How do scheduled c sections work

C-Section (Cesarean Section): Procedure, Risks & Recovery

Overview

What is a C-section?

A C-section, also called a cesarean section or cesarean delivery, is a surgical procedure in which a baby is delivered through incisions in your abdomen and uterus. They're performed when a vaginal delivery is not possible or safe, or when the health of you or your baby is at risk.

When would I need a C-section?

You may need a C-section if you have certain medical conditions or if complications occur during labor in a vaginal delivery. A planned C-section happens when any of the following conditions exist:

Cephalopelvic disproportion (CPD): CPD is a term that means that your baby's head or body is too large to pass safely through your pelvis, or your pelvis is too small to deliver an average-sized baby.
Previous C-section: Although it’s possible to have a vaginal birth after a previous C-section, it’s not an option for everyone. Factors that can affect this include type of uterine incision used in the previous C-section and the risk of uterine rupture.
Expecting multiples: Although twins can often be delivered vaginally, two or more babies might require a C-section.
Placenta previa: In this condition, the placenta is attached too low in your uterus and blocks your baby's exit through your cervix.
Transverse lie: The baby is in a horizontal, or sideways, position in your uterus.
Breech presentation: In a breech presentation, your baby's feet- or bottom-first in your uterus. Some providers may attempt to turn your baby, but a C-section will be necessary if that's unsuccessful.
Health conditions: Conditions like heart disease could worsen with labor during a vaginal birth. A C-section is necessary if you have genital herpes at the time of delivery.
Obstruction: A large uterine fibroid, a pelvic fracture or you're expecting a baby with certain congenital anomalies may also be reasons for a C-section.

An unplanned C-section delivery might be necessary if any of the following conditions arise during your labor:

Labor isn't progressing: Also called prolonged labor, this means your cervix dilates and stops, doesn't efface (or thin) or your baby stops moving down the birth canal.
Umbilical cord compression: The umbilical cord is looped around your baby's neck or body or caught between your baby's head and your pelvis.
Umbilical cord prolapse: The umbilical cord comes out of your cervix before your baby does.
Placental abruption: The placenta separates from the wall of your uterus before your baby is born.
Fetal distress: Your baby might develop problems that cause an irregular heart rate during labor. Your obstetrician might decide that the baby can no longer tolerate labor and that a C-section is necessary.

How common are C-sections?

According to the Centers for Disease Control (CDC), C-sections account for about 30% of all deliveries in the United States.

Procedure Details

What can I expect before a C-section?

If you have a planned C-section, the following procedures will take place:

You'll sign consent forms for the procedure.
The anesthesiologist will discuss options for anesthesia. Most often, it's an epidural (or spinal block) that numbs you from your breasts down to your feet.
The hair in the area around the incision will be clipped or shaved.
A catheter will be inserted to keep your bladder empty.
You will have heart and blood pressure monitors applied.
You'll get an IV in your hand or arm to give you medicine and fluid.
You'll discuss the procedure and what to expect with your obstetrician (if you haven't already).

If you need an emergency C-section, your obstetrician delivers your baby quickly because either the health of you or your baby is at risk. However, there's typically not much time to prepare, and you may need general anesthesia because it works faster.

What actually happens during a C-section?

The first step in a C-section procedure is preparing you for anesthesia. Most planned C-sections use an epidural, so you are awake for the delivery. However, in some cases, you're asleep under general anesthesia.

Your abdomen will be cleaned with an antiseptic, and you might have an oxygen mask placed over your mouth and nose to increase oxygen to your baby. Next, your provider places a sterile drape around the incision site and over your legs and chest. Finally, your providers raise a sterile curtain or drape between your head and your lower body.

The obstetrician will then make an incision through your skin and into the wall of your abdomen. They might use either a vertical or transverse incision. A horizontal incision is also called a bikini incision.

Next, your provider cuts a 3- to 4-inch incision into the wall of your uterus. This incision can also be transverse or vertical. Finally, the obstetrician removes your baby through the incisions. The umbilical cord is cut, the placenta is removed and the incisions are closed with stitches and staples.

