How long does emergency c section take

Why They're Needed and What to Expect

Congratulations, you’re expecting! This exciting time includes a lot of changes for you, as well as planning for the arrival of your baby and the not-so-distant future. It can also mean lots of anxiety and trying to make your birth plan just right.

Sometimes we plan, and the universe gently smiles. For many reasons, your birth plan may change — sometimes in regards to its smaller details, and other times in regards to its bigger ones, including how you want to give birth.

Whether your plans are for a vaginal birth or scheduled cesarean delivery (also called a C-section), both of these options will be off the table if you need an emergency C-section.

Don’t worry. You and your baby are in expert hands. Although almost 32 percent of births in the United States occur by C-section, you’re less likely to need an emergency C-section, which only happens when it’s the safest option for you and your baby.

An emergency C-section is one that happens very quickly due to immediate concern for the health of the mother and/or baby. The goal is that no more than 30 minutes pass between the decision to perform an emergency C-section and delivery, but it can take up to 75 minutes.

Any kind of C-section is a major surgery that requires a room full of healthcare professionals and a great deal of organizing. This means that when a patient needs an emergency C-section, a lot of doctors and nurses have to get ready faster than normal.

You can end up having an emergency C-section even if you already had a scheduled, planned, or even unplanned C-section in the works. All of these are sometimes called medical C-sections, as they happen for health reasons. In comparison, an elective C-section is one that you choose to have.

What’s the difference between the types of C-sections?

• Scheduled C-section. This is when you and your doctor decide that it’s safest for you and your baby to deliver via C-section, potentially because you’ve had a C-section before. Your doctor will schedule a C-section date around your estimated delivery date, possibly months in advance.

• Unplanned C-section. This is when you were planning to have a vaginal birth, but a little while before your delivery your doctor decides that a C-section is best for you and your baby. This decision can be made a few weeks, days, or even hours before you’re about to give birth. With an unplanned C-section, there’s no emergency, but the change in plans is made to get you and baby onto the safest birth route.

• Emergency C-section. This happens when delivery must occur urgently to make sure both you and baby are safe. This can happen whether you’re planning to have a vaginal birth or a C-section.

They might seem like the same thing, but not all C-section experiences are created equal. Your experience, as well as the actual procedure for an emergency C-section, will be different than those of a scheduled or unplanned C-section.

What will happen during an emergency C-section?

One main difference is how you might be prepared for it. Everything must move quickly, including administering pain medications and getting the baby delivered.

Most scheduled C-sections are performed with local or regional numbing (anesthesia). This means you’ll still be awake, but you won’t feel pain during the procedure. Local anesthesia is usually administered via a spinal injection, and this can take time.

In an emergency C-section, the timing and details of your situation, along with hospital policies, can affect your options for anesthesia.

Your doctor and the anesthesiologist may decide that there’s time to administer a spinal injection. Or, you may already have an epidural in place, which helps with the surgery preparations. However, depending on multiple factors, some of these options may not be possible.

Alternatively, you may have general anesthesia, using both injected and inhaled drugs to make sure you’re pain-free during the surgery. This will allow the C-section to happen more quickly, but this combination means you’re not able to be awake during the procedure.

Another difference may be the incision used during the surgery. In non-emergency C-sections, a horizontal (bikini) cut is typically performed. If you’re at term, you’ll likely have this type of incision, even in an emergency.

However, during an emergency surgery in which your baby’s health needs immediate attention, the surgeon may opt to use a vertical incision on your uterus to get to your baby faster. This type of incision may be necessary in cases of preterm birth, as well as due to adhesions from previous surgeries or fibroids that may be in the way of the uterus.

Again, this is dependent on the circumstances of your birth. Your surgeon’s training, as well as your and your baby’s health needs, are taken into consideration.

The reasons you might need an emergency C-section are also different than the reasons you might have a scheduled C-section.

Basically, an emergency C-section means that your baby isn’t cooperating with the planned exit or decides they want to come out before a scheduled or unplanned C-section. It may also mean that your health is a concern and waiting for progress isn’t the right choice.

In most cases, there’s nothing you or your doctor can do to change the need for an emergency C-section.

The following are several reasons why this might happen:

Very long labor

Prolonged or delayed labor is when labor goes on for much longer than normal. This can sometimes cause health problems for both baby and mom. Prolonged labor is the most common reason for an emergency C-section. About 8 percent of pregnant women who are about to give birth have a prolonged labor.

When this happens, your doctor may decide that it’s much healthier for you and your baby to have an emergency C-section than to try to deliver vaginally. You might have a prolonged labor because:

• Your labor didn’t really start. Sometimes you’ve had contractions for ages, but they don’t seem to be doing anything. Plus, you may not be dilating as you should.
• Your labor stalls. Everything might be on track as you start having contractions and even begin dilating, but then everything stops. Sometimes this happens because your baby’s head cannot fit through your pelvis.

Baby’s position

Your baby’s position might have already been a concern when your labor began, or an external cephalic version might have seemed successful, only to have baby return to a breech position at the last minute. Whatever the circumstances, labor may not progress as expected if your little one can’t be coaxed into turning around into a cooperative position.

If your baby is positioned with their behind first (breech), feet first, or stretched out sideways straight across your stomach (transverse), a vaginal delivery may not be possible. Your doctor may try to coax baby into position by turning your baby under controlled conditions, but this doesn’t always work.

Exhaustion

Sometimes all the pushing and trying in the world doesn’t seem like enough. Your doctor may have pulled out all the stops, even trying a vacuum-assisted delivery, to no avail.

At this stage you’ve likely been pushing for ages and are too exhausted to push any more. Your health may begin to show signs of distress, suggesting continued pushing is not an option.

At the same time, the fetal monitor might show that your baby’s heart is beating too fast or too slow. Your doctor may decide that it’s no longer safe for you and your baby to keep this up.

Health condition

If mama has a health condition or infection that comes up during labor, an emergency C-section might be recommended. For example, a herpes infection or other infection in the vaginal area can suddenly become active and harm the baby.

Alternatively, if your blood pressure or heart rate gets too high, it may not be a good idea to keep pushing. Also, if you have any kind of sudden heart or brain health issue, you may need an emergency C-section.

Tangled umbilical cord

If the umbilical cord gets compressed, tangled, or tries to come out before your baby, you’ll likely need an emergency C-section.

