedures are performed: an enema is placed and the hairs are shaved at the site of the incision. An empty intestine will help not to strain damaged muscles in the first few days after surgery, and the absence of hair will reduce the risk of replenishing the suture. After this, a urinary catheter is placed, which will be removed when the action of anesthesia is over, the woman in labor changes into a special disposable shirt and lays on the operating table, where she is treated with a special solution and anesthetized. The operation site is fenced off with a special screen so that the expectant mother herself could not observe the actions of the doctors.

- anesthesia methods

In modern medicine, three methods of anesthesia are used for caesarean section: spinal, epidural and general anesthesia.

Spinal anesthesia is the most modern anesthesia method for this operation. It is used for elective caesarean section. The puncture is carried out with a very thin needle and the woman practically does not feel pain, the drug is injected directly into the spinal membrane and begins to act literally 3-5 minutes after the injection. The duration of spinal anesthesia is about 2 hours. All this time the woman is conscious and can see her baby immediately after his birth.

Epidural anesthesia is in many ways similar to spinal anesthesia, but is now more often used for pain relief during natural childbirth. Nevertheless, sometimes its use with planned caesarean section is possible. A thicker needle is used for epidural anesthesia, and the drug is injected into the epidural space through a catheter. Such anesthesia begins to act after 15-20 minutes, during the operation, periodic administration of a new dose of the drug is required.

General anesthesia is used for emergency operations or in cases where for some reason the use of spinal or epidural anesthesia is impossible. In this case, the woman is unconscious. Doctors try to resort to general anesthesia as little as possible, since it has a lot of side effects and, unlike the first two methods, the drugs used are almost 100% likely to pass through the placenta into the bloodstream of the child.

The choice of anesthesia method is the task of the anesthetist who will be in the operating room during a cesarean section and monitor the condition of the woman and her body's response to the drugs administered.

- how long does the operation last?

Caesarean section takes approximately 40 minutes. First, doctors make an incision on the skin, muscles and uterus, during a planned operation, they usually make a transverse incision in the lower abdomen above the pubic bone, in case of emergency cesarean, the incision is made longitudinally from the navel down, as this allows you to access the child faster. The baby is born about 10 minutes after the start of the operation, the rest of the time is spent on the separation of the placenta, processing of the internal space and suturing.

Possible consequences and complications after cesarean section

At the end of the operation, the woman is transferred to the intensive care unit, where she departs from the action of anesthesia. The first time she is allowed to get up after 6 hours, this helps to avoid vein thrombosis. Epidural and spinal anesthesia have relatively few consequences, limb tremors, headaches and back pains can be observed. After general anesthesia, it is more difficult to recover, this process may be accompanied by dizziness, nausea, confusion and other unpleasant symptoms.

As after any abdominal surgery, complications may develop in the form of bleeding, inflammation, infection, the formation of adhesions in the intestines and divergence of sutures (both internal and external). Also, in rare cases, during the operation, damage to internal organs (for example, the bladder) is possible. For any suspicious symptoms, you should immediately consult a doctor.

The mother and child spend the first few hours after the operation separately, so the baby is fed with a mixture. Sometimes this can lead to difficulties in the formation of the lactation process, but, as a rule, by the end of the first week everything comes back to normal. In no case should you refuse the mixture without the recommendation of a doctor, as this can lead to negative consequences for the child - a sharp decrease in weight, a drop in blood sugar, etc.

Rehabilitation period after cesarean section

On the first day after surgery, a woman is only allowed to drink plain still water, the next day you can add liquid cereal, light broth, boiled chicken meat to the diet. A strict diet must be followed for at least 3 days.

The uterus after cesarean section does not shrink as quickly as after a natural birth, therefore, regular administration of oxytocin is necessary, antibiotics and pain medication can also be prescribed. Several times a day, cold must be applied to the suture in order to reduce inflammation.

Wearing a postoperative bandage reduces pain in the early days, with it it becomes much easier to get up and move around. It is recommended to empty the bladder as often as possible, this also reduces unpleasant and painful sensations.

Sutures must be processed regularly, after discharge it will have to be done on their own, the first week to wet them is categorically not recommended. Within 2 months after the operation, you should not take a bath or swim. Bathing is allowed only in the shower. Physical activity should be limited as much as possible, sports should be resumed no earlier than six months later. You can return to sexual life in 1.5-2 months, but only after consulting a gynecologist. The next child should be planned no earlier than after 2 years, at this point the sutures will completely heal and will be able to withstand a new pregnancy.

