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Caesarean Section

Caesarean Section (or C-Section) is a surgical procedure that is performed under anesthesia through the abdomen and is done to help deliver a child.

An incision is made specifically into the abdomen and therefore into the Uterus.

This procedure is an alternate form of delivery than a vaginal delivery.

It has been done for several reasons and these will be discussed on this page.

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 80-90%% rate of Caesarean Section.

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

1.)  When vaginal delivery may pose a risk to the Mother or the Child

2.)  Recently women are choosing to have C-section to limit pain or other.

3.)  Others

Risks to the Child

–   Fetal distress
–   Breech position
–   Transverse placement
–   Larger than expected baby
–   Umbilical cord problems
–   other

Risks to the Mother

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

Risks or Complications of having a Cesarean Section

–   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 labor 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.

Anesthesia

–   Epidural is often used
–   Spinal anesthesia 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 anesthesia
–   Also allows for mother and baby bonding and interaction following delivery