A prolapsed umbilical cord is a very rare complication that happens when the cord slides into the birth canal ahead of your baby. When this happens there’s a risk that it’ll be squeezed too much while your baby is trying to make their grand entrance. This can cut off baby’s blood supply.

Similarly, your baby might not be getting enough oxygen if the umbilical cord gets kinked or tangled like a garden hose.

Placental problems

Like the umbilical cord, the placenta can also complicate delivery.

Part or all of the placenta can come away from the lining of the womb. This is called placental abruption. When this happens your baby can’t get the necessary nutrients and oxygen inside the womb, and you may need an emergency C-section.

Womb tear

In very rare cases, the increased pressure on your body during birth can tear or rupture the womb. Having had a prior C-section increases your risk. If you have a womb or uterus tear (uterine rupture), you’ll need an emergency C-section.

Most of the risks of an emergency C-section are similar to those of any type of C-section.

Risks to your health include:

• an infection inside the womb or at the opening site
• opening or splitting stitches
• injury to the organs, nerves, or blood vessels near the uterus
• blood loss during the surgery
• heavy bleeding afterward
• blood clots
• a reaction to the anesthesia
• not being able to deliver vaginally in the future

Risks to your baby’s health include:

• accidental injury during the C-section
• temporary breathing problems for a few days after birth

There are also some risks to consider after the delivery is over.

If you’re asleep for the emergency C-section, you’ll likely not be able to have skin-to-skin contact with your baby right after birth. Also, the effects of the medications you were administered might make breastfeeding challenging for a while.

This does not mean that breastfeeding or bonding is impossible. You can begin a solid and satisfying breastfeeding relationship after an emergency delivery. Know that support is available, and you can work with a lactation consultant and your provider to meet your goals.

You may also be at higher risk of post-traumatic stress and its related effects. It’s important to spend time caring for yourself and your mental health. Discuss any issues or concerns you have with your provider or a mental health professional.

Like other major surgeries, you’ll need time to rest and recover after any kind of C-section. This could mean bed rest and not being able to climb stairs or lift anything heavy for a while.

It’s important to avoid putting too much pressure on the incision site to help it heal well. You might not be able to pick up or hold your baby for too long if you’re sore. You’ll need to change the bandages and see your doctor for follow-up visits to make sure the area is not infected.

You’ll also likely need a dose of antibiotics to prevent infection. And if you need pain meds to stay comfortable, you may not be able to breastfeed your little one until you stop taking them. Ask your doctor about when it’s safe to breastfeed.

Also, unlike other C-sections and most surgeries, your doctor decided to do an emergency C-section at the eleventh hour. This means you may not have felt emotionally or mentally prepared for it.

Again, an emergency C-section may lead to post-traumatic stress disorder (PTSD). Talk to your doctor if you’re having difficulty dealing with your birth experience or feel you may have postpartum depression.

You might need an emergency C-section if your doctor decides that it’s the best option for you to deliver a healthy baby, and the need may arise due to a number of reasons.

Neither you nor your doctor can control this outcome. While a C-section might be a major detour from your birth plan, the important thing is that you and your baby remain healthy and safe.

Unplanned vs emergency C-section | HealthPartners Blog

As you approach your due date, you’re probably wondering what it will be like when it’s finally time to welcome your baby into the world. And while hopes, dreams and anticipation swirl in your mind, another thought may be creeping in, too: What if I need to have a C-section?

The possibility of an unplanned or emergency C-section – or Cesarean section – can be a common source of concern. Many women write their birth plans with the assumption that they’ll have a vaginal birth. So if your care team recommends a C-section, it can be overwhelming and a little scary.

If the need for a C-section arises, your care team will be there to walk you through everything – and your support partner can usually be with you the whole time. But it can also be helpful for you to learn a little bit about this common delivery method in advance. This can help you feel more prepared and in control.

Below we walk you through the different types of C-sections, reasons why a C-section may be recommended, what you can expect during delivery, and much more.

What is a C-section?

A C-section is the surgical delivery of a baby through incisions in the abdomen and uterus. There are three different types of C-sections, which are generally separated by level of risk or urgency.

Scheduled vs. unplanned vs. emergency C-section

Scheduled C-section

Typically, a planned C-section will be scheduled to take place around week 39 of pregnancy, usually because there is a known medical reason to do so. For example, if you have certain medical conditions like high blood pressure or heart issues, a scheduled C-section may be recommended to help make sure the delivery process is as safe as possible. Another reason for a scheduled C-section may be to help prevent sexually transmitted infections that can be passed on to the baby during a vaginal birth.

But one of the most common reasons for a scheduled C-section is that a mother has delivered this way in the past. Although many mothers who’ve had a previous C-section try for a vaginal birth after a C-section (VBAC), many choose to schedule another C-section.

Unplanned C-section

Most C-sections are unplanned because the need for one doesn’t present itself until much closer to labor, or during it.

In these cases, moms have been planning for a vaginal birth. But a few weeks, days or even hours before delivery, mom and their doctor decide that a C-section is the safest option. This kind of change can be disappointing and stressful, but rest assured that your care team will still do everything they can to make your birth experience match up to your birth plan.

Emergency C-section

As you might expect, the difference between an unplanned Cesarean and an emergency Cesarean is urgency. Generally, this means there is an immediate safety concern for you or your baby, and immediate intervention is needed to keep you both as healthy and safe as possible.

Reasons for an unplanned or emergency C-section

There are a number of reasons why an unplanned C-section, or in more serious cases an emergency C-section, may be recommended. But they all stem from one reason in particular: it’s in the best interests of you and your baby.

Your birth team will be working to ensure a healthy, safe delivery and may recommend a C-section as the best way to do so. Situations that can require a C-section include:

Your labor slows, stops or doesn’t start at all, despite strong contractions

Stalled labor can sometimes be restarted with things like oxytocin infusions, which can strengthen contractions. But a C-section may be recommended if these kinds of labor stimulation methods don’t work.

The difference in size between your baby and your pelvis puts both of you at risk

This is often referred to as cephalopelvic disproportion, and it happens when a baby’s head or body is too big relative to their mother’s pelvis to pass through safely.

The umbilical cord comes out first

This is referred to as a prolapsed cord. If the cord gets damaged or wrapped around the baby, this can interfere with their oxygen.

