What are the reasons for choosing a caesarean section?

There are eight main reasons why pregnant women choose cesarean section, including inability to bear the pain, malposition of the fetus, multiple births, delayed labor, heavy bleeding during delivery, high fever, etc.

Director Lin Peiying of the hospital's obstetrics and gynecology department will tell you under what circumstances will a caesarean section be scheduled in advance or converted to a caesarean section halfway through labor? Let's take a look.

Reason 1: Abnormal fetal position

How high is the chance of a caesarean section for an abnormal fetal position? Director Lin Peiying emphasized that for expectant mothers with an abnormal fetal position, the chance of a caesarean section is as high as 99%. Regardless of whether the fetus is in a horizontal position or a sitting position in the mother's belly, most of the time an appointment for a caesarean section is required.

Reason 2: Multiple births

Most expectant mothers who are pregnant with twins or more have problems with malposition of the fetus, so they often need a caesarean section.

Reason 3: Delayed labor

If the natural delivery process is not smooth, such as the cervix does not progress or the fetal head cannot come down, and after a certain medically recognized time point for cesarean section, it will be changed to cesarean section.

Reason 4: Placenta previa

If the expectant mother has placenta previa, when the cervix opens, the placenta will be pulled and cause heavy bleeding, which will put the mother and baby's life in danger. Director Lin Peiying explained that when the expectant mother has placenta previa, caesarean section will be the main option and will be arranged before 37 weeks of full term, which is earlier than the normal caesarean section time.

Reason 5: Heavy bleeding during labor

There are many reasons for sudden heavy bleeding during labor, such as placental abruption, unstable vital signs, or the baby's heartbeat drops for some reason. At this time, the situation of mother and baby is unsafe and the delivery will be performed by emergency cesarean section.

Reason 6: Sudden high fever during labor

Director Lin Peiying emphasized that if a woman suddenly develops a high fever during delivery, even though the mother is making good progress and has received antibiotics, it is impossible to wait too long for fear of increased risk of infection with meningitis or pneumonia. The patient may be observed for a while, but if the labor does not progress, a caesarean section will still be performed.

Reason 7: Designating an auspicious day

Designating an auspicious day and time for delivery is also one of the reasons why many expectant mothers choose caesarean section.

Reason 8: The mother cannot bear the pain of natural childbirth

Theoretically, the pain of a natural birth will be greater, but the recovery will be faster, while the opposite is true for a caesarean section.

Director Lin Peiying said that if the expectant mother's fetus is in an abnormal position, the probability of the fetus turning normal after 32 weeks of pregnancy is usually less than 3%, so the hospital will usually take a general ultrasound and check the fetal position at 32 weeks. If the fetal position is normal, the hospital can explain the knowledge of delivery to the mother and arrange a visit to the delivery room. When the expectant mother's fetus is in an abnormal position, the hospital will communicate with the expectant mother and make an appointment for a caesarean section between 32 and 34 weeks. The operation will usually be arranged after 37 weeks of full term, and most commonly between 38 and 39 weeks, because the jaundice index of babies born at 37 weeks is higher than that of babies born at 38 weeks on average, and statistically the number of hospital stays and costs are higher. Caesarean section is more ideal during this period.

After deciding on the time for a cesarean section, you should make 7 preparations before the operation actually begins.

Preparation 1: Psychological adjustment

Director Lin Peiying emphasized that we should first understand why a caesarean section is necessary. Some mothers may want to give birth naturally, and the psychological adjustment of the mother is an important preparation before the operation.

Preparation 2: Stay in the hospital the day before surgery

Lai Yanjun, chief of the hospital's anesthesiology department, said that regular caesarean sections should be hospitalized the day before the operation, and a pre-anesthesia self-assessment form must be filled out, including personal medical history, surgery history, allergy history, and prenatal check-up status, etc. At the same time, blood tests, electrocardiograms, fetal heart sounds, and placental examinations are performed. The anesthesiologist will conduct an anesthesia risk assessment based on whether the blood values ​​of hemoglobin and coagulation function are normal, as well as the self-assessment form, and explain the anesthesia method and steps to the mother during the ward visit.

Preparation 3: Fast for 8 hours

Qiu Murong, head nurse of the hospital's delivery room, explained that the anesthesia method for caesarean section is mostly semi-anaesthesia, and the patient must fast for 8 hours before the operation, and is prohibited from eating any food or drinking any boiled water to avoid vomiting during the anesthesia operation and causing aspiration pneumonia.

Preparation 4: Remove nail polish

In addition, if the mother has applied nail polish or undergone phototherapy, the nursing staff will remove it first. If hypoxia occurs during the operation, the nail color will be checked. A blood oxygen concentration detector will also be clipped on the finger during the operation, and it cannot be detected if there is nail polish.

Preparation 5: Enema before surgery

A few hours before the operation, the nursing staff will give the mother an enema. Director Lin Peiying said that enema can help expel gas and feces from the rectum.

Preparation 6: Take a shower and change into surgical gowns before surgery

To prevent infection before surgery, mothers will be asked to use a bathing agent with antiseptic and cleansing effects to reduce the amount of bacteria on their skin. After taking a bath, they will change into surgical gowns without underwear.

Preparation 7: Get an IV and remove your jewelry

Before leaving for the delivery room, the nurse will give her an IV drip. Qiu Murong pointed out that all jewelry, watches, hairpins, contact lenses, and removable dentures on the parturient must be removed because an electrocautery scalpel will be used during the operation, which may cause electrical conduction.

Preparation 8: Check the information at the delivery room nursing station

After the mother arrives at the delivery room, the nursing station staff will check her information with her and confirm again whether she has any special internal or external diseases or allergies. She will then enter the operating room to prepare.

The main surgical method is intraperitoneal cesarean section

Director Lin Peiying said that when it comes to cesarean sections, the main method is intraperitoneal. There are two ways to make incisions. The first and most common one is "low cesarean section", which is to make an incision above the cervix and make an incision similar to "open smile". The second is to make a straight incision in the middle of the belly. This is mostly used when the fetus is small, premature, or there are problems with fibroids and placenta previa. Because the uterus is too small and the cervix is ​​not wide enough, it must be cut straight from the middle to allow the baby to be born. In what cases will an extraperitoneal cesarean section be performed? Director Lin Peiying believes that extraperitoneal cesarean sections were more common decades ago when prophylactic antibiotics were not administered during surgery. It was mainly to reduce intraperitoneal infections, but since antibiotics were administered before surgery, they have gradually been used less.