How is a caesarean delivery done

The caesarean section: you absolutely have to know that

The caesarean section - Caesarean section from Latin caesarean section "cut"And Caesarea"imperial”Is derived from the Roman writer Pliny. Caesar was already cut from the womb. In March 2021, the Federal Statistical Office published the caesarean section figures for 2019. Compared to the previous year, the rate increased from 29.1 to 29.6%. In 2011 the rate was 32.1% (the highest Caesarean section rate). In 1991 it was still 15.3% (the lowest number in German hospitals). Currently every third delivery in the hospital takes place by caesarean section.

Reasons for a caesarean section

The reasons for a caesarean section are as different as the babies themselves. Some caesarean sections have to be performed from a medical point of view, while others are so-called desired caesarean sections. As part of obstetrics, many doctors and midwives choose to have a caesarean section when it comes to one Birth arrest comes or the Baby's heart sounds worsen. The increased risk of Birth defects lets doctors do one for problematic pregnancies, for example because your baby has a very large head circumference Premature birth threaten or the CTG shows suspicious values, tend to have a caesarean section.

High birth weight

Another reason for the high number of caesarean sections is the ever increasing number Birth weights of children in industrialized countries. Gestational diabetes also increases the risk of natural birth. In terms of liability, a doctor must bring a woman with him diabetes and an estimated child weight of more than 4,000 grams about the possibility of a caesarean section to avoid complications. These explanations, albeit legally completely correct, lead to fears of a natural birth in the pregnant woman.

Caesarean anesthesia procedure

Regardless of the reason a woman decided to have a caesarean section, the surgical procedure is always almost the same. In the case of a caesarean section, the baby is Abdominal incision taken from the pregnant woman's womb. This cut is made across the top of yours Pubic hairline. Of course you will get one before the procedure anesthesia.

The form of anesthesia, however, depends on various factors:

  • What is your mental and / or physical condition
  • Do you have coagulation disorders?
  • Do you have an obstetric emergency?

Caesarean anesthesia: spinal anesthesia

Depending on the situation and your constitution, your doctor will decide on an anesthetic procedure. Many doctors prefer regional anesthesia (spinal anesthesia). Your doctor will pierce your area with a very thin needle Lumbar spine. With a certain technique, he then gets into a space that is filled with brain water, so-called liquor. Your doctor will then apply the anesthesia here. But don't worry, that sounds a lot worse than it actually is.

The advantage This caesarean anesthetic means that you do not sleep and that you experience the birth “live”. In addition, you will be spared a long waking up from general anesthesia. Certain previous illnesses (heart defects, coagulation disorders, severe spinal deformities) and an obstetric emergency (emergency cesarean section) prohibit regional anesthesia and general anesthesia is necessary.

Caesarean anesthesia: epidural anesthesia (PDA)

Epidural anesthesia - also known as a PDA - works according to a similar procedure to spinal anesthesia. Here, too, the lower part of your body is injected into the Lumbar region stunned. Your doctor will insert the syringe exactly where the nerves that feed your legs, stomach, and uterus are. So that your doctor can repeatedly inject anesthetics during the procedure, a very thin tube remains.

However, there is a slightly higher risk of infection through this tube. So your doctor is more likely to use spinal anesthesia for a planned caesarean section. The PDA is also used in natural births for pain relief.

Caesarean anesthesia: general anesthesia

If you have a Emergency caesarean section must be done, your doctor will, in most cases, choose one general anesthetic decide. Here you get access to a veinwho ensures that you are in a Deep sleep expires. So you won't notice anything about the actual procedure. Some women find this to be a major disadvantage.

It can also be caused by general anesthesia Complications come because you have to be intubated. This means that a tube will be inserted into your throat so that you can breathe better. If you've eaten and drunk beforehand (which is usually the case), stomach contents can get into the lungs. Your doctor will assess these complications beforehand and will therefore take extra care of you.

This is how the caesarean section is performed

The process of a caesarean birth is basically always the same, but a distinction is made between two different types.

Primary & secondary caesarean section

A primary caesarean section is determined as part of the birth planning. This often means that you are looking for a so-called "Desired cesarean section”Decided. One speaks of a desired caesarean section when there is no medical need for an imperial birth. Many women state that they are afraid of pain or fear of losing control and therefore decide to have a cesarean section of their choice. The date for the operation is set a few weeks in advance.

It does not have to be that you have decided to have a caesarean section yourself. Sometimes there are complications during pregnancy that mean that you cannot give birth naturally. These include, for example:

  • Your child is not in breech position
  • Mortal danger for you and / or your baby
  • You have certain serious illnesses (brook wall defects)
  • Suspicion of a disproportion between maternal pelvis and child size (very large children> 4200g)

Of a secondary cesarean section one speaks when the birth has already begun with labor and / or rupture of the bladder. Then a caesarean section is advised during the birth process (e.g. in the event of a birth arrest).

Preparation for the operation

If it is a planned caesarean section, you will come to the hospital one day before the procedure. The anesthetist will examine you thoroughly and explain all the risks to you again. Of course, your baby will also be examined again. Your doctor will talk to you about the anesthetic method. So you already know exactly what to expect before the procedure.

