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| Home > Complication & Medications > Cesarean Birth > Before the Cesarean Birth
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| | Before the Cesarean Birth
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The nurse prepares you for the planned or unplanned cesarean delivery by shaving your abdomen and the upper portion of your pubic hair. An enema will be administered and a thin, flexible tube (a cathe-ter) will be inserted through your urethra into your bladder to keep it empty. The catheter may be safely removed twenty-four to forty-eight hours after surgery. An intravenous drip in a hand or arm vein also needs to be started and may continue for twenty four hours after the delivery.
Anesthesia
 Surgery needs to be performed under anesthesia. A regional anesthesia may be administered which allows you to be awake without feel-ing pain. Spinal, epidural and caudal are three basic types: A spinal numbs you from your chest to your toes, and your legs become immobile. Pressure and pull are felt more in an epidural or caudal anesthesia while numbing you in the same area as a spinal. The symptoms of regional anesthesia are nausea, burning sensations, shoul-der pain, trembling and shortness of breath. Other medications to relieve these sensations may make you drowsy during recovery and unable to enjoy your baby.
In extremely rare cases of life- threatening emergencies where immediate intervention is re-quired, you may be administered general anesthetic because of its fast action. An intravenous drug to relax your muscles and put you to sleep along with the insertion of an airway in your throat through which an anesthetic gas is administered is required. Adverse side effects on the mother and baby make physicians avoid this type of anesthesia.
The Surgery
You will be lying on your back with a wedge under one hip to reduce the likelihood of supine hypotension, during surgery. The uterus is dissociated from the large blood ves-sels by the wedge. Your abdomen will be washed with an antiseptic solution and draped with sterile sheets. A screen would be placed between your head and abdomen to maintain a disinfected field for the surgery and also prevents you and your part-ner from viewing the surgery. If you wish to see the babies at birth, request your attendant to lower the screen. Cesareans take about one hour to perform, but the baby is usually born ten to fifteen minutes after surgery begins.
A cesarean section requires two incisions: one through the abdominal wall-the skin, muscle, fat and connective tis-sue; and the other through the uterus. Both incisions may be vertical or transverse (horizontal) or one may be vertical and the other transverse. For example, you may have a transverse skin incision with a vertical uterine incision. The doctor should mention the type of incisions undertaken for medical management future births.
Skin Incisions
There are two types of skin incision for a cesarean. The trans-verse skin incision (or bikini cut) is the more common of the two; it is made horizontally just above the pubic bone. The midline incision is made vertically between your navel and pubic bone. It allows for a quick delivery in an emergency.
Uterine Incisions
There are three types of uterine incision. The classical incision is made vertically in the fundus. It is done for fetal emergencies like placenta previa. and transverse lie and normally not advised.. Vagi-nal delivery is usually not feasible for future births after this type of incision.
The lower segment trans-verse is the most common incision though requiring more time to perform, as blood loss and postpartum infections are considerably reduced. After a lower segment transverse incision, a future vaginal birth is possible.
The lower segment vertical incision is commonly performed when it is thought that a larger incision might be needed.
The doctor makes an incision and suctions the amniotic fluid out of the uterus, to lift the baby and manually separate the placenta and remove it. The fluid and mucus are suctioned out of the baby`s nose and mouth. The baby is dried off, examined and given an Apgar score .
After surgery, the uterus and abdominal muscles are closed with absorbable thread. The skin is closed with non absorbable thread, clamps, or staples are removed before you leave the hospital.
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