When is a caesarean section necessary? The most comprehensive knowledge on caesarean section

Comparing the recovery speed of natural birth and cesarean section, theoretically natural birth will be faster, because cesarean section requires surgery and will leave scars on the belly. Cesarean section and natural birth are both healthy ways of delivery. No matter which one you choose, the health of the baby and the mother should be the top priority. Choose the method that suits you and listen to the doctor's advice. If mothers still have questions about cesarean section, you can read the comprehensive introduction to cesarean section below.

Everyone knows that mothers who give birth naturally will not have scars on their bellies, and they will recover faster after delivery. But don’t believe that “babies born by caesarean section have big heads and are not smart”, and don’t be kidnapped by pseudo-scientific moral claims such as “everyone can give birth naturally” and “only mothers who give birth naturally are great”. Not all mothers’ bodies are suitable for natural births, and “only mothers who give birth naturally are smart” has no scientific basis at all. The choice of natural birth or caesarean section should be based on the mother’s reproductive conditions and your own wishes. After all, in the hearts of those who love you, your own safety is the most important!! In order to reduce the psychological burden of expectant mothers and choose the method that suits them, this issue of the righteous editor will take a deep look at caesarean section, from how to choose, prenatal preparation, surgical process to postpartum care, and sort out all the conditions of natural birth to caesarean section, so that expectant mothers can enter the delivery room with ease!

*A. Pregnant women

1. The pelvis is narrow or the birth canal is blocked, and the fetus cannot pass through. In fact, many petite mothers may encounter this problem when they are pregnant with fat babies.

2. Placenta previa and early placental abruption. In this case, it is difficult to give birth naturally and heavy bleeding during delivery is likely to occur.

3. First child born at an advanced age of over 35 years old

4. The delivery process is very slow or stagnant, or even problems occur during the process, such as threatened uterine rupture, maternal failure, etc.

5. The mother’s reproductive tract is infected

6. Scarred uterus, history of cesarean section, myomectomy or uterine rupture.

7. Adverse obstetric history, such as the last delivery was assisted by forceps.

*B. Fetal

1. The fetal heart rate is continuously <120 times or >160 times, and the fetal heart rate monitoring indicates fetal hypoxia and amniotic fluid contamination.

2. Macrosomia: The estimated fetal weight is more than 8 catties, and the biparietal diameter on ultrasound is too large.

3. The fetus is less than 36 weeks and weighs less than 5 pounds and cannot withstand vaginal delivery.

4. Malposition of the fetus

5. Multiple births

6. Umbilical cord prolapse

Generally speaking, narrow pelvis, malposition of the fetus, and overly large baby are the more common reasons. Among them, "malposition of the fetus" is a problem that many expectant mothers should pay special attention to.

Expectant mothers should have a prenatal check-up every 2 weeks in the late pregnancy (after 28 weeks of pregnancy), and the fetal position is the focus of the check-up.

1. Normal fetal position

Normally, the fetus is head down in the uterus.

There are four categories:

2. Fetal position requiring cesarean section

Malposition of the fetus generally refers to the abnormal position of the fetus in the uterus after 30 weeks of pregnancy. Abdominal wall relaxation or excessive amniotic fluid may also lead to malposition of the fetus.

▶Types of head presentation – head up or head tilted back

Although some fetuses are also head-down, the baby's head is not flexed, but stretched back or the occipital bone is at the back (head up or tilted back), which is considered an abnormal fetal position.

▶Types of buttocks/leg presentation

The breech position is the most common, and the transverse position is the most dangerous.

Abnormal fetal position will bring different degrees of difficulty and danger to delivery. Placenta previa will block the passage of fetal delivery, and placental abruption will seriously affect the supply of oxygen and nutrition to the fetus. Therefore, when encountering such a situation during delivery, cesarean section is generally chosen.

→Tips: In fact, when the fetal position is abnormal at 30-34 weeks, it needs to be corrected. Correcting the fetal position is of great significance in preventing dystocia. Mom tried to adjust it at home through the "knee-chest lying position exercise".