Finally

Caesarean section is an operation that allows you to maintain the health of your mother and her baby, when something goes wrong during pregnancy or childbirth. Therefore, you should not be afraid of it. As it is not worth it and strive to give birth naturally in any way, this price may be too high. If the doctor insists on a planned cesarean section, it is worth listening to his opinion. If this decision raises any doubts, it makes sense to consult with another specialist. It is also not necessary to insist on the operation, without the availability of evidence, no doctor will agree to take responsibility for unnecessary surgical intervention.

Especially for   - Maria Dulina

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In some cases, natural delivery is not possible, and doctors have to remove the baby from the mother’s womb through surgery.

  - This is an surgical intervention through the abdominal wall as a result of which a newborn is born. This operation was carried out in ancient Rome and ancient Greece, but in those days it was only made dead.

Medieval doctors attempted to operate on living women, but this venture was unsuccessful: only a child could be saved.

Only in the 19th century did doctors learn how to save their mother’s life, and in the middle of the 20th century, with the beginning of the era of antibiotics, cesarean section became the standard procedure that carries minimal risks for women.

Indications for cesarean section (list)

Despite the fact that cesarean section is quite common, it is prescribed only if certain indications are available, see the list.

Absolute indications:

• Complete placenta previa - suggests that the baby’s place was implanted so close to the entrance to the cervix that, as it increased, it began to block the baby’s exit through the natural birth canal.
• Anatomically narrow pelvis - an absolute contraindication to conventional childbirth. Such a diagnosis is made if the pelvic bones of a woman are fused in such a way that they do not allow the child to go outside.
• Transverse presentation of the fetus - if before the birth the child could not stand in the head or at least in the gluteal presentation, then he will not be able to be born on his own.
• The presence of more than two caesarean sections in history. It is believed that natural childbirth in this case creates a threat of uterine rupture and intra-abdominal bleeding, which can become fatal for the expectant mother.

Relative indications:

• Incomplete placenta previa - in some cases, according to the results of ultrasound, doctors decide that the baby will be able to be born independently, since the entrance to the uterus is not completely blocked.
• Gluteal presentation of the fetus - cesarean section is performed in the presence of additional risk factors (for example, multiple entanglement of the umbilical cord).
• The presence of fibroids - an operation is indicated only when the tumor is large or if the fibroid is located in the cervix and blocks the natural birth canal.
• Multiple pregnancy - the doctor decides on a cesarean section if the condition of the mother and children is alarming.
•   - surgical intervention is mandatory in cases of preeclampsia and eclampsia. The stages of late toxicosis that precede these two conditions are not always an indication for cesarean section.
• Diseases of the mother that were before pregnancy - the doctor must evaluate whether the natural birth will lead to a worsening of the course of the chronic diseases of the future mother, and if the threat to her health is obvious, she will be prescribed a obstetric operation.

The decision on surgical intervention is not made by the patient at will, but by the doctor, based on medical indications.

Conventionally, the operation can be divided into four phases: anesthesia, dissection of the abdominal wall, walls of the uterus and placenta, fetal extraction, suturing of the walls of the uterus and abdominal cavity.

Choice of anesthesia

Currently, most caesarean sections are performed under epidural anesthesia. The lower body is anesthetized, and the woman in labor is conscious. In the event that an emergency cesarean section (EX) is performed, the woman is given general anesthesia.

Throughout the entire period of surgical intervention, an anesthetist is present who monitors the effect of general or epidural anesthesia on a woman's well-being. The question of how long the cesarean section lasts is difficult to answer definitely. It usually takes no more than 40 minutes, but can be completed earlier. The action of anesthesia ends after the surgeon sews the incisions.

Tissue Dissection

Surgical manipulations are performed in several stages:

• 1. A catheter is inserted into the bladder for timely removal of urine, the pubic area is shaved - this is an additional guarantee of hygiene of the upcoming intervention.
• 2. A screen is placed between the upper and lower torso, thus delimiting the operable zone.
• 3. The incision site is pre-marked, and then the edges of the marked area are manually pulled together to make sure that the skin is sufficiently stretched and that the edges of the wound can subsequently be sutured.
• 4. If there is an old scar from the previous cesarean, then first it is excised with a scalpel.
• 5. The surgeon makes a transverse or longitudinal section of the abdominal wall with smooth translational movements. He has to draw a scalpel along the marked lines several times, slightly deepening the instrument into the thickness of the skin and fat layer.
• 6. When dissecting muscles, the doctor makes efforts to manually push them to the sides and get to the uterus.
• 7. The edges of the wound are fixed by the assistant and parted to provide the surgeon with more complete access to the body of the uterus.
• 8. On the uterus in several stages, the same transverse incision is made as on the abdominal cavity.