Emergency C-sections follow the same steps; however, the speed at which your baby is removed is different. During a planned C-section, the delivery takes about 10 to 15 minutes. Your provider removes your baby in only a few minutes in an emergency C-section.

If you're awake for your C-section surgery, you will be able to see and hold your baby shortly after it's born.

What does a C-section feel like?

You'll be under anesthesia, which should prevent you from feeling any pain. Most people report feeling a tug or pull when their baby is removed from their abdomen.

Are C-sections safe?

Vaginal births are usually preferred, but in some cases, a C-section is the only safe option. For example, a C-section is the safer option when your baby is breech or you have placenta previa (placenta covers part of the cervix). A C-section carries risks and benefits, which should be discussed with your pregnancy care provider.

How long does a C-section surgery take?

The typical C-section takes about 45 minutes from start to finish. After your provider delivers your baby, they'll stitch your uterus and close the incision in your abdomen. Different types of emergencies can arise during a delivery. In some cases, the delivery will happen very quickly, with your baby being delivered in as little as 15 minutes. This is an emergency C-section.

What happens after a C-section?

Like vaginal births, your obstetrician will deliver the placenta after your baby is born. Next, your provider will stitch your uterus and stitch or staple your abdominal muscles. Stitches should dissolve, but staples are removed at the hospital about one week later. Your abdomen will be sore for several days or weeks. In some cases, your provider may prescribe stronger pain medication.

You can expect to limit your activities, take it easy and rely on family and friends once you go home. A typical C-section surgery requires at least two to three days in the hospital.

Risks / Benefits

What are the benefits of a C-section?

The advantages of a C-section depend on your pregnancy. In most cases, the biggest benefit of a C-section is that it's safer for both you and your baby. When a vaginal birth is risky or could hurt your baby, most providers will turn to a C-section to minimize risks. Sometimes C-sections are unplanned. For example, if your baby's heart rate drops to an unsafe level, an emergency C-section is safer than letting your baby's heart rate decline further.

What are the risks involved in a C-section?

Like any surgery, a C-section involves some risks. The risks of complications are slightly higher with C-sections than with vaginal delivery. These might include:

Infection.
Loss of blood (hemorrhage).
A blood clot that may break off and enter your bloodstream (embolism).
Injury to the bowel or bladder.
A cut that might weaken the uterine wall.
Abnormalities of the placenta in future pregnancies.
Risks from general anesthesia.
Fetal injury.

Other disadvantages of having a C-section are:

Recovering from a C-section may be more difficult than a vaginal delivery.
C-sections are more likely to cause chronic pelvic pain.
You're more likely to have a C-section in future pregnancies.
Your baby may have trouble breastfeeding.
Your baby may be at greater risk for breathing problems.

Recovery and Outlook

How long does a C-section recovery take?

Once the anesthesia wears off, you’ll begin to feel the pain from the incisions. You might also experience gas pains and have trouble taking deep breaths. Make sure an adult is there to help you get up from bed the first several days following C-section surgery. Most people stay in the hospital between two and three days.

A full recovery can take between four and six weeks. Ask your healthcare provider what you can expect during recovery. Most providers recommend avoiding steps, lifting, exercise and other strenuous activities for several weeks. Ask your friends or partner for help with errands, cooking and cleaning so you can rest and recover. Your provider may put restrictions on driving until you're able to turn your body and apply pressure to the pedals with ease.

You can expect cramping and bleeding for up to six weeks, as well as some discomfort around the incision. Taking over-the-counter pain relievers such as acetaminophen or ibuprofen for pain may help. Avoid sex for at least six weeks or until your healthcare provider gives you the OK.

You will also have a vaginal discharge after the surgery due to the shedding of your uterine lining. The discharge, called lochia, will be red at first and then gradually change to yellow. Be sure to call your healthcare provider if you experience heavy bleeding or a foul odor from the vaginal discharge. Use sanitary pads, not tampons, until you're completely done bleeding.

Can I have a baby vaginally after a C-section?