▶Empty your bladder and loosen your belt.

▶Lie on a hard bed, push up with your knees on the bed, hips raised high, thighs perpendicular to the bed, and chest as close to the bed as possible.

▶Do it once a day, morning and evening, for 15 minutes each time, for one week. Then go to the hospital for a follow-up check.

But if you haven't adjusted by 36 weeks (9 months), there are risks in having a natural birth, so only a caesarean section is safe for the mother and baby!

1. Go to the hospital immediately if you experience any signs of labor.

When labor pains occur, go to the hospital immediately. If the fetus has already entered the birth canal, it will be difficult to perform a caesarean section. Mothers who have given birth before should pay special attention to this.

Many mothers who have chosen cesarean section in advance choose to schedule a cesarean section with the doctor before they have any labor symptoms. This is completely ok~

2. Pay attention to rest and fast before surgery.

The night before the operation, you should get enough sleep and avoid excessive tension and anxiety. When waiting for delivery, you can relax by listening to music, reading books, and communicating with the expectant father or other pregnant women. Eat easily digestible food. Generally, you should fast for 6 to 8 hours before the operation and avoid drinking water for 4 hours.

3. Be admitted to the hospital at least one day before the operation.

The hospitalization time for cesarean section preparation is determined by the doctor based on the fetal condition. The patient should be hospitalized the day before the operation as agreed. The abdomen, vulva and umbilical fossa should be cleaned. Before the operation, vital signs should be measured and the fetal heart rate should be listened to. A fetal heart rate of 120 to 160 beats/min is normal.

4. Before the operation, the nurse will make the following preparations for the mother. Please cooperate well and don't be nervous.

Take 2-3 ml of venous blood for blood matching when blood transfusion is needed during surgery;

Use a razor to shave the hair on the abdomen, waist, etc.;

Intramuscular injection of anti-bleeding injection

Placement of urinary catheter

Initial disinfection of abdominal skin

5. Then just lie on your side and wait.

After entering the operation, mommy can rest assured to leave it to the doctor. However, there are always questions about "anesthesia" and "horizontal and vertical incision" in caesarean section surgery from expectant mothers. Here is a popular science article~

1. Anesthesia – local or systemic?

In emergency situations, general anesthesia helps to speed up the operation and reduce the occurrence of unexpected situations. In non-emergency situations, regional anesthesia is generally the first choice for surgery.

At present, the most commonly used anesthesia method in hospitals is epidural anesthesia (local anesthesia); the anesthesiologist usually gently inserts an epidural tube between the 3rd and 4th lumbar vertebrae. The drug is slowly released through the tube, and the expectant mother remains awake, but the pain disappears. The benefits of this anesthesia method are very obvious, and the anesthesia tube can be retained after surgery. After surgery, it can be retained for 24 hours with the help of a pain pump, which effectively relieves postoperative pain.

2. Open the uterus - horizontal or vertical?

The doctor will feel the lower part of the uterus to determine the position of the fetal head and then start the cesarean section. A horizontal incision is more suitable for normal maternal physical conditions, while a vertical incision is more conducive to special and emergency treatment during delivery.

*a: transverse incision

When a doctor performs a cesarean section, he or she makes a small, horizontal incision above the woman's pubic hair line, also called a "bikini incision."

→Advantages of cross-cutting

▶As the name suggests, the "bikini incision" is very small and low, mostly below the edge of the underwear, and not easy to be noticed. Many beauty-conscious mothers insist on natural childbirth because they don't want to leave scars. It's okay to wear a bikini with a transverse incision scar! If the scar is well repaired after delivery, it will be too light to be seen. It's scary!

▶You can choose natural delivery for the second pregnancy. The risk of uterine rupture is less than 1%, which is super safe~

▶The wound follows the growth direction of the skin texture, which is conducive to suturing and postoperative healing, and it is also more comfortable when holding the baby for feeding.