The position of your baby prevents a safe, head-first delivery

When a baby is positioned to come out feet or buttocks first, this is known as breech presentation. If they’re sideways, this is known as a transverse lie. Any position other than the standard, head-down position can increase the chance of complications such as an injury to the baby, a prolapsed umbilical cord or prolonged labor.

The placenta presents a problem

As you likely know already, the placenta is the organ that develops inside your uterus to deliver oxygen and nutrients to your baby through the umbilical cord. Sometimes issues can develop with the placenta to make a C-section necessary.

For example, the placenta can cover the opening of the cervix. This prevents the baby from exiting the birth canal, and is known as placenta previa.

As another example, sometimes the placenta can separate from the wall of the womb before the baby has been delivered. This is known as abruptio placentae, and it can deprive the baby of oxygen.

Your baby’s heart rate indicates distress

Your birth team will be monitoring your baby’s vitals to make sure they’re not experiencing any distress. If their heart rate is abnormally high or low, a C-section may be recommended to get them out as soon as possible.

You're having twins

Twins can often be safely delivered vaginally. But because there’s more than one baby sharing the same space, ensuring a safe delivery can be more complicated. For example, either one of the babies could be in a position that makes vaginal delivery impossible.

What happens during a C-section?

While your C-section may not be planned, your doctor and care team are highly trained and experienced in delivering babies this way. Also, your partner or support person can usually be with you through it all. And it won’t take long for you to meet your baby.

To get you ready for surgery, you’ll be given fluids – usually through a vein in your arm – and your vitals will be checked and set up for monitoring. Then, to make sure you’re as comfortable as possible during surgery, you’ll receive medications to help you relax and to numb your belly and legs so you won’t be in pain.

Typically, you’re awake for a C-section. General anesthesia, which puts you in a sleep-like state, is usually only used during emergency C-sections. So, while you may feel a little sleepy from the pain medications, you should be relaxed and ready to see your beautiful baby as soon as they make their arrival.

Before the surgery begins, a curtain will be drawn between your upper and lower body. This helps keep you calm and relaxed while your surgical team works to deliver your little one.

When surgery begins, an incision is made across the lower abdomen where the lowest part of the uterus lies underneath. Once your baby has been delivered and the umbilical cord has been cut, your surgeon will remove the placenta, do a routine check of your reproductive organs, and then start stitching you up.

How long does an unplanned or emergency C-section take?

C-sections generally don’t take very long. Delivery of your baby can be done in minutes, and the whole thing is usually done in less than an hour. To put that into perspective, the pushing process to deliver a baby vaginally can last anywhere from just minutes to up to three or four hours.

Your care team will be looking after you the whole time, and your support partner will usually be able to stay with you too. Barring any immediate medical needs, you’ll be able to meet and feel your baby next to you – and maybe even try breastfeeding for the first time – almost immediately.

What are the potential risks of a C-section?

C-sections are an incredibly common method for delivering babies, accounting for about 1 in every 3 births in the United States. While C-sections are generally considered safe, like any major surgery, they still carry some risks.

While rare, infection is always a possibility with any surgery. Your surgical team and your postpartum care team will follow rigorous health and safety protocols from start to finish to help minimize any risk. But it will also be important for you to closely follow wound care instructions while you heal at home.

Other risks can include allergic or other negative reactions to anesthesia, blood loss, blood clots and accidental injury of you or your baby.

What to expect from unplanned or emergency C-section recovery

Whether you give birth vaginally or by Cesarean section, your body will have done an incredible thing. You’re going to be tired, sore and maybe even a little anxious. But it’s going to be okay.

When it comes to C-section recovery, the healing timeline is a bit longer than a vaginal birth because you just had a major surgery. This usually means a couple more days in the hospital and a couple more weeks at home before returning to normal activities, when compared to an average vaginal delivery.

While you heal, a lot of bending and lifting will be off the table, as you will need to avoid straining your lower belly. Don’t worry – you can pick up your baby, but you should ask for help with anything heavier or more involved. You can expect pain in your abdominal area too, for which medication may be prescribed. You may also experience some vaginal bleeding throughout the weeks of your postpartum recovery.

Getting enough sleep and doing some light walking every day will help your recovery progress and help prevent post-C-section complications. Be gentle with yourself, and plan to take things slow. You’ll be given plenty of instructions and tips for recovering from your C-section before you go home.

But if you find yourself unsure about what to do or not do, we’re available 24/7 and just a phone call away. HealthPartners patients can call 800-551-0859. Park Nicollet patients can call their clinic directly during regular business hours, or 952-993-4665 if it’s after hours. For questions and advice on new baby care, you can also call our 24/7 BabyLine at 612-333-2229.

But most importantly, take this time to adjust to your new life. You’ve earned it! Kick back (gently), try to relax and bond with your baby.

Unplanned doesn’t have to mean unprepared

The thought of having an unplanned C-section can be overwhelming. But unplanned doesn’t have to mean unprepared.

Know that C-sections are common – and that you didn’t do anything wrong if one is recommended. Your care team has just one thing in mind when recommending a C-section: the health, safety and well-being of you and your baby.

When the time comes to bring your baby into the world, we want you to feel ready. So, if you have any questions, talk with the doctor or midwife who’s providing your pregnancy care. Also, choose a hospital-based birth center that’s prepared for every possibility.

We want to help you have the safest, most comfortable birth experience possible. Our birth centers are designed with flexibility in mind and supported by expert care professionals. We’re ready to help you through every step of the birthing process, planned and unplanned.

Find a hospital-based birth center that’s ready for everything

indications, how they do it, which anesthesia is better, how to recover quickly, how long it lasts, contraindications and complications, cost

In 2016, I had an emergency caesarean section.

Veronika Vysotina

went through a caesarean section

All five days before the discharge, doctors called me and other women who needed an operation “cesareans”, and our babies were called “cesareans”.

I was not at all ready for the operation: the pregnancy was going great. For almost half a year after the cesarean, I struggled with various thoughts, went through the stages of "I'm not a real mother" and "I'm ashamed in front of the child", I envied my friends who gave birth themselves. Fortunately, now all this is behind us.

In this article I will tell you what a caesarean section is, how it is done and how the recovery goes.