The majority of people who had a C-section can consider a vaginal delivery in future pregnancies. If you meet the following criteria, your chances of vaginal birth after cesarean (VBAC) are significantly increased:

Your provider used a low transverse incision.
Your pelvis is not too small to accommodate an average-sized baby.
You're not expecting multiples.
Your first C-section was only performed because your baby was breech.

When to Call the Doctor

When should I see my healthcare provider?

If you have an infection at your C-section incision, contact your healthcare provider. Watch for signs of infection such as:

Red or swollen incision.
Pus or leaking discharge from the incision.
Fever or worsening pain.

Other signs of a problem include heavy bleeding or severe pelvic pain and cramping.

Additional Details

What is more painful: a C-section or natural birth?

The level of pain you experience during childbirth is unique. For example, if you opt for an unmedicated vaginal birth, you can expect more pain than someone who had an epidural before a vaginal birth. During a C-section delivery, you won't feel much pain. However, recovering from a C-section may be more painful and take longer than recovering from a natural birth. There isn't a right or wrong answer as to what is more painful because every birth is different.

How many C-sections can you have?

The number of C-sections you can have is unique to your medical history and pregnancy. An exact number hasn't been agreed on. The surgery may be slightly more complicated each time due to prior incisions or scarring.

A note from Cleveland Clinic

C-sections are often necessary for the health of you and your baby. If you know you're having a C-section, your obstetrician can walk you through the procedure and discuss the recovery process with you in advance. In the cases where a C-section is unexpected, you may end up feeling upset that your birth plan didn't go as expected. Just know that most providers prefer a vaginal delivery and that the decision to proceed with a C-section was made for you or your baby's wellbeing. The best thing you can do after a C-section delivery is rest and allow others to help you recover.

Elective caesarean birth: what to expect

About elective caesarean birth

A caesarean section is an operation to give birth to your baby. A caesarean section is also called a caesarean, a c-section or a caesar.

Sometimes health problems or pregnancy complications mean that a caesarean birth is a safer option than vaginal birth.

You might have a planned or elective caesarean birth for medical reasons or because there are signs late in your pregnancy that you or your baby might have problems with a vaginal birth.

If you feel worried or there’s something you want to know about caesarean birth, talk with your doctor or midwife before you go to hospital. You can also let them know beforehand about any special preferences you have for the birth so they can try their best to support you.

Before you go to hospital: getting ready for your elective caesarean

A caesarean can be done only if you give your written permission. Before your hospital admission, your doctor will explain the benefits, risks and complications of your elective caesarean. Then you’ll need to sign a consent form.

You’ll need to fast before an elective caesarean birth. This usually means having no food or drink, including water, for 6 hours before the surgery. The length of fasting before surgery varies from hospital to hospital, so make sure to ask your hospital about their fasting requirements.

Most hospitals give you a list of what to bring, like clothing for yourself and your baby. Before you leave home it’s a good idea to check that you have everything you need.

You might like to ask your support person to bring a camera or phone, but remember to check with hospital staff that it’s OK to take photos or videos of your baby being born. You’ll also need permission to take photos of hospital staff or equipment.

In the maternity ward before your elective caesarean

At hospital, you’ll usually be admitted to the maternity ward. You might have to arrive at the hospital very early in the morning.

Being pregnant and having an operation can increase your risk of developing blood clots. To help prevent this, you’ll be given compression stockings to wear during the surgery.

The top few centimetres of your pubic hair and your lower tummy might be clipped. This is so the area is clean and clear for the cut. It might also make it less likely you’ll get an infection.

Before you have a caesarean section, medical staff will want to talk with you about whether you have any health problems, allergies, and bleeding or bruising problems and whether you take any medications.

Caesarean section surgery usually takes 30-60 minutes. But the entire process can take a few hours, from going to the operating theatre, preparing for surgery, having the surgery, and then returning to your room in the maternity ward.

In the operating theatre: anaesthetics and other preparations

You’ll be taken to an operating theatre for your elective caesarean. Your theatre team will prepare you for surgery, which can take some time.

You’ll be prepared for your anaesthetic so that you don’t feel any pain during the surgery. A spinal anaesthetic is most common for planned caesarean births. An epidural is more likely to be used for an unplanned (emergency) caesarean birth.