Education in the context of an emergency caesarean section
If you have to have an emergency caesarean section, you will also be informed about all risks and complications as far as the situation allows. Everything happens a little faster, because quick action is often required.

Shave the upper pubic area

Before you get into the operating room, your superior must Pubic area shaved become. That serves to make possible Germ sources to reduce. If you have a planned caesarean section, you can do this preparatory step at home. The doctors will also put a catheter into your bladder so that your bladder does not fill with urine during the procedure. In addition, of course - as with any other operation - you have to do everything Take off jewelry. If you have prostheses, these must also be taken off. You exchange your everyday clothes for Surgical shirtwho have favourited socks against Thrombosis stockings. So that you don't feel sick or vomit, you will get a so-called Citrate solution to drink.

That happens in the operating room

If you have a Spinal or epidural anesthesia occurs, the corresponding area on your back will be anesthetized locally. So you should hardly feel anything from the actual prick. If you are given general anesthesia, you will be given access beforehand. In the operating room that will be Anesthetics injected. The operating table is tilted slightly to minimize the pressure on the vena cava. But nothing can happen to you, because you have already been secured well beforehand.

Now yours will be Disinfected abdomen. However, you don't feel any more of that. A sterile surgical drape is stretched so that you have no view of the procedure. If your condition and the hospital allow, the future may now Papa in the operating room. He too will not notice much from the caesarean section. He is only allowed to stand at the head end and is actually responsible for calming you down. With general anesthesia, your partner is not allowed to go into the operating room, but has to wait in front of the door. As soon as your little darling has seen the light of day and everything is in order, dad can take over.

The engagement

Once all the preparations have been completed, the actual intervention takes place. Your doctor will place an approximately six inches long horizontally above the pubic hairline cut do. Before doing this, it will be checked again whether the anesthesia is working properly and you definitely don't feel anything. Regarding the cut, the following applies: If everything heals well, the scar will be in the so-called “bikini zone”. Then you will not see them at all in the summer while bathing and sunbathing. Now the doctor cuts through the layers of the Abdominal wall Bit by bit. The same thing happens with your abs. The bladder is pushed aside.

Subsequently opens the doctor yours uterus to bring your baby into the world. In this context, doctors say that the baby is “developing”. Some women say that the opening of the uterus can be felt in the form of pressure.

Your baby is here!

When your baby is born away Your doctor nor those Membranes and the placenta. It may also widen the neck of your uterus a little. So your weekly flow can then flow off better. The actual procedure only takes about 30 minutes. The longest part of the caesarean section is that Sewing.

Misgav-Ladach method: the “gentle” caesarean section

The Misgav-Ladach method is also called "gentlerCaesarean section" designated. Your doctor tries to cut as little as possible. Your muscles and tissues are hand-picked by your doctor pushed aside, very stretched or torn. That sounds anything but gentle, but with this method you lose less blood, the injuries are not as severe and the scars heal faster. The duration of the operation is shortened to around 30 minutes, including the suturing of the incisions.

Caesarean section risks

The caesarean section is a surgical procedure, which is always certain Risks and Complications can bring with it. More common complications include:

  • Injury to neighboring organs
  • Tissue injuries
  • Blood loss due to increased bleeding
  • Wound healing disorders
  • Increased risk of thrombosis
  • Intolerance to anesthetics

These complications can have different consequences:

  • Adjustment disorders in the newborn (breathing problems, lack of oxygen)
  • The regression of the uterus may be delayed
  • Scar endometriosis
  • Risk of a ruptured uterus in a subsequent pregnancy
  • Adhesion of the mother cake in a subsequent pregnancy
  • Breastfeeding problems due to delayed milk entry and pain when breastfeeding through the surgical wound
  • Iron deficiency due to increased blood loss
  • increased risk of diabetes, allergies and other autoimmune diseases in cesarean section children.

Effects on later pregnancies

Despite all caution, a caesarean section can have an impact on your later pregnancies and births. During the caesarean section, your uterus will be opened with a scalpel. This cut has to heal later, of course, and this creates scars. These Scarring can increase certain risks for a subsequent pregnancy. While it happens very rarely, it is possible that your uterus at another birth ripsthat is called then Uterine rupture.

It can also happen that during your next pregnancy your placenta will grow to the lower part of the uterus and thus the natural part Obstructed birth path (Planzenta praevia). These risks are increased if you become pregnant again very soon after the caesarean section. However, a one-time caesarean section does not mean that you can only bring your other children into the world by caesarean section!

Bonding after the caesarean section

Especially during a caesarean section, it is a very nice experience for parents-to-be to hear their baby's first cry. Your midwife will be there for the caesarean section. She speaks calmly to you and takes the baby from your doctor. If the newborn is doing well, it can even be shown to the new parents. A first tender Touching and caressing is possible. However, your doctor will decide whether you can hug your baby immediately or whether you need full care first.

Have trust in midwives and doctors, after all, we all want beautiful births with healthy children!

The topic of caesarean section in the video with midwife Anna-Maria

Our texts on health topics are in no way a substitute for a doctor's visit.
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