What is a caesarean section

What is it. Caesarean section is also childbirth, only operational. And efficiency here is not about time, but about surgical intervention. Unlike natural childbirth, when a woman gives birth to a child herself through attempts, during a cesarean, the doctor makes an incision in the abdomen with a scalpel and takes the child out of the uterus through it.

Caesarean section - Medscape

Initially, a caesarean section was performed to save the baby if the mother died in childbirth. This operation is mentioned even in Greek and Roman myths - even the name itself came, according to one version, from the Roman law, according to which a pregnant woman could be buried only after the child was taken out of her stomach.

Caesarean section - Britannica

In the 17th century, caesarean sections were performed on living women, but almost always the patient died due to blood loss or infection. mid 19For centuries, doctors came up with the idea of ​​removing the uterus, and a little later they began to put stitches on it, leaving a chance for the next pregnancy.

Methodological letter of the Ministry of Health of the Russian Federation on the classification of caesarean sectionPDF, 2.98 MB

Nowadays, caesarean section has become a fairly common situation: in Russia, about every third birth ends like this.

Which is better: caesarean or natural childbirth. The term "natural birth" is a little outdated: childbirth cannot be unnatural. A caesarean section is carried out according to indications from the mother or fetus - often otherwise the woman cannot give birth or there is a risk to the health and even the life of the child.

It cannot be said that some way to give birth is definitely better: doctors recommend the method of delivery that will be the safest in a particular situation.

What week is the caesarean section. If a caesarean section was planned in advance, then it is usually done starting from the 39th week of pregnancy.

Types of cesarean section

Elective. The term "natural birth" is a little outdated: childbirth cannot be unnatural. A caesarean section is carried out according to indications from the mother or fetus - often otherwise the woman cannot give birth or there is a risk to the health and even the life of the child.

Caesarean section - NHS

Emergency. This is when the need for operative delivery arises unexpectedly, usually already in the process of childbirth. For example, when a woman suddenly stops labor and this creates a danger to the child, or heavy bleeding begins.

In addition, there are several types of operations in obstetrics, but in general they can be divided into two large types.

Transverse or horizontal. In this case, the incision is made horizontally across the lower abdomen. Doctors prefer this method if the caesarean section is planned and the patient's life is not in danger. Such an incision takes a little longer, but it is less dangerous in terms of infections. The scar from the horizontal incision is subsequently less noticeable.

Longitudinal or vertical. In this case, a large vertical incision is made almost from the navel to the pelvic bone. This allows you to quickly remove the child in an emergency.

Who is having a caesarean section

A caesarean section can be elective or emergency. Planned is so called because the woman and the doctor know about it in advance, while agreeing on a specific date.

Clinical guidelines for caesarean section in Russia

There are many reasons for surgery. Here is some of them.

Breech presentation of the child. This is a situation where the fetus in the mother's abdomen lies with its legs or buttocks down and cannot roll over in any way. The Russian clinical guidelines state that breech presentation of a fetus weighing more than 3600 g is a direct indication for caesarean section.

Of course, natural childbirth in such cases is possible, but the risks for mother and child are too great, so doctors prefer to do caesarean. There are other incorrect positions of the fetus, which serve as indications for surgery.

Mother's health problems. These include, for example, cardiovascular disease or spinal problems. In such situations, the period of attempts can become deadly for a woman. Also, an indication for caesarean section may be fibroids, a neoplasm on the cervix or its deformation after plastic surgery - for example, after suturing severe tears during previous births.

Anatomically narrow pelvis. This is a situation where the size of the pelvic bones in a woman is smaller than necessary for a normal birth. In ordinary life, this does not cause inconvenience, but in childbirth it can become a serious problem: the baby's head will not go through a strong narrowing. That is why, already when registering pregnant women, gynecologists must measure the external dimensions of the pelvis and calculate the internal ones using a special formula.

This also includes other situations that are called “fetal-pelvic disproportions” in the clinical guidelines: for example, deformity of the pelvic bones or a mismatch between the size of the pelvis of the mother and fetus.

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How much does pregnancy management cost?

Placenta previa. In some women, the placenta is located in the lower part of the uterus and covers the internal os - in other words, blocks the "exit" for the child.

Previous cesarean. In general, there are quite a lot of situations when, after a caesarean section, a woman gives birth to a child in a natural way. However, this may not always be the case.

With regard to emergency caesarean section, everything that threatens the life of a woman and a child serves as a reason. These are, for example, placental abruption, car and other accidents, lack of oxygen in a child, stopping labor after it begins.

My experience. I had an emergency caesarean at 41 weeks pregnant, at that time I had already been a week and a half past the planned date of delivery. The reason for the operation was a clinically narrow pelvis: its dimensions were normal, but the child still could not pass. As the doctor later explained, my son decided to rest his forehead against the bones of the pelvis, while usually children are born with the back of the head forward, while pressing the chin to the chest.

My friend had an emergency c-section at 37 weeks due to eclampsia, a serious complication that often presents with swelling and very high blood pressure, threatening two lives at once. The reasons for this condition are still poorly understood - in Germany, where my friend lives, eclampsia is even called "pregnancy poisoning".

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How much does it cost to give birth in Germany

Can a woman have a caesarean at her request?

Oksana Bogdashevskaya

gynecologist of the Fomina Clinic network

In some countries, for example in the USA, operative delivery can be performed without taking into account medical indications - simply at the request of the woman. The local association of obstetricians and gynecologists asks that decisions be made carefully, but such births account for about 2.5% of all cases of caesarean sections.

As with any operation, risks and complications must be considered. A caesarean section requires a longer hospital stay and has its own risks associated with pain relief, bleeding, thrombosis, bowel or bladder injury. A scar on the uterus complicates the course of the next pregnancy, creating a threat of uterine rupture during pregnancy and childbirth.

Although vaginal delivery after a previous cesarean is possible, in practice there is a “domino effect”: a cesarean gives rise to a cesarean, and two cesareans lead to a third cesarean. Each time, the risks increase more and more, so "caesarean at will" is not the best option for women who want to have many children.

In Russia, it is officially impossible to have a caesarean simply because you want to. The list of indications for it is strictly defined by federal clinical guidelines.