×Disadvantages of cross-cutting

▶The operation is time-consuming and requires high anesthesia, so it is more suitable to make an appointment with the doctor in advance before the operation.

▶The incision is small, and the field of view exposed during the operation is limited. In special and emergency situations, extensive exploration is not possible. (However, as long as the mother is well checked in advance, there will be basically no problem if she is in good health.)

*b: vertical incision

When doctors perform a cesarean section, they make a vertical incision along the midline of the abdomen, from the mons pubis to the navel.

→Advantages of vertical incision

▶ Rapid suturing, good surgical field of view, and the incision can be extended according to the situation, which is conducive to the rapid removal of the fetus and is suitable for the treatment of special circumstances and emergencies.

▶The operation time is short and the anesthesia is simple.

Disadvantages of vertical incision

▶Most people will develop very thick scars after surgery, which are traditionally known as "centipede scars", and recovery is also relatively slow.

▶When giving birth again, you cannot have a natural birth as there is a risk of uterine rupture.

1. Wound care

*1. Supplement nutrition and eat properly before delivery, do not eat or drink excessively, and gain weight scientifically

The natural lines of the skin on the lower abdomen are horizontal, so the tension on a transverse incision is small, and the scar will look better after suturing; the tension on a vertical incision is large, and the scar will naturally be uglier than a transverse incision.

However, if you eat a lot during pregnancy and become overweight and have a thick fat layer, it will not be easy to make a cross-section, and the wound will be particularly large, so the scar will naturally be large and ugly.

*2. People with scar-prone constitutions should communicate with doctors in advance so that more appropriate techniques and products can be used during the operation.

The price will definitely be higher, but for those with scar-prone constitutions, even minor injuries will leave a mark. The scar from a caesarean section will definitely be more exaggerated, and it makes me shudder just thinking about it, so be sure to consult a doctor before the operation.

*3. Eat more fresh fruits, vegetables, eggs, milk and other foods rich in vitamin C, E and essential amino acids

This can promote blood circulation and improve the metabolic function of the epidermis. It is also conducive to wound healing and reduces the formation of scars. Eat less or no irritating foods such as peppers, onions, garlic, etc. to prevent itching and aggravation of scars.

*4. Prepare products that help wound repair, inhibit scar growth and reduce scars

Part B: Avoid scarring minefields

▶1. Avoid strenuous activities before and after stitches are removed. When sleeping at night, it is best to rest in a side-lying position with the body slightly bent to reduce tension on the abdominal wall.

▶2. It is common sense not to let your belly touch water before the scabs fall off completely. So try to sweat less and stay in an air-conditioned room in summer.

▶3. Do not remove the scab on the incision too early! The scab needs to mature and fall off naturally. Pulling it off artificially may irritate the wound, cause itching, and form pigmentation.

▶4. Be careful when itching scars. Don't scratch them! You can apply some topical medications, such as dexamethasone, to relieve itching. Don't scratch them! Otherwise, it will irritate the skin, causing hyperplasia and tingling to become more severe.

▶5. Don’t forget to protect your skin from the sun! The stimulation of ultraviolet rays will not only cause itching in the repairing wound, affecting the recovery speed, but will also directly lead to pigmentation!

▶6. Don't use water that is too hot when taking a bath! Hot water will also irritate the recovering skin and aggravate the itching. On the contrary, if you feel that the scar is stinging and itchy, you can apply cold compresses~

Part C: Reliable "anti-scar" tips

1. Compression therapy

→After the stitches are removed, you can press cosmetic tape or silicone sheets onto the healing wound to reduce the force pulling the wound outward and make the scar flatter and thinner.

2. Massage therapy

→After the scab falls off, rub the scar with the base of your palm to soften hard scars and improve scars that tend to bulge or contract.

