Also referred to as a C-section

Is a surgical procedure that is performed under anesthesia through the abdomen and is done to help deliver a child.

An inscision is made specifically into the abdomen and into the uterus.

Is an alternate form of delivery than a vaginal delivery.

Is done for several reasons as will be discussed.

As of 2006 – over 30% of births in the United States were done by C-section

This is the highest it has ever been.

Some clinics in Italy have a 90% or 80% rate

Possible Theories on the name Caesarean

1.)   From the word Caederein latin which means “to cut”.
2.)   From an ancient story by Pliny the Elder - reports a similar form of delivery
3.)   From Roman legal code “Lex Caesarea” – a law that allows a baby to be cut from the mother only in cases of emergency or probable death of the mother

Reasons for Caesarean section

  -   When vaginal delivery may pose a risk to mother or child
  -   Recently women are choosing to have C-section to limit pain or other

Child
   -    Fetal distress
   -    Breach position
   -    Transverse placement
   -    Larger than expected baby
   -    Umbilical cord problems
   -    other

Mother
   -    Longer then expected delivery
   -    Placenta previa
   -    Placenta abruption
   -    Uterine rupture
   -    Pre-eclampsia
   -    Hypertension
   -    Mulitple births
   -    HIV
   -    STD’s
   -    other

Risks or Complications

   -    Mortality is plausible for both vaginal and C-section births
   -    Mortality rate is between 20-25 per 1,000,000
   -    UK reports a 3 times increase of mortality with a C-section than a vaginal birth
   -    May have increased risk with other pregnancies

*** – it must be noted that those who have C-section are often at more risk because of health concerns and are already at a higher concern than a “typical vaginal birth”

Types of C-sections:

1.)   Lower Uterine Segment  –  Transverse cut above bladder
                 -   most common type used today

2.)   Classic Caesarean section  -  Incision along mid-line with a longitudinal incision
                 -   rarely performed today due to complications

3.)   Repeat Caesarean  –  Performed through the scar from a previous incision site

4.)   Emergency Caesarean section  -  Done after labour has begun

5.)   Crash Caesarean section  -  When quick action is required because of complication to mother and/or child

6.) Caesarean hysterectomy – 1 type of C-section plus the removal of the uterus
                 -   done when complications cause problems with bleeding or removal of placenta

7.) Others

Vaginal delivery after having a C-section

-      Past belief held – once a C-section, always a C-section
-      However, vaginal delivery following a C-section is not uncommon
-      The decision should be made between the mother and family along with the Physician
-      If vaginal delivery is decided then the facility should be able to handle an emergency should one arise.

Elective C-sections

-      Are increasing in number
-      Some are for medical reasons
-      Some are prescribe by Doctors
-      Others are requested by the patient

***  -  several medical providers argue that because of the concern of litigation with vaginal delivery – C-section
is a viable performed treatment option.

Anaesthesia

   -    Epidural is often used
   -    Spinal anaesthesia is often used
   -    Can be either or together
   -    Often the mother is awake during the procedure
   -    This allows for decrease in risks of complications associated with anaesthesia
   -    Also allows for mother and baby bonding and interaction following delivery