How to prepare for surgery

Caesarean section, like any other abdominal surgery, is performed on an empty stomach. With a planned caesarean, at least eight hours must pass after eating and two hours after drinking water. In Russia, they still often give an enema to cleanse the intestines, although I found a study that this is not necessary before a planned caesarean.

On the eve of the operation, a general blood test is performed, its group, Rh factor and coagulation are assessed. It is imperative to get tested for HIV, syphilis, and hepatitis B. Also the day before, an anesthesiologist comes to the woman's room. He asks the patient in detail about injuries, illnesses, allergies to drugs and more. This information is needed by a specialist in order to choose the safest type of anesthesia.

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You have the right to free analyzes under compulsory health insurance

After the conversation, the doctor signs a voluntary informed consent for medical intervention with the patient. This document does not relieve doctors of responsibility, but only confirms that the patient understood the essence of the procedures - anesthesia and the operation itself - and agrees with them.

In my emergency caesarean situation, there was no preparation at all. When my water broke at ten in the evening, the nurse took blood tests and gave me an enema. During the contractions, the doctor examined him several times and put CTG sensors. Either the problems were not visible, or they were not reported to me, but until seven in the morning I was still preparing for a natural birth. Then the head of the department came, conducted an examination, studied the CTG data and, as a result, announced: “I give the child three hours. If it doesn’t turn around as it should, we will have a Caesarean.”

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What kind of anesthesia is used for caesarean section

There are two types of anesthesia for caesarean section: general and regional. The doctor is obliged to find out the presence of contraindications to both: if the patient has contraindications to the general one, they make a regional one - and vice versa.

Labor pain relief - Medscape

Anesthesia. At the same time, the patient is asleep and does not know what is happening. And the effect of regional anesthesia extends only to part of the body, that is, the woman is conscious during the operation and can immediately see the child. General anesthesia is usually used in emergencies or when the patient is unconscious. There are almost no contraindications to anesthesia, but recovery from it can be long and difficult, it is often accompanied by nausea, muscle pain and confusion.

Regional anesthesia. It is divided into two subtypes - epidural and spinal. In both cases, the doctor uses a thin needle to make an injection in the area of ​​the spine. They differ in where exactly the needle goes: into the epidural space or into the cerebrospinal fluid. Epidural anesthesia begins to work within about 20 minutes, spinal anesthetic works faster.

Regional anesthesia has more contraindications than general anesthesia: these include spinal injuries or pressure problems in the mother, oxygen starvation of the fetus. Nevertheless, it is used much more often for cesarean delivery: local anesthesia is safer for the patient and is recommended by numerous protocols around the world. For example, only in the USA at 95% of births use this option.

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How to go to give birth in the USA

Can a woman choose the type of anesthesia herself

Alexander Ronenson

Head of the Department of Anesthesiology and Resuscitation of the Perinatal Center named after E. M. Bakunina

In short, maybe. However, if there are no contraindications, the doctor will first of all recommend spinal anesthesia to the patient - she has the lowest risks of complications.

If a patient, for some personal reasons, refuses spinal anesthesia and chooses general anesthesia, she has every right to do so in accordance with Art. 20 of the Federal Law of the Russian Federation "On the fundamentals of protecting the health of citizens" (No. 323). At the same time, a woman must understand all possible risks and complications, and is also obliged to sign an informed voluntary consent for general anesthesia and refusal of spinal anesthesia.

How is a cesarean performed and how long does the operation take?

The operation usually takes about 40 minutes. It involves several obstetrician-gynecologists with assistants, a team of anesthesiologists, a pediatrician or neonatologist - a doctor who assesses the condition of the newborn.

The nurse inserts a urinary catheter, a special bag with a hose that prevents fluid from accumulating in the bladder. A full bladder can interfere with surgeons during surgery, and if accidentally cut, creates a high risk of infection in the abdominal cavity.

The anesthesiologist performs anesthesia, after which the operating team can start working. The skin is treated with an antiseptic and the first external incision is made along the abdominal wall.

Then the skin and all layers of the tissues of the abdomen under it are pulled apart and an incision is made on the uterus. The child is removed, the umbilical cord is cut off and transferred to a neonatologist for examination.

Surgeons continue their work during this time. If during natural childbirth the placenta is born on its own after a while, then during caesarean delivery it has to be removed by doctors. If even a small piece of the placenta remains inside the uterus, there is a high probability of postpartum hemorrhage and inflammation.

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After successful removal of the baby and placenta, the uterus and all subsequent layers up to the skin are sutured in reverse order, using self-absorbable threads or special surgical glue. Sometimes the skin can be held together with metal staples or non-absorbable threads, but then they will have to be removed separately. And some studies say that the use of staples is sometimes fraught with the risk of wound complications.

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Sometimes a woman is only shown a baby, sometimes she is allowed to hold or attach to her breast right in the operating room: it all depends on the internal rules of a particular maternity hospital.

Is it safe for a child to have a caesarean? For example, premature babies are removed from the uterus in the whole fetal bladder - this is a very complex and delicate procedure.

In other cases, it is important for a baby to go through birth stress: this increases his adaptive abilities. That is why it is now recommended to carry out planned operations only after the onset of labor activity - in order to allow the baby to "be born".

When passing through the birth canal of the mother, the child's body is colonized with maternal lactoflora. Research is even being carried out now: is it worth lubricating newborns born via caesarean with the mother's vaginal secretions, how adequate this imitation is.

Are children born after caesarean different from those born vaginally? There is an opinion that the heads of children who were born in different ways are different. This is not entirely true. In newborns born naturally, at first a really characteristic shape of the head is called a birth tumor. However, these changes pass quickly, and in the future, the heads of babies do not differ.

How I had a caesarean section

I had an emergency caesarean section that was not warned about in advance. Although even so, the preparation stage turned out to be the same as during a planned operation. Blood tests, ultrasound and CTG were standard. Dinner the day before was at 5:00 pm, then around 9:00 pm I drank a cup of tea with a small cookie — by the time of the operation I had not eaten anything for 13 hours.

The anesthetist, who came to see me on the day of delivery, quickly interviewed me and said that the anesthesia would be spinal. He immediately gave me some paper to sign - apparently, consent to the operation and anesthesia. I honestly don’t remember what happened there: after ten hours of contractions, it seemed to me that I was ready to sign a donation for an apartment, if only all this would end soon.