With spinal anaesthetic and epidurals, you’re awake and can breathe normally.

You might have a general anaesthetic if you can’t have a spinal or epidural anaesthetic. You might also have a general anaesthetic if your baby needs to be born very quickly. In this case, you’ll be asleep during your baby’s birth.

You’ll have a small plastic tube inserted in the back of your hand or the crook of your elbow for your fluid drip.

Your tummy will be cleaned with antiseptic by the theatre team and covered with sterile cloths to lessen the chance of infection. A plastic tube (a catheter) will be put into your urethra (where urine comes out) to keep your bladder empty.

Operating theatres can be quite cold, so ask for some extra blankets if you feel cold.

It’s normal to feel anxious and sometimes teary as you go into surgery.

During preparation and surgery, you can probably have a support person with you, unless you need a general anaesthetic or there are serious medical problems. Your support person can sit next to you, hold your hand and be there to welcome your baby.

Your caesarean section operation

There’ll be many people in the operating theatre with you, including the obstetrician, an assistant surgeon, an anaesthetist, theatre nurses, a midwife and sometimes a paediatrician. Each person in the room has an important role in keeping you and your baby safe.

You’ll have a drape or curtain over your chest area so that you and your support person can’t see the surgery.

Once the anaesthetic is working properly, the doctor will make cuts in your tummy and your uterus. Both cuts will be about 10 cm long.

Your baby will be lifted out through the cuts. You might feel a tugging or pulling sensation, but there won’t be any pain. Sometimes the doctor might use forceps to help with lifting out your baby’s head. If everything is OK, you can ask the doctor to hold your baby up so you can get a first look.

The umbilical cord will be cut and your placenta removed. Then the doctors or midwives will check your baby very carefully.

Your doctor will recommend an injection or medicine through an intravenous drip to make your uterus contract and to reduce bleeding. You’ll be given antibiotics through your drip to reduce the risk of infection.

The doctor will stitch the layers of the uterus, muscle, fat and skin in your tummy back together and put a dressing over your wound.

Early skin-to-skin contact helps your baby to stay warm and feel secure. It also lets you and baby bond physically and helps with breastfeeding. If everything is OK with your baby, it’s good to have skin-to-skin contact as soon as possible. You should be able to have it in the operating theatre. If you can’t, your support person will probably be able to hold your baby instead.

After your caesarean birth

Midwives and nurses will look after you in the recovery room until you’re ready to go back to the maternity ward. You’ll most likely have your baby stay with you. You can ask a midwife to go with you to the recovery room to help you breastfeed your baby. If the medical staff are worried about your health or your baby’s, this might not be possible at first.

After a general anaesthetic, the midwife or nurses will look after you in the recovery room until you wake up. Once you’re awake and stable you should be able to see your baby.

It’s normal to feel pain and discomfort after a caesarean, especially when you move. Let the midwives know how you’re feeling. It’s best to keep on top of pain, because this will help you recover faster.

The midwives will regularly check your blood pressure, your wound and how much vaginal bleeding you have. You’ll probably have a drip and a urinary catheter for the first 12-24 hours. After the first 12 hours, a midwife will help you get up so that you can shower.

Getting up and moving around as soon as possible after the surgery will help reduce your risk of blood clots. And you might be asked to keep wearing compression stockings or be fitted with another compression device over your lower legs to reduce your risk. Some birthing mothers are also given daily injections of blood thinning medicine.

Breastfeeding after caesarean

Breastmilk is the best possible food to help your baby grow healthy and strong.

After a caesarean, starting to breastfeed can take a while. It’s a good idea to ask for support from midwives and a lactation consultant, if the hospital has one. The midwives can help you find the most comfortable ways to hold your baby while breastfeeding.

The sooner you start with breastfeeding, the easier it is for you and your baby. The hospital should help you breastfeed as soon as possible after birth. This is usually in the recovery room but sometimes you can do this in the operating theatre.