Until the genital organ is dissected, the operation is almost bloodless and the assistant’s help in terms of stopping bleeding is minimal.

Fetal extraction

From the moment the uterus is cut and before it is sutured, as little time as possible should pass. Therefore, the child is removed quickly, if there are umbilical cord loops on his neck, then they are removed, and the umbilical cord itself is cut off.

For several minutes, doctors are waiting for the placenta to separate itself from the walls of the uterus. Then it is removed and the accumulated blood and clots are removed.

Suturing tissue

The edges of the wounds of the uterus are fixed and sutured. At the same time, the assistant eliminates the released blood with the help of cotton pads.

The uterus itself is located outside the abdominal cavity, it is repaired after the suture is applied. Then the skin together with the fat layer is bred to the sides and fixed, and the surgeon at this time sutures the abdominal muscles. Unlike the uterus and skin, they dissect vertically.

The last layer of skin is sutured, after which the operated surface is treated with an antimicrobial solution.

After cesarean section

If the delivery was made by surgical intervention, this does not mean that the woman will not have bleeding from the uterus.

The reproductive organ, as in the situation with natural childbirth, will contract, which will provoke the appearance of discharge after a cesarean section, but how many days they will go depends on how successful the operation was. Normally, Lochia are abundant for the first 5 to 6 days, and then gradually stop within a month. If there were any postoperative complications, then the duration of bleeding may increase.

• 6 hours after surgery, the woman is allowed to get up.

Many people care about the question how many days after cesarean section you can be discharged from the hospital? Typically, these patients are under observation for slightly longer than those who had a natural birth. But on days 7-10, as a rule, most women are ready to be discharged.

At first, increased attention should be paid to the condition of the seam. If it is found that he has become swollen, inflamed, festering, or his pain does not decrease, but rather intensifies, it is urgent to consult a doctor to avoid the development of infection.

To prevent muscle strain after cesarean section, a bandage should be worn. The fact is that in the first few weeks it is necessary to exclude pressure on the press, so a sagging stomach needs to be provided with support.

Pregnancy and childbirth after cesarean section

The suture on the uterus must be given time to heal. This means that the uterus should not be allowed to stretch in the first few months. Excessive load on the not yet healed suture may result in rupture of the genital organ, peritonitis and death of the woman.

The earliest time that will be relatively safe for a woman in labor is a cesarean section, performed one year after the first cesarean section. And even in this case, a woman puts her body at serious risk - for long periods, the suture on the uterus can begin to diverge, so the doctor should regularly monitor his condition and thickness according to the results of ultrasound.

In such a situation, there is no chance of having a second baby naturally. Doctors will not take risks and will not allow women in childbirth in natural birth - the risk of rupture of the genital organ is too great. Of course, the uterus can be urgently amputated, but the woman will not survive due to extensive internal hemorrhage.

Normally, the next pregnancy can be planned no earlier than a year after cesarean section. The most ideal is in one and a half to two years. During this time, the seam will finally heal, but before planning the conception, it is necessary to evaluate its condition using ultrasound.

There are cases when the suture after surgery has grown extremely unsuccessfully, and it is very dangerous for a woman to bear the next pregnancy.

In Soviet times, there was nothing to think about natural delivery, if there was a Caesarean section in the history. Such experiments were not practiced. Now the situation has changed, and in recent years, many mothers, planning a second child, are thinking about how he appeared not on the operating room, but on the birth table.

In large clinics in Russia they undertake such a difficult task, there was even a case of independent birth after two obstetric surgeries in the anamnesis (which is a reckless risk from the point of view of doctors).

Therefore, a natural birth after cesarean section is now possible, however, the doctor will give permission for this only if the suture from the previous operation was in good condition, and after it has passed at least 3 years.

When can I have sex after cesarean section?

As with natural delivery, you should have sex only 2 months after the baby is born. Even despite the fact that the vagina itself was not damaged by tears as a result of the baby passing through the birth canal, there is a chance of introducing an infection that will cause the suture on the uterus to become inflamed.

In addition, in the first month after birth, there will be spotting that sexual life will only interfere. In the first weeks, the suture after cesarean section heals: it is very painful and sensitive, so you should postpone intimacy until a more suitable time.

Surgical delivery is usually performed according to certain indications, although sometimes it is done at the request of the woman in labor. When surgical delivery is carried out according to certain indications that were identified before delivery, they speak of planned caesarean. The outcome of the operation depends largely on how to prepare for cesarean section. What should be done before surgery and how?