In the operating room, I had to completely undress and climb onto the table. The anesthesiologist ordered me to lie on my side and drew something on my spine - apparently, he marked the place of the future injection. I did not feel the injection itself, there was only a slight tingling sensation.

Then I was allowed to lie on my back, and my hands were fixed on special stands on the left and right. The anesthetist connected a pulse oximeter to my finger, put a blood pressure cuff on my arm, and put oxygen tubes in my nose to make it easier for me to breathe. The nurse inserted a urinary catheter into the urethra.

I was very scared, most of all I did not want to watch how the operation would go. She closed her eyes and immediately received a scolding from the anesthesiologist: "I must see your condition." At this time, the nurse put a curtain in the chest area - just so that I could not see anything.

The legs became very warm - the anesthesiologist said that the anesthesia had begun to take effect, and gave the command to the surgeons that "we are ready." Now, when I am writing this article, I read that they can check the readiness with a piece of ice or with clamps that lightly pinch the skin.

During the operation, for some reason I really wanted to talk-talk-talk. It seems that I told the anesthesiologist my entire biography. The doctor at that time looked at the values ​​of the devices and told me about the actions of the surgeons: “Now, now they will get the baby. Now scream. You have a boy!"

Now I don't remember the baby's first cry. But she clearly remembered him outwardly: they carried her son past - for some reason, his skin was blue-violet. Later, the baby was washed, shown to me and given a kiss on the forehead. They didn’t offer to put it on the chest, and then I didn’t know that it was possible at all.

How was the day in the intensive care unit

Immediately after the operation, I was taken to the intensive care unit. My son was taken to the neonatal unit - I already found out a few hours later, when a neonatologist came to me and asked for consent to vaccinations.

I remember that my head was very foggy: apparently, fatigue from ten-hour contractions and the effect of anesthesia had an effect. I did not ask where my child was and where they took him. It was important for me to know only one thing: did I forget my slippers in the antenatal ward. Now it seems funny and scary at the same time.

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How much does it cost to pack a bag for the maternity hospital? I didn't argue. Or did not have time - fell asleep.

What can I eat after a caesarean section

When I woke up after the operation, I realized that I was terribly hungry, but the doctor did not allow me to. You could only drink low-fat chicken broth with white meat, and even then only a few sips. My husband unknowingly gave me a two-liter jar filled to the neck. The nurse then laughed: “Is this what they brought for the whole resuscitation, or what?”

I also had to drink a lot of water, probably to make up for the loss of blood. My relatives also gave me water. The doctor advised me to buy bottles of 0.25 liters: it is difficult and uncomfortable to drink lying down from a "one and a half" bottle. The resuscitation nurse approached each patient in the ward every 40 minutes and reminded them to drink. At the end of the day, she wrote down in a notebook how much she drank and how full the urinal bag was.

Later doctors allow solid food. It is important to eat so that there is no constipation, in particular, eat vegetables and drink plenty of water.

How was the recovery

On the first day after the operation, the lights out was announced at about ten in the evening. I clearly remembered that the thought then flashed through my head: “This is my last good night for the coming year. You need to sleep." The next morning, I was already transferred to the postpartum ward. I felt great, I was ready to jump around the ward.

I spent five days in the maternity hospital after the caesarean: I was operated on on Friday and discharged on Tuesday. Starting on Saturday, they gave injections of oxytocin, a hormone that helps the uterus contract and at the same time stimulates milk production. The injections were very painful - the buttock then hurt for another three weeks.

Back in the maternity hospital, I had a dressing done once. In the operating room, of course, they put a bandage on the wound, but after all, the caesarean was an emergency, so I didn’t have good postoperative plasters. The bandage was a gauze soaked in something pink. It was not very pleasant to remove such a seam: the fabric stuck to the seam.

I had all the sutures made with self-absorbable threads, they did not need to be removed. On the day of discharge, only an ultrasound was done to make sure everything was healing well and not bleeding.

How to recover quickly after a caesarean section

Suture after caesarean section. As a rule, a bandage is applied to the suture after a caesarean section for 24-48 hours. After its removal, the wound is treated. If the sutures need to be removed, this is usually done on the sixth, seventh or eighth day after the operation.

C-section Recovery - NHS

How and how to treat a stitch. It is enough to gently clean and dry the wound every day, and also monitor the appearance of signs of infection - this is redness, swelling, increased soreness, a feeling of heat in the suture area, a change in the color of the discharge. The maternity hospital will give recommendations on the treatment of seams, which should be followed at home.

C-section recovery - Mayo Clinic

How long does the uterus and suture heal after cesarean. Recovery after surgery takes four to six weeks. A scar gradually forms on the skin: at first it will be bright and noticeable, but after a few months it will brighten and will not stand out so much.

How much does the uterus shrink after cesarean. Uterine contractions may be felt during the first few days after surgery. They remind menstrual cramps.

These contractions may be uncomfortable, but they help prevent excessive bleeding by constricting the blood vessels in the uterus. An over-the-counter pain reliever, such as ibuprofen, can be taken to relieve pain.

Exercise after caesarean section. After the operation, you should start moving as soon as possible, but the physical activity should be moderate. Any exercises can be done only after the permission of the doctor.

Usually they can be started three to four weeks after the caesarean if everything went without complications. It is important not to do exercises that lead to abdominal tension: abdominal exercises, squats, straight leg raises from a prone position, and others.

Massage after caesarean section. Body massage can be done after complete healing of postoperative sutures. Massage of the hands and feet is allowed, and there is evidence that it can alleviate the discomfort associated with the operation.

Period after caesarean section. The operation does not affect the restoration of the menstrual cycle after pregnancy. When breastfeeding, menstruation will return after it stops or when the woman becomes less likely to put the baby to the breast. If a woman is not breastfeeding, then her periods will return on average two months after the birth of the baby.

Bandage is an elastic bandage that is worn over the waistband to support fabrics. It is believed that the bandage helps to relieve pain after surgery, especially during movement. There is evidence to support this, although other studies show that wearing a brace has little effect on discomfort.

How to wear a bandage after a caesarean section. The bandage must fit snugly enough to the body, but not squeeze. It needs to be fastened so that support is felt, but the bandage does not interfere with breathing and does not cause discomfort.