It’s good to ask for practical help, especially in the first 6 weeks after caesarean. For example, you can ask friends to help with housework or with driving your other children while you recover.

what will work in the next seven days? / News of the Society of Krasnoyarsk and the Krasnoyarsk Territory / Newslab.Ru

Krasnoyarsk, together with all of Russia, is on the verge of an unscheduled week-long vacation. The reason is not the most joyful and there are not so many options to spend this week having fun. Newslab has prepared for you a complete list of open and closed institutions and companies for the coming week. What you can afford in these 7 days - read in the material.

Newslab alerts : The coming week of holidays is not organized for recreation and entertainment, but to reduce the need for the population to move. It is best if you spend this time at home. You should not go out anywhere without unnecessary necessity, especially in crowded places. Stay at home and ask your family and friends about the same. It is very important!

Locking yourself up at home with a cat is the best plan for the week

The most important thing is to understand that this is not someone's stupid whim, but a purposeful plan of the authorities to combat the spread of coronavirus infection. From March 28 to April 5, by order of Governor Alexander Uss , all public catering (except for food delivery), all retail outlets, with the exception of pharmacies, stores with food and non-food essentials, as well as gas stations, will be closed. Beauty salons, swimming pools, fitness centers, SPA centers and other institutions providing services in the beauty and leisure industry will stop working. In general, for a week you will have to say goodbye to "Planet", "June" and other favorite shopping centers.

But don't worry too much - you can always buy food, medicine, go to the hospital in case of urgent need.

This is exactly what will work:

HOSPITALS. Krasnoyarsk hospitals will work in emergency mode. Planned visits have been cancelled. It’s the same with dentistry — it will be possible to visit a doctor only in an emergency with acute pain.

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In all medical institutions of the region, scheduled appointments and appointments for consultations of non-emergency patients are suspended. At the polyclinic, it will be possible to call a doctor at home on a first-come, first-served basis, both for adults and children.

The Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare will provide emergency medical care to children and pregnant women of a high risk group for medical reasons. Elective surgeries will be performed on patients who cannot be postponed for medical reasons. For other patients, the appointment will be postponed to a later date. The resuscitation and advisory center will operate as usual.

In the regional hospital, from March 30, face-to-face consultation of patients in the polyclinic is temporarily suspended and transferred to remote consultation mode. The attending physicians at the place of residence will notify the results of the remote consultation. If necessary, the patient will still be referred for an in-person consultation.

These measures are necessary to minimize the contacts of citizens, maintain quarantine measures to counteract the spread of coronavirus infection.

PHARMACIES. Pharmacies will work during the holidays according to the usual schedule.

BANKS. By order of the President, all banks must work as usual on schedule.

STORES. Only those that sell food products and (or) non-food essentials (masks, antiseptics, wipes, soap, paste, washing powder and other household goods) will work.

PENSION AND INSURANCE FUND. These organizations will also continue their work in accordance with the decree. All organizations providing the payment of pensions, as well as other social benefits to citizens, will be available. The same applies to all insurance companies.

POST OFFICES. From March 30 to April 1 inclusive, post offices of the Russian Post will not be available for customers to visit. Those wishing to receive or send parcels or written correspondence are offered to use the delivery service. Delivery of pensions and benefits will be ensured on time.

PUBLIC TRANSPORT. Buses, as previously reported, will run according to a changed schedule. There are several duty routes ( No. 2, 7, 9, 12, 19, 49, 52, 53, 55, 80, 83, 85, 87, 91 and trolleybus route No. 7) , which will carry Krasnoyarsk residents until late, the rest will go on the last flight 21:00. By the way, all week in the city it will be possible to drive along dedicated lines with impunity.

ORTHODOX CHURCHES. Temples will be open to visitors, nothing is said about changing services.

Will work partially:

NATIONAL PARK "KRASNOYARSKIE PILLARS". Only nature will be open at Pillars. Absolutely all infrastructure facilities - toilets, service centers, shopping pavilions and bases - will be closed until April 5.

GREAT MANE. There are no restrictions on walking yet. You can walk along the paths of the ecopark without problems, but it is important to remember that visitor centers and toilets will be closed.

REGISTRY OFFICES. Anyone planning to get married on vacation (or use other services) was advised to postpone the procedure to a later date. For those who refused, they provided a limit on the number of people at the ceremony - NO MORE THAN 10 . The remaining procedures are recommended to be issued through the State Services.