A caesarean section is an operation in which a child is removed through an incision on the stomach and uterine wall. The procedure is carried out in cases where natural delivery is impossible, or at the request of the patient. Many people believe that it is much easier to give birth by caesarean section, because there are no contractions, nor hellish, tearing pain. But in reality, this is not so at all. This is a full-fledged surgical intervention, which should be carried out only in the presence of the strictest indications, when the child is physically unable to be born in a natural way.

It cannot be argued that in the process of operative delivery, a smaller burden is placed on the newborn. Quite the contrary, when the baby is born with a whole bladder, at the time of its removal from the uterus, a strong and sharp jump in pressure occurs. With natural delivery, the baby smoothly passes into the big world, gradually getting used to different pressures inside the abdomen and in the external environment. Moreover, with normal delivery, the baby is more likely to avoid a variety of birth injuries than with surgical delivery.

Indications for planned surgical labor

Depending on the course of pregnancy, the doctor may recommend that the patient undergo a cesarean section, because traditional delivery can adversely affect the health of the mother or the baby. Caesarean surgery has a number of indications.

There are relative contraindications, in which the issue of the operation is decided individually by the gynecologist. This can be a variety of pathologies that in some way threaten the fetus or mother, for example, nervous system pathologies or disorders of the vascular structures, oncopathology of various localization, etc.

Preparation stages

Caesarean section of the preparation requires mandatory, because regardless of the evidence - this is a full-fledged abdominal operation, which nevertheless carries certain risks for the mother herself and for the newborn. This is a surgical intervention, therefore, it is proposed to use strong medications, the action of which will provide sufficient pain relief and a full course of vital processes. Even the modern level of medicine does not guarantee the flawless course of the operation; the risks of various complications always remain. Even in the absence of obvious risks, no doctor can guarantee a successful course of surgical intervention.

Independently

Self-preparation for cesarean section can begin already from the moment of appointment of such an operation. Mom is advised to learn as much information as possible about this surgical event. You can start attending special courses a couple of months before cesarean, in which the spouses learn in detail about the operation. They will be told about the necessary items in the hospital, what should be prepared for and how soon to recover after the operation.

The recovery period after cesarean is much longer than after normal childbirth, so the stay in the maternity hospital will be longer. It is also worthwhile to find out from the doctor a list of products that require restrictions or exceptions in the diet before surgery. In addition, it is necessary to take care of intimate hygiene procedures in advance. Lie in the bathroom, because next time a similar case will not be presented soon.

It is recommended to purchase a bandage designed to be worn in the postoperative period. With the help of such an invention, a woman will quickly get to her feet and relieve soreness in the suture area. At home, shaving the perineum is not recommended to avoid purulent rashes and irritation, which can delay the operation. In addition, it is necessary to prepare all the necessary accessories for yourself and the baby, for example, a medical center and documents, clothes and diapers, medicines, pads, etc. There should not be varnish on the nails, because the doctor will evaluate the progress of the surgery by the shade of the nails.

In the hospital

When the patient goes to the hospital, the immediate preparation for the operation begins, which involves the following measures:

• Ultrasound diagnostics;
• Refusal of food and drink about 12 hours before the intervention, since anesthesia may not work.
• Lab tests like a vaginal smear, blood, or urine;
• Shaving hair in the groin and perineum.

The night before the intervention, the patient is forbidden to eat, drink and smoke, you can not candy, chewing gum and water. You need better sleep, in the morning you can brush your teeth. If you are taking any medications, then you need to inform your doctor about this. Before the surgery itself, the woman in labor puts on a sterile shirt, hat and shoe covers. Then the anesthetist introduces the necessary anesthetic drug, and the incision site is treated with iodine solution, after which the cesarean procedure itself begins.

Psychologically

Psychological preparedness is important, therefore, in advance of surgery, mom is recommended to attend specialized courses where psychologists work with women in labor. Women should not be afraid, hiding internal fears. Fears of operative labor are common and understandable. But the baby is much worse than mom, because he will have to leave the warm and soft mother’s tummy in a new and completely unfamiliar world. Therefore, the primary task of mom is to help the baby in everything so that he is most safely born. To do this, you must accurately follow all medical recommendations.

In the absence of contraindications or any complications, the doctor can do spinal anesthesia, then the woman in labor will be fully conscious, she will be able to get acquainted with the baby immediately after it is removed from the womb. Previously, cesarean was carried out through a vertical incision on the abdominal wall, but now the incisions are made along the bikini line, where the seam is less noticeable.

Many mothers are difficult to survive the definitive decision of the gynecologist about the need for childbirth in an operational way. They worry because of a long recovery after surgical procedures, the presence of an ugly scar on the abdomen. Many mothers want to see the baby immediately after birth, and with general anesthesia this is impossible. But today you can take advantage of epidural or spinal anesthesia, in which the mother is fully conscious.