Before using the bandage, you should consult your doctor. Also, it should not be worn if there are signs of infection or inflammation in the suture area.

How long to wear a bandage after a caesarean section. It should not be worn all the time without taking it off. The brace is usually worn four to eight hours a day. You can’t sleep in it, as it is uncomfortable, it can make breathing and blood circulation difficult.

Wear a brace, as a rule, from six to twelve weeks after childbirth - after this time the body will recover sufficiently.

What are the restrictions on sexual life and subsequent pregnancy

Oksana Bogdashevskaya

gynecologist of the Fomina Clinic network

The first postpartum visit to the antenatal clinic should be planned within two weeks after discharge.

Sex after cesarean. Sexual activity can be resumed four to six weeks after the operation, but it is better to see a doctor again before that and discuss contraceptive issues.

If you are planning a new pregnancy, then do not forget about the safe interval. The optimal interval between births should be about two and a half years - different protocols give slightly different numbers. However, these data are similar to recommendations for natural childbirth.

If less than six months have elapsed from delivery by caesarean to a new conception, then the next pregnancy is at risk of uterine rupture. If less than 12 months, there are high chances of placenta previa and abruption.

When can I exercise after a caesarean section

For at least four weeks after surgery, you should avoid exercises that directly affect the abs, and during the recovery period, you should not lift weights, run, do weight training. The load should only be light.

Sports activities are usually not possible until eight weeks after surgery. From that point on, it's usually safe to return to swimming, Pilates, yoga, light jogging, and low-resistance gym activities.

Aerobics, running, strength training are usually possible 12 weeks after surgery. In any case, you should consult a doctor before resuming sports.

When does milk come after caesarean and is it possible to breastfeed

After caesarean section, you can immediately breastfeed, just like after a normal birth. Sometimes breastfeeding takes longer after surgery. For example, milk production may start a little slower.

Breastfeeding after a caesarean section - Australian Breastfeeding Association

Babies born by caesarean section may not breastfeed as actively. This can be solved by trying to feed the baby more often.

Complications after caesarean

Although caesarean has become commonplace, it is wrong to think that this is just an “easy way to give birth”. This is a real abdominal operation, which is much more dangerous than natural childbirth.

It happens that after a caesarean section, a woman develops complications. One of them is endomyometritis, an inflammation of the lining of the uterus.

Women after cesarean have a high risk of leg thrombosis. This is due to the fact that anesthesia weakens and expands the vascular walls, the blood flow slows down. That is why doctors recommend wearing special compression stockings for a planned cesarean, they maintain the desired level of blood flow.

Sometimes, after a caesarean, women have problems with the onset of lactation - this is due to the fact that hormones in such a situation begin to work a little differently than during natural childbirth. Fortunately, I didn’t have such a problem: the milk came already on the third day.

Babies delivered by cesarean may have slightly different gut microflora. When a child is born naturally, he receives some of the microorganisms from the mother's birth canal. This does not happen with a caesarean, so these babies may develop colic earlier.

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Even after a normal birth, a woman is not recommended to lift weights of more than five to six kilograms for the first few months - the approximate weight of a baby in winter overalls. In the postpartum period, this can lead to bleeding, and in the case of a caesarean, even to rupture of the sutures.

A month and a half after giving birth, I noticed that three red pustules appeared near the suture. Wildly frightened, I made an appointment with the first gynecologist I came across. Ultrasound of the soft tissues showed that everything was in order with the suture, and later small pieces of threads came out of the pustules, which had not yet had time to resolve. The doctor said that this sometimes happens and you should not be afraid - the seam will not open. And so it happened, everything quickly healed.

But I had enough worries. The fact is that during the operation, my son accidentally made a large cut a centimeter from his eye and another one on his head. Fortunately, they healed within a month and a half and are now completely invisible.

Psychological pressure and depression after a caesarean

Somehow I came across a comparison of women who gave birth by caesarean with those who leave children in maternity hospitals. Some people stigmatize such mothers as “not a real mother” and reproach them: “I couldn’t even give birth, how are you going to educate?”

"No, it's okay: don't feel guilty about a caesarean birth" - NEN

Such words, to put it mildly, do not add self-confidence. Some women are already feeling ashamed that they allegedly "lost control" and that they "got the child already ready."

Not far from postpartum depression. Here are its main signs: depressed state, lack of interest in the child or too strong feelings for him, inability and unwillingness to enjoy life, tearfulness, impaired appetite. Postpartum depression is extremely dangerous and should not be ignored, especially if the symptoms recur regularly.

Postpartum Depression - Medscape

If you notice these signs in yourself or a woman you know who has recently given birth, it is important to see a psychologist or psychotherapist. The specialist will do tests to determine the level of depression, possibly send them for tests, and in emergency cases even offer medical treatment in a hospital setting. Alas, there are stories on the Internet about the suicide of women who have recently given birth.

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Fortunately, I was able to cope with my feelings on my own, even though they came to me periodically for six months. The switch was the idea that the birth went well and that it is not clear how the situation would have developed if the doctors had not performed a caesarean. My son got an Apgar score of 8/8, which is a good and high number.

Apgar score - Medscape

How to apply for sick leave after cesarean

Caesarean section is considered a complication of childbirth. Because of it, maternity leave is extended by two weeks. At the same time, an additional code 020 is put on the sick leave.

I was issued a sick leave at the maternity hospital before discharge. It indicated this additional code and a new deadline for starting work. On the new sick leave they wrote that it was a continuation of the previous one.

How much does a caesarean section cost

I didn’t pay anything for a caesarean section. This operation is included in the list of those that are performed under compulsory health insurance. However, if a woman enters into a paid contract for childbirth, surgery is paid separately, such programs are more expensive. Here are some examples.

How much does a contract for operative delivery cost in different clinics

Clinic	Contract price for operative delivery
Mother and Child	From 222 000 R
Maternity hospital No. 25	135 000 R
Maternity hospital No. 8	Complicated childbirth program - 120,000 R
Center. V. I. Kulakova	From 85 000 R
Regional Clinical Perinatal Center. E. M. Bakunin	From 27 600 R

"Mother and Child"

From 222 000 R

Maternity hospital No. 25

135,000 R

Maternity hospital No. 8

Complicated childbirth program — 120,000 R

V. I. Kulakova

From 85,000 R

Regional Clinical Perinatal Center named after V.I. E. M. Bakunina

From 27,600 R

Remember

1. Caesarean section is a real operation with real incisions, numerous sutures, anesthesia and possible complications.
2. Whenever possible, doctors choose local anesthesia, most often spinal anesthesia: it is safer.
3. It is better to wear special compression stockings during the operation: they maintain blood flow at the desired level and prevent thrombosis.
4. A woman after a caesarean section needs additional support and assistance. At least she can't lift anything heavy. It is especially important to monitor the mental state.
5. A caesarean delivery extends maternity leave.

