Usually, the prospect of a caesarean section (CS) scares women in labor. Nevertheless, the CS allows a woman to know in advance the exact date and time of the birth of the child and to carry out the birth as planned, without any excesses and unpredictable moments. However, many women are interested in why the gynecologist decides that delivery by caesarean section is necessary, and how the optimal time is determined, whether a planned caesarean section will not be harmful to the mother and child.
What is a caesarean section?
Caesarean section is an operation in which the baby is removed from the uterine cavity through an incision in the abdominal wall. CS can be performed as planned, when the woman in labor and doctors know in advance about the operation, and urgently, if for some reason the woman cannot give birth on her own for a long time, and this begins to threaten her he alth and life.
What can be a caesarean
Most often, doctors write in the patient's card not a detailed wording of the referral, but an abbreviation. Therefore, there are often situations when women find out already in the maternity hospital that there will be not a natural birth, but a planned caesarean section, and everything will happen in the coming days. Therefore, it is worth remembering the abbreviations: COP - caesarean section, the prefix "E" to the abbreviation means emergency, the prefix "P" - planned.
The difference between EKS and PKS
Since a pacemaker cannot be planned, an experienced gynecologist in late pregnancy may suggest that such an outcome of pregnancy is also possible, but the chance of giving birth on her own is still or higher than expected, then the direction will say that a pacemaker is possible.
If a planned caesarean section is supposed, then this will be indicated in the referral, the reasons leading to such a decision will also be indicated, the referral itself will be issued on a specific date. In addition, some referrals are not issued to a specific maternity hospital, but with an open “place”, so that a woman in labor can independently choose the hospital where she will give birth, having previously met with obstetricians and anesthesiologists, and sometimes with specialized doctors, such as cardiologists or traumatologists.
The difference between a pacemaker and a PCS can sometimes be seen in how the incision is made. If the birth is very difficult, there are some serious problems, then the doctors do not reflect on the aesthetic appearance of the incision. Accordingly, it can take place anywhere in the abdomen, where itconvenient and as safe as possible. With PKD, the incision usually passes barely above the pubis and is most often hardly noticeable to strangers even without the use of cosmetic sutures.
Elective caesarean section is also safer for future pregnancies and deliveries. Emergency CS, on the contrary, is less safe for women's he alth. After a pacemaker, a planned caesarean section is almost always scheduled for subsequent births to avoid uterine ruptures and other complications.
Indications for caesarean section
There are not always indications for such operations. But it happens that a woman herself is afraid to give birth, then the expectant mother herself informs the doctors about her desire. Closer to the date when a planned caesarean section is scheduled, careful preparation is required.
Besides personal factors, there are other reasons directly or indirectly related to he alth. Thus, in the presence of immunodeficiency diseases, cancer, diabetes mellitus, diseases associated with the heart and blood vessels, and in any other diseases that affect the functioning of internal organs, as well as severe edema associated with pregnancy, PCS will be prescribed, and the possibilities A woman will not give birth on her own. Of course, unless the woman in labor hides her illnesses and puts her life and the life of the child at risk.
An elective caesarean section will also be performed if there are bone problems before or during pregnancy. A common cause of PCS is severe separation of the symphysis (symphysitis).
Possible indicationsorgans that are not sufficiently prepared for the time of childbirth, for example, an insufficiently opened uterus with already departed waters, can serve. Then the doctors decide to administer oxytocin, but if it does not help, an EX is performed.
When do EKS
EX is done if the pregnancy proceeded normally, the woman in labor is he althy, the fetus too, but there are circumstances that can lead to injuries and other bad consequences. In this case, the operation is carried out for a period of 38-42 weeks.
Usually, ECS is performed if during childbirth the child in the womb began to choke or there were obvious problems with the blood flow in the fetus or mother. In such situations, the COP may be at a period of 36 weeks or earlier. Also, an emergency delivery passes if the water has already broken for several hours, and the uterus has not opened enough for the baby to pass. Most often, such situations occur on terms from 36 to 40 weeks.
There are also cases when the baby just gets stuck in the birth canal. This happens if the fetal head is too large. In this case, doctors are also forced to resort to a pacemaker to eliminate the risks.
Less often, ECS is used when the pregnancy is overdue, when more than 42 weeks have passed since the beginning of the last critical days, as well as when the fetus is not positioned correctly, for example, with frontal insertion of the fetal head.
How long do PCS
It is impossible to say unequivocally at what time a planned caesarean is donecross-section, since the terms of pregnancy for each woman are different. The difficulty in determining the correct term lies in the fact that pregnancy lasts 38-42 obstetric weeks. However, they do not show the actual age of the fetus. If we are talking about natural fertilization, the actual terms may differ from the obstetric ones up to 4 weeks, and this is quite a long time. At the same time, the doctor needs to know how mature the child is, whether his life support systems are working, and even an ultrasound scan will definitely not be able to show this.
