Caesarean section delivery: What you need to know before the cut

Caesarean section (C-section) is the commonest surgical operation performed worldwide.

The aim of C-section is for safe delivery of the baby and mother. There are many reasons why this procedure is performed. Broadly, these are divided into elective and emergency.

An elective C-section refers to a planned surgery and is categorised into four groups depending on the urgency of the surgery. Some people erroneously think that an elective C-section is one that is performed on request by the woman.

This is not always the case since there are many situations where it is known beforehand that vaginal delivery would be dangerous.

Such dangers include an abnormally implanted placenta, previous multiple C- sections, or other surgeries on the womb such as fibroid removal, extremely big babies and congenital anomalies such as hydrocephalus among others. In these cases, the attending doctors will advise on the timing of the delivery, usually between 38 to 39 weeks. The reason for this is to prevent any eventuality of the women going into labour, a situation that could necessitate an emergency C-section with associated attending risks.

Emergency C-section on the other hand is performed if in the assessment of the attending doctor, it is felt that continuing with either labour or pregnancy could be dangerous to the health of either the mother or the foetus. Some of the indications include distress of the baby, prolonged labour, failure of the cervix to open up, abnormal bleeding in pregnancy and prolapse of the umbilical cord among others.

Unless otherwise indicated, a C-section should always be performed under spinal anaesthesia. This numbs the lower part of the body and the woman doesn’t feel pain as the surgery is undertaken.

C-section is also associated with risks to both mother and child. Some of the risks include excessive bleeding, injury to other organs such as bladder and gut, infection, prolonged pain post surgery and increased risk of forming clots within the blood vessels, which could be lethal.

The long-term risks include persistent scar pain, scarring of the abdomen making subsequent surgeries more dangerous, limit on the number of pregnancies, risk of placenta sticking to the womb which in itself is a life threating condition and higher risk of low implantation of placenta in subsequent pregnancies.

Babies born through C-section are at increased risk of breathing problems, compared to those born vaginally.