*TIPS:

Some mothers apply ginger, scallion, L-vitamin C, pearl powder, etc. to the wound after the scab falls off, saying that it can reduce pigmentation. Shubaobao recommends not to trust these "beauty methods" because the tender flesh of the wound is actually very fragile and easily irritated by many ingredients. If mothers must use them, they should also ask the doctor in advance.

2. Postoperative body care

*Within 6 hours after delivery

▶Lying posture: Mothers who return to the ward after surgery need to lie flat with their heads tilted to one side and without a pillow.

▶Breastfeeding in time: The baby's sucking can promote uterine contraction, reduce bleeding, and make the wound heal as soon as possible.

▶Fasting: You should fast within 6 hours after surgery. This is because surgery irritates the intestines, slows down intestinal motility, and causes gas accumulation in the intestinal cavity, which can cause abdominal distension after surgery.

*First day after delivery (after 6 hours)

▶Lying posture: You can use a pillow after lying flat for 6 hours. It is best to lie on your side. You can put a quilt or blanket behind your back to reduce pain when moving your body.

▶Pain relief methods: After the anesthetic wears off, you will feel pain in the abdominal wound. You can ask your doctor to prescribe some prescription drugs or use a pain pump to relieve the pain.

▶Eating: 6 hours after caesarean section, you can drink some gas-releasing soup, such as carrot soup, to replenish the body's water. Add special full nutrition powder for caesarean section to replenish lost protein as soon as possible and promote wound healing and milk secretion.

Attention! Foods that are easily fermented and produce a lot of gas, such as sugars, beans, and starchy foods, should be eaten less or not to prevent the bloating from becoming more severe.

▶Move as soon as possible: After 12 hours, the mother can change her position, turn over, and move her legs with the help of her family or nurses. After 24 hours, she should practice turning over, sitting up, and getting out of bed and moving slowly. If conditions permit, she should also walk on the ground. Exercise can promote blood circulation, make wounds heal faster, enhance gastrointestinal motility, and exhaust gas as soon as possible. It can also prevent intestinal adhesion and thrombosis from causing embolism in other parts.

*First week after delivery

▶Drink plenty of water: Within three to five days after delivery, the mother's body is still very weak and may feel constipated and swollen. This is caused by anesthesia, so she needs to drink plenty of water.

▶Defecation in time: After cesarean section, due to the pain, the abdomen dare not exert force, and the urine and feces cannot be discharged in time, which can easily cause urine retention and constipation. Therefore, it is even more important to follow a normal schedule and defecate in time.

▶Eating:

a. After the mother passes gas, her diet can be changed to semi-liquid food, which is nutritious and easy to digest.

b. You can drink confinement soup such as pigeon soup and black fish soup 72 hours after the operation. It can not only help the body function recovery but also help milk production. Remember to remove the floating oil on the surface after boiling.

c. Do not add any irritating seasonings within one week, such as: pepper, fennel, onion, garlic, ginger, etc.

3. Resuming exercise after cesarean section:

On the 20th day of the confinement period, I started to practice Pilates formally. My physical test data in the first class was very bad. All mothers will have these problems. Mothers who have given birth can check it out by themselves. Rectus abdominis separation (it is easy to accumulate fat and grow a big belly in the future), pelvic floor muscle relaxation (some relaxation is not serious, but most of them will still affect life), pelvic enlargement (mommy taste is caused by big buttocks), rib eversion, uterine prolapse, and breast sagging caused by late breastfeeding. My rectus abdominis separation is three fingers, which is very serious. I saw a mother on Xiaohongshu saying that rectus abdominis separation can basically not heal. I want to say that my rectus abdominis has recovered now, and the widest place is only half a finger. Whether the belly can be restored to firmness depends on whether the rectus abdominis can be restored.

The method to check the rectus abdominis is: lie flat on the bed, take a deep breath and slowly raise your upper body, then touch the linea alba above and below the navel, and press your fingers into it. Three fingers is more serious, which is what I was like at the time. Many mothers don't know about rectus abdominis separation, and think that a loose abdomen can be tightened again by sit-ups, which actually aggravates the separation.

