C Section: Elective or an Emergency

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Labour and delivery preparation for C section

A cesarean section can be elective or emergency-based. For an elective section, a suitable date is chosen and the patient is admitted either on that day or 1 day prior to the surgery. Shaving is done from below the chest to mid-thigh. Antibiotics and intravenous fluids are started before the surgery. An enema may be given to the patient. Blood may be required, depending on the individual condition of the patient. Certain blood tests may be required e.g. hemoglobin, blood sugar etc. The patient needs to fast for at least 6 hours prior to a C section. An emergency C section is done if complications develop during labor. It usually carries a higher risk than an elective C section.

Natural Child Birth: Uncomplicated and Healthy

Labour and delivery preparation for natural childbirth

For natural childbirth, the patient is usually admitted when she develops labor pains or the bag of water surrounding the baby breaks and the patient starts leaking. After admission, shaving of the local part is done and enema is given to the patient. Intravenous fluids may be started if required. Epidural Analgesia for pain relief may be given if the patient asks for it. Labor pains may be enhanced with drugs. Monitoring of the baby’s heart rate is done. Antibiotics are required in selected cases. Most of the times, the patient is allowed a liquid diet.

Risks for mother in C section

In C section, all mothers are given anesthesia and although these days it is very safe, still the risk of anesthetic complications is always there. During the surgery, there may be increased bleeding and the patient may require blood transfusion which carries its own inherent risk. Very rarely the bleeding may force the surgeon to take a decision for hysterectomy (removal of the uterus). There may be an injury to major organs like bowel (gut), bladder or ureter. The chances of these injuries increase in cases of repeat surgery.

These injuries may be detected at the time of surgery or later on and sometimes the patient may require repeat surgery for the same. Another major complication is Thromboembolism (clot formation in the blood vessels) which can cause respiratory distress and even death. After C section it takes the patient more time for recovery as compared to a normal delivery. The patient may develop stitch line infection needing dressings, increased hospital stay or a daily visit to a doctor and more drugs and medicines. The patient also has increased chances of uterine infection which can cause fever, pain etc.

Risks for mother in natural childbirth

In natural childbirth, there is a small risk of pelvic floor injury which may cause bladder dysfunction and vaginal laxity. Sometimes the patient requires episiotomy (local stitches) which may cause discomfort after delivery and infection of these stitches may also occur. In addition, within the course of labor, unexpected situations may force a decision for emergency C section which carries a higher risk than a planned section. Certain situations may also require instrumental delivery which carries increased risk as compared to normal delivery.

Risks for baby in C section

A cesarean baby carries a higher risk of respiratory distress and transient tachypnoea of newborn and may require nursery care. Very rarely there may be an injury to the baby with the knife.

Risks for baby in natural childbirth

In a normal delivery, a difficult and prolonged labor may result in caput formation (head of the baby becomes soft and of abnormal shape). Instrumental delivery may cause injury to the baby. Undetected distress may also cause fetal hypoxia and the baby may require nursery care.

Benefits of C-section over normal delivery

The C section is painless. It can be preplanned and thus is convenient. There is no midnight rushing to the hospital etc.

Benefits of normal delivery over C-section

Normal delivery is natural. An uncomplicated normal delivery results in a healthy baby and mother without all the risks of C section. Early ambulation is by far the biggest advantage of a normal delivery, that is, soon after a normal delivery, the mother can breastfeed her baby. Within a week, at the most, she can completely take care of herself and her baby.

Labour and birth medications for C section

For C section anesthesia drugs, antibiotics, painkillers, intravenous fluids drugs like syntocinon to control blood loss are used.

Labour and birth medications for normal delivery

In normal delivery intravenous fluids, drugs to increase labor pain are used. Antibiotics and painkillers may be required after delivery in selected cases.

Postpartum recovery for C section

A hospital stays for 3- 4 days in C section deliveries is needed because the mother may experience discomfort due to the surgery and needs care.

Postpartum recovery for natural childbirth

In a normal delivery, the recovery starts in 1- 2 days.

* Expert inputs from Dr. Madhu Goel, Consultant, Gynecologist at Rockland Hospital, New Delhi

Original Source: https://drmadhugoel.needstreet.com/post/c-section-elective-or-an-emergency/510

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