Elective C-Section in Milan
Caesarean Section
Cesarean section is a surgical procedure used to deliver a baby through an incision in the mother’s abdomen and uterus. This method, unlike vaginal delivery, is often chosen for medical reasons, both to safeguard the health of the mother and the baby. The reasons can range from complications in pregnancy to emergency situations during labor. In recent years, there has been an increase in the use of this practice, raising debates about the appropriateness of the indications and safety. Although it is a common procedure, cesarean section carries risks and requires a post-operative recovery period for the mother.
Elective Cesarean Section Indications
Elective caesarean section is distinguished by being a planned choice, not dictated by immediate emergencies during labor. This decision is taken into consideration when pre-existing conditions or situations evaluated during pregnancy suggest that a vaginal delivery may present greater risks for the mother or the baby. Among the main indications are placenta previa, in which the placenta partially or totally covers the cervical os, situations of presentation dystocia, such as breech presentation (baby in a sitting position or with the feet down), and maternal health conditions that contraindicate the effort of vaginal delivery. In addition, the presence of uterine scars from previous caesarean sections may represent another indication towards the elective choice of this procedure, in order to reduce the risk of uterine rupture.
This procedure is chosen in certain circumstances to ensure the safety of mother and baby during childbirth. Currently, it can also be performed upon maternal request.
When is an elective cesarean section performed?
Elective cesarean section scheduling is done with precision, choosing the optimal time for the health and well-being of both the mother and the baby. Generally, this procedure is scheduled for the 39th week of pregnancy or later, to ensure that the baby has reached sufficient physiological maturation, especially regarding lung development. Exceptions to this rule include specific clinical situations that may compromise the safety of vaginal delivery. These include:
- Breech presentation: when the baby is in a sitting position or with the feet down, increasing the risks during natural birth.
- Placenta previa: a condition in which the placenta partially or completely obstructs the internal cervical os, making the passage of the baby dangerous.
- Hypertensive disorders of pregnancy: such as preeclampsia, which can put the life of both mother and baby at risk if not managed in a controlled environment.
- Multiple pregnancies: especially in the case of twins or more, where the risk of complications increases, both due to fetal positions and pressure on the uterus.
- Maternal health problems: pre-existing conditions or conditions that develop during pregnancy that could make natural birth excessively risky.
The decision to anticipate the cesarean section before the 39th week is made with extreme caution, carefully weighing the benefits against the potential risks for the baby and the mother. The final decision follows a thorough discussion between the pregnant woman and her medical team, based on a holistic assessment of the health conditions, personal preferences and available clinical evidence.
Risks of the intervention
Elective cesarean section, although a safe and routine surgical procedure, does carry risks, as does any surgery. It is essential that the decision to proceed is made after careful consideration of the potential benefits and risks. Risks associated with cesarean section include:
Infections: The surgical incision may put you at greater risk of infection in the uterus, bladder, or incision itself.
Blood loss: During cesarean section, blood loss is generally greater than with vaginal delivery, with an increased risk of blood transfusions.
Complications related to anesthesia: Reactions to anesthesia, whether spinal or epidural, may include back pain, headache, or, in rare cases, more serious complications.
Breathing problems for the newborn: Babies born by cesarean section may be more likely to develop mild breathing problems, known as transient respiratory distress.
Risk of adhesions: Internal scars, or adhesions, can form after a cesarean section, potentially causing pain, intestinal obstruction, and problems in future pregnancies.
Longer recovery time: Recovery from a cesarean section is generally longer than after a vaginal birth, impacting the mother’s physical and emotional well-being.
It is important to note that despite these risks, a cesarean section may be the best choice for the safety of mother and baby in certain circumstances. Open and informed communication with the medical team is key.
How is an elective cesarean section performed?
Elective caesarean section is a surgical procedure undertaken with care and precision, aimed at ensuring the safety and well-being of both the mother and the newborn. The procedure begins with a series of preparations that include the administration of antibiotics to prevent infection and the application of anesthesia, usually spinal or epidural, to ensure that the mother does not feel pain but remains conscious. This preparatory phase is essential to create a safe and controlled environment for the operation.
Next comes the incision, carefully made in the lower part of the abdomen. This step is crucial and is performed with techniques that aim to minimize post-operative discomfort and promote aesthetic healing. Once access to the uterus has been opened, the most anticipated moment is the arrival of the newborn. This moment is followed by the cutting of the umbilical cord and the first pediatric checks on the baby.
Once the birth is concluded, the doctor proceeds with the removal of the placenta and the suturing of the incisions, restoring the integrity of the uterus and abdomen. These steps are essential for the mother’s proper healing and recovery.
The duration of the entire procedure can vary, but is generally contained within an hour, depending on the individual circumstances and specific clinical needs. Each step is carefully planned and carried out with the utmost respect for the needs of the mother and baby, ensuring that the experience of the caesarean section is as positive and safe as possible.
Preparation for elective cesarean section
Preparation for an elective cesarean section begins well before the day of surgery, involving both physical and emotional aspects. It is a process that requires attention to detail and close collaboration with the medical team to ensure that the mother and baby are in the best possible condition for the procedure.
First, pre-operative medical visits and check-ups are scheduled to assess the health of the mother and fetus. These tests may include blood tests, ultrasounds and fetal heart rate monitoring. This is crucial to identify any conditions that may affect the procedure or require adjustments.
At the same time, the mother is encouraged to follow specific instructions to physically prepare for the procedure. These may include fasting from midnight the day before the operation and the use of medications to reduce the risk of infection. It is also important to discuss anesthesia options and any concerns or personal preferences with the doctor in advance.
Emotional preparation plays a key role. Many hospitals offer antenatal classes or consultations to help mothers-to-be familiarize themselves with the cesarean section process, reducing anxiety and fear. It is also helpful to prepare a birth plan, discussing it with your partner and the medical team, to express your preferences on aspects such as the presence of the partner in the operating room and the first care of the newborn.
The last phase of preparation involves hospital logistics, such as the time of admission and the organization of the hospital stay. This includes preparing a hospital bag with everything needed for the mother and baby during the stay.
Post-surgery recovery
Immediately after the procedure, the mother is moved to a recovery area where medical staff monitors her vital signs, the effectiveness of the anesthesia, and her initial response to the procedure. Postoperative pain is managed with analgesic medications, and early mobilization is encouraged to promote circulation and prevent complications such as deep vein thrombosis.
The hospital stay after a cesarean section varies from woman to woman, but it typically lasts about 2 to 4 days, during which time the caregiver supports the mother in breastfeeding and caring for her baby, and monitors the healing of the incision. Before discharge, detailed instructions are given for home care of the incision, pain management, and signs of possible complications to watch for.
Once home, it is important for the mother to follow these instructions carefully, keeping the incision clean and dry, and resting as much as possible to promote healing. Physical activity should be resumed gradually, following the doctor’s advice and listening to the body’s signals.
Emotional support plays a vital role during this time. It is common to experience a mix of emotions, from excitement about the new arrival to fatigue and worries about healing and adjusting to motherhood. Talking to your partner, family, friends, or professionals can help you manage these feelings.
Postpartum visits with your doctor or midwife are essential to assess your healing progress, discuss postpartum contraception, and address any physical or emotional health concerns. This recovery period, while it can be challenging, is also a time to deeply connect with your newborn and adjust to your new family dynamic.
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