Rectus abdominis recovery method: 1. Take a deep breath and let your belly bulge; exhale slowly, feeling the deep muscles tighten layer by layer, and pull the ribs back. Do it 15-20 times a day, 3 sets. When you can't feel it at first, you can push your abdomen inward with your hands. 2. Four-point support, inhale and relax your belly, exhale and pull your abdomen back with force, as if there is a belt tightening your belly. Another one is the plank support, you can practice the movements with keep.

The recovery of the pelvis is also very important. The most important part of girlishness is the buttocks. Next time I will write a special method for retracting the pelvis.

This is how I look like 68 days after giving birth. I am still far from being satisfied with my figure. Keep working hard. I will continue to update when my abs appear.

This bed is called Reformer. Victoria's Secret Angels use it for training. Sun Li also loves Reformer. Of course, there are also professional equipment such as Kick Bucket and Cadillac. However, one Reformer is enough for the fairies to spin and jump for a year.

I took a new measurement yesterday. The thickest part of my waist is 8cm smaller than after giving birth. My pelvis is completely retracted. I tried on a pair of tight jeans I wore before pregnancy and they were stress-free. The circumference of all parts of my body is smaller, but I have only lost one kilogram. My trainer told me that I will lose a lot of weight in a month. Anyway, my whole body is tighter now and I am taller than before. I am looking forward to the sense of accomplishment when I lose weight in a month.

In fact, many expectant mothers want to give birth naturally at first, but they may encounter some problems before or during delivery. For the safety of themselves and their babies, they need to switch to a caesarean section. In fact, there are many mothers who suffer from "two sins"~

☀If any of the four factors of childbirth, namely the birth canal, fetus, uterine contraction, and maternal condition, is problematic, the fetus must be removed by cesarean section immediately. Common situations include:

1) Labor is proceeding very slowly.

2) After the onset of labor, the fetal position is abnormal and the fetal head does not come down.

3) Fetal distress or abnormal bleeding occurs.

4) Umbilical cord compression or umbilical cord prolapse occurs.

5) Failure of forceps or suction cup assisted delivery.

6) Maternal complications of gestational hypertension or diabetes.

7) Older pregnant women have cardiovascular diseases.

8) If the amniotic fluid becomes turbid for the second time, a caesarean section should be performed immediately to prevent fetal hypoxia and suffocation.

Q: How long after a caesarean section can I have sex?

A: 42 days after delivery, both mother and baby should undergo a comprehensive checkup. If the postpartum checkup is normal, you can resume a sweet and innocent sex life. However, you must take precautions to prevent pregnancy.

Q: How long does it take to reproduce after a caesarean section?

A: Generally, you need to wait 2 years before you can get pregnant again, so that you don’t get sick. Getting pregnant again too soon may be dangerous.

Q: What should I do if the incision pain after cesarean section occurs?

A: The wound from a cesarean section will generally heal in about two weeks and the pain will disappear. If pain or redness and swelling persist for a long time, you should go to the hospital for a check-up to rule out abdominal adhesion or infection.

Q: Will a caesarean section affect the quality of my sex life?

A: Absolutely not.

Q: How soon can I take a shower after a caesarean section?

A: Generally speaking, you can take a shower one week after a caesarean section in summer and two weeks in winter. The specific time depends on the recovery of your own wound. If the wound has not recovered yet, showering may cause the wound to become infected.

Q: How long does it take for menstruation to occur after giving birth?

A: The recovery of menstruation after childbirth varies from person to person. Some may have their period resume one month after childbirth, while others may have their period resume one or one and a half years after childbirth. Furthermore, the menstruation after childbirth may become irregular due to the body's hormonal adjustments.

Q: How long does it take for the lochia to be cleared after delivery?

A: Generally speaking, lochia can be discharged within three weeks after delivery. If it continues to discharge after three weeks, it is called "retained lochia" and you need to see a doctor.