Will definitely be closed:

This is what the perfect couple looks like in the next week

SHOPPING AND ENTERTAINMENT CENTERS. In accordance with the decree of the governor, shopping and entertainment centers must suspend work. Only grocery stores, pharmacies and places where essential goods are sold can trade.

CHILDREN'S CENTERS. All game rooms, children's centers, sections and circles will be locked up next week.

CAFE AND RESTAURANTS. Cafes and restaurants will also be closed. The exception is the delivery of ready meals, there are no restrictions here. If you are planning to order food home, check out the contactless delivery that many establishments are now resorting to. It is enough to pay for the order online and pick it up at the door, and not from the hands of the courier.

FITNESS CENTERS. Krasnoyarsk residents are unlikely to be able to go in for sports in the usual way. Most of the fitness centers are closed, Excellent, Pool&Gym, Balance, DaVinci Club, Colosseum announced the voluntary termination of classes. The same is with the pools - most of them went into voluntary quarantine. However, some still worked, despite the danger. For example, the WorldClass network club canceled only group and children's classes, leaving the gym, swimming pool, martial arts hall, etc. open. In any case, from March 28, all of them must go into quarantine until April 5, it is forbidden for centers to accept clients.

CINEMAS. Movie theaters were supposed to close, but the official orders did not work on them immediately. Only the Epicenter and the Cinema House voluntarily closed. Again, from March 28 to April 5, their work falls under the ban, according to the decree of the governor.

HAIRDRESSERS AND BEAUTY SALONS Hairdressers, beauty salons, spas, massage parlors and similar establishments must also close until April 5th.

KINDERGARTEN AND SCHOOLS . Schoolchildren are still on vacation, but from April 1 they will switch to distance learning. Kindergartens "kept on" until the last minute, but they will also be closed next week.

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"BEaver LOG". Funpark is closed for visitors from March 28 to April 6 inclusive. Absolutely all facilities will be closed - the Oasis service center, cable cars, ski slopes, the Master of the Taiga restaurant, the Husky cafe-bar, etc. Tourists who came from the side of the forests of the tourist trails "Stolbov", will NOT be able to use the chairlift to go down.

ROEV Stream. The Krasnoyarsk Flora and Fauna Park was decided to be closed for an indefinite period on March 24th.

THEATERS, MUSEUMS, CONCERT HALLS, LIBRARIES. All cultural institutions have been closed for more than a week. Most have switched to online - you can watch performances, attend excursions and look at exhibits on the Internet. Concerts of visiting stars are either canceled or rescheduled. Follow it in the Newslab poster.

In general, as you already understood, it is best to spend the next seven days at home. Nobody forbids walking - the main thing is to keep a distance of 1.5-2 meters from passers-by and avoid crowded places. The main thing now is to stop the spread of a dangerous virus! And the best cure for it (before the invention of the vaccine) was and remains social isolation - after all, all these corona holidays were invented for its sake.

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Against the backdrop of an increase in the incidence of COVID-19 and record mortality, Rospotrebnadzor canceled mass events in Russia. Other quarantine measures are also introduced and tightened in the regions

Photo: Maxim Shipenkov / EPA / TASS

Mass events across Russia have been canceled due to the pandemic, said Anna Popova, head of Rospotrebnadzor. Moscow Region Governor Andrey Vorobyov asked Prime Minister Mikhail Mishustin to include coronavirus vaccination in the national vaccination schedule.

In addition, more and more regions are introducing QR codes for vaccinated and recovered patients and are turning to the idea of mandatory vaccination of certain categories of citizens. Read in the materials of RBC, where QR codes are already operating, and which subjects introduced mandatory vaccination of some citizens this fall.

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From October 4, the region decided to increase the number of seats that can be occupied in the auditoriums and stands (by how much was not specified). If the visitor has a medical exemption from vaccination, they will need a negative PCR test done within 72 hours before the event. Children's playrooms and centers will also stop working in the Perm Territory until further notice.