How does the operation

The anesthesiologist places respiration, pulse and pressure sensors, will monitor the process of anesthesia during cesarean. A Foley catheter is inserted into the bladder and the abdomen is treated. Special blinds are placed over the patient. An incision is made on the abdominal wall (either transverse or vertical). Then the surgeon spreads the muscle tissue, cuts the uterine wall, opens the bladder. The baby is removed, then the placenta, the uterus is sutured with self-absorbable sutures, then the suture is applied to the abdominal wall and closed with a sterile dressing.

To reduce blood loss and increase uterine contractions, ice is placed on the woman's belly. The duration of all surgical procedures is no more than 40 minutes, and the baby is removed after 10 minutes, and the remaining half an hour the child’s seat is removed, the stitches and dressing are performed.

Caesarean Danger and Possible Consequences

After the operation, it is possible to identify various complications.

Mom can also face a number of complications. For example, a frequent problem of women giving birth after cesarean is anemia, uterine infections, problems with intestinal motility, etc. A separate article is the adhesion process, which also often becomes a consequence of cesarean. Adhesions for a long time can not show any signs, but can lead to intestinal obstruction or blockage of the fallopian tubes, etc.

Postoperative rehabilitation

The first time after the operation, the woman is in the ICU, where her condition is monitored around the clock. When the action of the anesthetic drug stops, the patient is injected with anesthetic, drugs to normalize intestinal activity, as well as saline, replenishing fluid loss. The first hours the patient only lies, you can not get up. During this period, she experiences weakness and chills, pain in the abdomen, etc. You can drink some water with the addition of lemon.

Only after a 7-8 hour period after surgery can you sit down. When a woman ceases to experience dizziness, it will be possible to go to the toilet with the help of a nurse. The newborn during this period is in the neonatology department, only a few times the nannies bring his mother. A day later, a woman in labor is transferred to the postpartum ward, where she independently takes care of the baby. About three days after the operation, painkillers are discontinued.

The seam area after surgery is regularly treated with disinfectant solutions. After about 5-6 days, the woman in labor passes the necessary laboratory tests, ultrasound diagnostics of the suture, uterine body and neighboring structures. A woman is examined by a gynecologist on an armchair, and if there are no complications, then after a week mother and baby are discharged.

It will be possible to take a shower in a week or two after the operative delivery, and in the bathroom it will be possible to soak up only after a month and a half. For 8 weeks, sexual intimacy and any physical increased stress are strictly prohibited.

Dates, duration and progress of the operation

All pregnant women are afraid of childbirth. And even worse, if the birth will take place not in a natural way, but in Caesarean section. But so that it would not be so scary, let's see why they do a cesarean section, how long the operation usually takes, how long it takes and consider the entire course of the operation.

During the monitoring of pregnancy, the doctor gives a recommendation on how the birth should take place. If a woman has a normal pregnancy, then most likely the birth will take place naturally. If there are any abnormalities during the course of pregnancy or during childbirth itself, then doctors may decide to have a birth using cesarean section.

Distinguish emergency and planned cesarean section:

•   appointed during the course of pregnancy. In this case, the woman in labor prepares for the operation in advance, undergoes all the necessary examinations, and lays in the pathology department at a predetermined period of pregnancy. The most common indications for elective caesarean section are:
• premature placental abruption;
• hemolytic disease of the fetus;
• multiple pregnancy;
• severe gestosis;
• absolutely narrow basin;
• transverse position of the fetus, etc.
• Emergency Cesarean Section   carried out in case of unforeseen complications directly during childbirth, threatening 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 conduct 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 performed without her consent).

Optimal timing

Planned cesarean section is usually done on the 40th week of pregnancy. This is the optimal time for the operation - with a sufficient mass, the fetus is already considered full-term, and the baby's lungs are developed enough to allow him to breathe on his own.

With repeated cesarean section, the duration of the operation is shifted to a smaller side - it is done a couple of weeks earlier than the planned term of delivery, usually this is the 38th week of pregnancy.

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

Preparation for surgery

A woman in labor who has been prescribed a planned cesarean is usually referred to the hospital about a week before surgery. If a woman wants to stay home, then she can come to the hospital on the day the operation will be performed. But this is permissible only in the absence of severe complications and with good health of the mother and child.

Postoperative period

After surgery, painkillers are usually prescribed, since a woman experiences strong pain after a cesarean section. Also, depending on the condition of the woman, the doctor may prescribe various medications, for example, antibiotics, or supplements that improve the functioning of the gastrointestinal tract.

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

Food after the operation should be special - in the first day after cesarean section you can drink only ordinary water.

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

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

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