Partly due to the above reason, a planned cesarean section is scheduled at 39 weeks and later, if there are no additional indications, which include circumstances that affect the he alth of the woman in labor with a longer pregnancy. That is, for some types of diabetes, a CS is prescribed as early as 36 obstetric weeks, and sometimes even earlier, since it is more profitable for doctors not to risk the life of a woman in labor and a child, removing an already overwhelming burden from a woman’s he alth and shifting it to devices for further and better development a child, thus doctors save many lives.
There are no defined boundaries. When is a planned caesarean section performed? Increasingly, doctors are looking at the underlying circumstances and how the child might be formed. But such conditions only work in the case of natural fertilization.
At the same time, if the insemination was artificial, then even from the moment of IVF, doctors will know the timing of the planned caesarean section, if the operationthere will be a need.
How often can I have PCS
How often can a planned caesarean section be performed and for how long? Can be done multiple times. But you need to remember that CS is an operation on the uterus, the incision from which, of course, heals, but the scar remains. Thus, every second planned caesarean section is another scar on the uterus, which means that after two or three operations, the flexibility and strength of tissues is significantly reduced, there is a risk of premature birth, ruptures and many other problems.
Due to the consequences associated with uterine wear, doctors try to resort to CS as little as possible, unless there is any special indication for this. Also, the practice is becoming more and more widespread when, after PCS, obstetricians try to give birth to a woman in a natural way, and only if the attempt is not justified, they perform an ECS.
There should be at least a year between CS and re-pregnancy. However, it is not uncommon for women to become pregnant within the first six months after a planned caesarean section. The second birth is again a surgical intervention. The CS is repeated again in a year and a half after the first operation, which negatively affects the he alth of the woman in labor.
How to prepare for PKS
Before you start preparing, you need to find out from the gynecologist how long a planned caesarean section is done in a particular case, when a referral will be issued, and follow the doctor’s decision in subsequent actions.
After the gynecologist decides on the indications and the term, he canrecommend the most suitable maternity hospital or give a referral to a specialized maternity hospital, if there is evidence. Usually, if a woman in labor has immunodeficiency diseases, she is sent to give birth in specialized institutions.
After getting a referral, a woman can either wait to go to the hospital, or go to meet obstetricians and anesthesiologists. The second approach is considered the most comfortable, since a few weeks before the CS, the woman in labor will be told and shown everything, if there are concerns, she can visit other institutions, as well as go to a psychologist. This will reduce the stress of the upcoming operation.
How does PCS work
Depending on whether the planned caesarean section and for how long, the complexity of the operation for the child and his mother will depend. Within the standard framework, namely at 38-40 weeks of gestation, PCD resolves quickly and without fear for the woman in labor.
During the operation, an incision is made in the abdominal wall and uterus, the baby is taken out, the umbilical cord is cut, the placenta is removed. After that, the tissues are sutured.
But if the PCS was scheduled for one date, but for some reason the birth began before the CS and there were complications, then the operation will take longer. It will be associated with other procedures or operations to preserve he alth and life. But such a combination of circumstances is incredibly rare, and all because doctors refer women to the hospital one to two weeks before PCS.
Operation duration
It is the operation that lasts from 20 to 40 minutes, butpreparation and subsequent manipulations go beyond this time period. The preparation includes the introduction of anesthesia, disinfection of the place being prepared for the operation, connection of the necessary equipment.
After the operation, the woman may be conscious, or may be under anesthesia. It also has its own nuances. The time of withdrawal from anesthesia is different for each person, while anesthesiologists do not always prefer serious medications, and then during the CS the woman in labor is conscious, although she does not feel pain. In this case, there is no need to withdraw from anesthesia.
Also often the operation ends with a "refrigerator", then the woman is taken from the birth to a room where the temperature is constantly maintained at a low temperature. This is done to exclude possible bleeding. A woman can spend several hours in the "refrigerator".
Recovery from PCS
If the doctors performed the CS on time, correctly stitched, removed the placenta and did not leave blood clots, then partial recovery after cesarean takes place within two weeks, during which time the woman can already stop experiencing pain and discomfort from the suture, start without problems and outside help to raise the child in his arms. Within three months, the seam is already completely overgrown, respectively, the discomfort associated with the seam and stiffness of movements disappear, problems with the stool disappear.
Psychological state after CS can also change as well as physiological. Therefore, women after surgery are advised to take helppsychologist.