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Since September 29, food courts have been banned in the region (except for those that work for delivery, are located at train stations and at the airport, another exception is catering points at gas stations), the occupancy of halls in cafes, restaurants, buffets, bars, eateries and other catering establishments (but the hall can be filled even more if all visitors have QR codes or negative PCR tests). Shopping centers and public catering were obliged to check the temperature of visitors at the entrance.

From October 1, minors are prohibited from visiting shopping centers unaccompanied by adults, circles and sections in schools work with small groups (no more than ten people). All new restrictions will be in effect until December 1.

Governor Dmitry Azarov instructed to strengthen control over the mask regime in public places, primarily in transport and shopping centers.

Sports (if there are more than 50 participants and organizers) and leisure activities in the field of culture have been suspended in the region. The requirement does not apply to theaters, philharmonics, concert halls, if the audience takes only seated places in compliance with social distance, and the occupancy of the hall does not exceed 50% of the total capacity.
An exception was made for events organized by organizations with additional educational programs in the field of physical culture and sports, sports organizations for children and adults, sports and recreation centers, fitness centers with individual and group training.
The requirement also does not apply to matches of the Baltika football club (no more than 1,000 spectators in the stands) and the Lokomotiv-Kaliningrad Region volleyball club (no more than 500 spectators in the stands).
The region has suspended the work of attractions, since October 5, children's entertainment centers and children's playrooms have been closed, and persons over 65 years of age have been obliged to observe self-isolation.

In the region, mass indoor events with more than 100 people present at the same time have been limited.

Since September 27, concerts, entertainment and other events outside of cultural organizations have been banned in the region. From the same day, food courts were limited in shopping centers (they work only for delivery), children's playrooms were closed; in state institutions, pregnant women were transferred to a remote location.
Restrictions were in effect until October 10th. Saratov schools and additional education organizations went on a two-week vacation (from September 27 to October 11), and planned hospitalization was suspended in hospitals.

Since September 28, the region has suspended leisure, entertainment, entertainment, cultural, physical education, sports, exhibition, educational and promotional mass events that spectators can attend. Such events can no longer be held in shopping centers, restaurants, other catering outlets and other crowded places.

How the number of new cases of Covid-19 infection in Russia is changing

Source: federal and regional headquarters for combating coronavirus

Data for Russia i

indoor activities.

In the region, the number of participants in physical culture and sports events was limited to 500 people. From September 27, the holding of such events with the number of participants exceeding the limit must be agreed with the regional department of Rospotrebnadzor. In the Tyumen region, personal receptions with officials were also suspended until October 24.

From September 20, social institutions with 24-hour accommodation, such as nursing homes, can only be visited by close relatives of the wards. Meetings with vaccinated, recovered COVID-19 visitors or those who have a negative PCR test should take place outdoors or in a separate room, during which you need to wear masks and gloves.

Educational organizations of the region have banned mass events, including cultural, sports, etc. , since September 28. All sports events, including matches of professional clubs, will be held without spectators. Children over 14 years old will be able to participate in outdoor competitions, and over 16 years old will be able to participate in indoor competitions.
Classes in circles and sections in educational organizations were recommended to be transferred to a remote format. Group classes in children's schools of arts, art and music-choirs, as well as in schools of folk crafts will also be held remotely, individual classes - in person.

From October 11 in theaters, cinemas, circuses and concert halls, no more than 50% of seats can be filled, while there should be no more than 500 spectators. The same restriction applies to sports, physical culture, entertainment and cultural events.
The requirements may be relaxed (70% of the seats will be allowed to fill) if all employees related to the event are vaccinated against coronavirus (except for the lack of vaccination according to the medical requirement confirmed by a certificate), adults (over 18 years old) are allowed to the event using QR codes for vaccinated or recovered, organizers of events in cinemas, theaters, etc. warn the operational headquarters about the event seven days before its start, and the organizers of mass sports, cultural, entertainment events - one month before the date of the event.
Hotels and hostels in Tatarstan should only be 50% full, if all employees are vaccinated against the coronavirus, except for those who cannot do so due to a medical requirement.
Persons over 65 years of age who have not been vaccinated against COVID-19 or have not been ill in the last six months will be required to observe a self-isolation regime.

