Caesarean Delivery

Caesarean delivery is a surgical procedure performed with the mother awake under a spinal (or ‘epidural’) anaesthetic or on some rare occasions with the mother asleep under a general anaesthetic. The procedure involves making a low horizontal cut on the abdomen at the top of the pubic hairline and then delivering the baby and the placenta through this incision.

REASONS FOR A PLANNED CAESAREAN DELIVERY

You may choose to have a caesarean for your own reasons—this is called a “caesarean section for maternal request”.

 

Medical and obstetric reasons for planning to deliver by caesarean section include:

 

  • You have previously had a caesarean delivery or other surgery in which the uterus was cut open; a vaginal delivery is possible after caesarean delivery in some, but not all cases.
  • There is an obstruction that prevents or complicates vaginal delivery, such as large fibroids or a pelvic fracture.
  • The infant is unusually large (especially if you have diabetes).
  • You have an active infection that could be transmitted to the infant during vaginal delivery.
  • The birth involves twins, triplets, or more.
  • You have cervical cancer.
  • The baby has an increased risk of bleeding.
  • The placenta covers the cervix (placenta praevia).
  • Other procedures, such as tying the tubes, can be done at the same time.

 

You can discuss these options with your doctor during your prenatal visits.

REASONS FOR AN EMERGENCY CAESAREAN DELIVERY

Sometimes, despite the best-laid plans, it may be necessary to initiate an emergency caesarean delivery. Adelaide Obstetrics & Fertility’s doctors are very experienced in identifying these circumstances and will discuss your options with you and your partner or support person so that you are completely aware of the situation.

 

Circumstances under which an emergency caesarean will tend to be performed include:

 

  • Labour is not progressing as it should—either contractions are too weak, the baby is too big, the pelvis is too small, or the baby is in an abnormal position. In many cases, the mother will be given a medication called Syntocinon to be sure that contractions are adequate. If labour still does not progress after several hours, caesarean delivery may be recommended.
  • The baby’s heart rate is dropping and the baby is not coping with contractions.
  • The baby is in a transverse (sideways) or breech (buttocks or legs first) position when labour starts—a caesarian delivery is a safer option in these circumstances.
  • Heavy vaginal bleeding—this can occur if the placenta separates from the uterus before the baby is delivered (placental abruption).
  • A medical emergency threatens the life of the mother or baby.

WHAT TO EXPECT

If the baby is going to be delivered by a planned or elective caesarean section, we will ask you to have a blood test so that we can accurately cross-match your blood in the unlikely event of you needing a blood transfusion.

 

You will typically be admitted to the ward a couple of hours before your caesarean section time. While your baby is usually born close to the planned time of your operation, elective cases can be delayed by unexpected emergencies elsewhere within the hospital.

 

If you have a caesarean section, you can usually give your baby a cuddle and kiss within a few moments of being born. Your baby doesn’t need to leave your sight and your partner or support person can stay with you throughout the delivery.

 

Once your baby has been checked over by a paediatrician attending the delivery, you can hold your baby on your chest while the operation is completed. As soon as you are in recovery, you can breastfeed your baby.

 

Following a caesarean, you typically stay in hospital care for about five nights. Providing you and your baby are doing well; you should be able to spend the rest of your recovery time at home.

 

Remember—an Adelaide Obstetrics & Fertility obstetrician is always on call, with another obstetrician backing them up.

 

If you have any concerns about the health of your baby or your delivery, please call Adelaide Obstetrics & Fertility (between 9.00 am and 5.00 pm Monday to Friday) on 08 8272 7755 or (outside of our office hours) Ashford Hospital Delivery Suite on 08 8375 5237.