Paid caesarean section in EMC

Perinatal center

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For an experienced obstetrician-gynecologist, a caesarean section is an ordinary operation, which, in the absence of complications, takes no more than 20-35 minutes. The baby and placenta are removed through an incision in the mother's anterior abdominal wall. The operation is most often performed under regional (epidural or spinal) anesthesia, if there are no contraindications to its use, in the rarest cases - under general anesthesia.

Caesarean section reasons

Distinguish between planned and emergency caesarean section. It happens that already at the stage of pregnancy, it becomes clear that physiological childbirth can, for some reason, threaten the life and health of a woman and an unborn baby. These are indications such as:

• two or more scars on the uterus;
• placenta previa;
• severe preeclampsia - eclampsia;
• diseases not associated with pregnancy (complications of the kidneys, cardiovascular system, retinal detachment).

In this case, the doctor who leads the pregnancy recommends operative delivery, and then at the time of childbirth, the woman is already mentally prepared for such a scenario.

It happens that at the stage of pregnancy, nothing indicates the need for a caesarean section. However, once labor begins, emergency surgery may be required. This happens, for example, in the following cases:

• clinically narrow pelvis and large fetus;
• baby in breech presentation, and labor is weak and not getting better;
• amniotic fluid poured out ahead of time, and the cervix is ​​not ready for childbirth;
• for acute fetal hypoxia (lack of oxygen).

Preparation for caesarean section

Before performing a caesarean section in the clinic, a woman needs to take some measures:

• pass the tests prescribed by the doctor within the prescribed time;
• the day before surgery, undergo an examination by an anesthesiologist to select the most appropriate method of anesthesia;
• CTG and fetal ultrasound;
• hygienic measures - in the evening and in the morning on the eve of the operation;
• last meal 12 hours and fluids 8 hours before surgery.

On the day of surgery:

• the patient enters the maternity hospital, she undergoes additional hygiene measures, if necessary;
• the patient is changed into sterile underwear, compression stockings are put on;
• is transferred to the operating block.

How a caesarean section works

1. The woman is placed with a peripheral vein catheter and a urinary catheter.
2. The anesthesiologist examines the patient again, performs anesthesia according to the chosen method.
3. Approximately at the level of the chest, a screen is placed in front of the woman so that she does not see the incision.
4. Once the anesthesia and appropriate debridement has begun to take effect, surgeons begin the operation.
5. Apply to the breast immediately after birth.
6. At the end of the operation, the patient is transferred to the intensive care unit, where she is observed for several hours. In the ward, she can also be with a child.

Benefits of having a caesarean section in the EMC

• Obstetricians and gynecologists of the EMC maternity hospital in Moscow are proficient in all modern techniques for performing a caesarean section. On the same day after the operation, the patient is already able to get out of bed, the next day she is completely independent, and 48 hours after the operation she can be discharged from the maternity hospital.
• Obstetricians and gynecologists at the EMC Maternity Hospital have 15 to 40 years of experience. Even when concluding a contract for childbirth with a team on duty, expectant mothers can be sure that they will be in the hands of high-level professionals.
• If the woman in labor wishes, a “partner caesarean section” is possible, when during the operation someone close may be nearby. In addition, a comfortable waiting room is provided next to the operating room in case relatives do not want to be present at the operation itself, but want to congratulate the mother and see the baby immediately after birth, cut the umbilical cord.
• After the operation, the child, as well as after natural childbirth, is applied to the breast, and the umbilical cord is cut only after the end of its pulsation, if there are no indications for emergency resuscitation.
• If a woman stays in the intensive care unit, she is sure to bring a baby to feed. This is very important for the proper formation of lactation.
• In the maternity hospital of the European Medical Center, there is no concept of " Paid caesarean section " as such. The cost of the contract does not depend on the method of delivery. Therefore, even if an emergency operation is required, the price of will not be increased.
• Our women in labor do not need to take care of the advance selection and purchase of compression stockings, as well as everything else that may be required in the maternity hospital. We deliver everything on the spot. The only thing you need to bring with you to the hospital is your passport.

Cost of services

* Prices in the Price List are indicated in conventional units (unless otherwise specified by the Parties, 1 conventional unit is equal to 1 euro), all settlements under the Agreement are carried out in ruble terms. Payment under the Agreement is carried out by the Customer at the exchange rate of the Central Bank of the Russian Federation in force on the day of payment, if the rate of the Central Bank of the Russian Federation does not exceed the internal rate of the Clinic on the day of payment, indicated by posting on the Internet, on the official website of the medical centers of the Clinic, and on information stands in medical centers. If the exchange rate of the Central Bank of the Russian Federation exceeds the internal exchange rate of the Clinic on the day of payment, payment is made at the internal exchange rate of the Clinic.

Designation	PRICE, USD*	Price, ₽	Code
DELIVERY PROGRAMS
Childbirth management program. VIP	7 500 USD	451 181 ₽	The code: PRG87
Childbirth management program. SUITE	10 000 USD	601 575 ₽	The code: PRG88
Childbirth management program. EXCLUSIVE	12 000 USD	721 890 ₽	The code: PRG89

Specialists of the direction

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Perinatal center

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Review of childbirth at the European Medical Center

October 25

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Only the warmest and most pleasant memories of the maternity hospital remain!

Only the warmest and most pleasant memories of the maternity hospital remain! Real professionals work here, to whom you want to return with smiles and gratitude! First of all, I would like to note the people who played the most significant role in the birth of my son: The wonderful doctor Sharova Marina Lvovna, thanks to whom a very difficult and lengthy birth ended easily and without complications! Marina Lvovna is a doctor who pays great attention to the wishes and feelings of the patient regarding the process of childbirth, and she really did everything possible to make everything go exactly as I wanted.

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