Since October 9, the region has banned sports events with spectators. From the same day until October 22, inclusive, the work of concert halls and venues, fairs, retail markets for non-food products was suspended.
Since October 11, people over 65 years of age have been obliged to observe the self-isolation regime (the requirement does not apply to those who have been vaccinated against the coronavirus and those who have recovered from COVID-19). From October 12, employers must also telecommute parents of students in grades 1-4. From the same day, schoolchildren of all grades will be transferred to distance learning. For how long is not yet known.

Starting October 4, employers were required to telecommute at least 30% of employees, including those over 65 and employees with chronic illnesses.
In medical organizations, preventive examinations and medical examinations have been suspended (an exception was made for in-depth medical examinations after COVID-19, medical examinations for children, as well as for vaccination in accordance with the national vaccination schedule and vaccination according to epidemic indications).
Until November 1, institutions of additional education for children will not work in the region, except for those that organize distance and individual classes.

From October 6 to October 31, restaurants and cafes will be able to work at night (from 0:00 to 6:00) only for delivery.
Employers must telecommute at least 30% of workers, including those who have not been vaccinated against COVID-19.
From October 6, local governments can transfer middle and high school students (from sixth to eighth grade, as well as tenth graders) to distance learning based on the sanitary and epidemiological situation.
Only those vaccinated against coronavirus will now be allowed to work with children, with a negative PCR test for COVID-19or with a certificate of the presence of antibodies to the virus.

Since October 11, people over 65 years of age have been obliged to observe the self-isolation regime (except for those who have been vaccinated and have been ill). They can go for walks, visit the nearest shops and pharmacies from 8:00 to 11:00.
Cultural and entertainment events have been banned in the region, and medical examinations have also been suspended. In-depth examinations of those who have recovered from COVID-19 are still allowed.

All public events have been cancelled.
Employers were advised to transfer employees over 65 to remote work.
Autumn holidays in the region will start ahead of schedule - from October 18 to November 8. Only those vaccinated will be allowed to work with children, with a certificate of illness and a negative PCR test (valid for no more than seven days).
In kindergartens and educational institutions banned matinees with the participation of parents. Circles and sections have suspended work in full-time mode, but classes can be held remotely. An exception was also made for professional athletes, but in order to attend classes they need to be vaccinated against the coronavirus, get a negative PCR test, or have a certificate of illness in their hands.

In the Medvezhyegorsk, Loukhsky, Muezersky and Kalevalsky districts, as well as in Kostomuksha, sports, entertainment, public and other mass events have been suspended until October 25.
Children under 14 years of age can only be in shopping centers with adults.
Until October 25, social service hospitals will not work in the region.

The region has banned banquets in public catering organizations, with the exception of family holidays and commemorations, where there are no more than 30 people.
Cultural, entertainment, sports and other events, including in cinemas, theaters, cultural and leisure institutions, can only be held if all participants and guests are tested for the coronavirus antigen on the day of the event at the expense of the organization. At the same time, no more than 50% of the seats can be filled in the halls and in the stands.
People aged 65 years and over, as well as at risk groups and pregnant women, should be transferred to a remote location if they are not vaccinated or have no antibodies to coronavirus.

How the incidence of COVID-19 has changed over the past month

Since August 8, the maximum increase in new cases per day in Moscow and St. Petersburg was recorded on September 17 — 2537 and 1738 infected, respectively. Daily indicators in these cities did not update the record for more than a month. The next day, September 18, 2746 cases were registered in Moscow per day, and in St. Petersburg a new maximum was recorded on September 19 - 1834 infected. The mayor of the capital, Sergei Sobyanin, explained the increase in the incidence in the city by the beginning of the school year and the return of residents from vacations.

All-Russian morbidity rates in early September were at the level recorded by the operational headquarters at the end of June. On September 16, more than 19.5 thousand cases were registered in Russia for the first time since August 29. The daily record in the country was updated for two days in a row (19.9 thousand infected on September 17, 20.3 thousand on September 18), and then the incidence, according to the headquarters, began to decline (20.1 thousand cases on September 19, 19 7 thousand - on the 20th).

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