Typically, the prospect of a cesarean section (CS) scares women in labor. Nevertheless, the COP allows the woman to know in advance the exact date and time of the birth of the child and conduct the birth as planned, without any excesses and unpredictable moments. However, many women are interested in, on the basis of which the gynecologist decides that delivery by cesarean section is necessary, and how the optimal period is determined if the planned cesarean section is harmful to the mother and child.
What is cesarean section?
A cesarean section is an operation by which a baby is removed from the uterine cavity using an abdominal incision. SC can be performed as planned, when a woman in labor and doctors know in advance about the operation, and urgently, if for some reason a woman cannot be born for a long time on her own, and this begins to threaten her health and life.
What Cesarean Can Be
Most often, doctors write in the patient’s card not a detailed wording of the direction, but a reduction. Therefore, there are often situations when women find out already in the maternity hospital that there will be not a natural birth, but a planned cesarean section, and everything will happen in the coming days. Therefore, it is worth remembering the abbreviations: KS - cesarean section, the prefix "E" to the abbreviation means emergency, the prefix "P" - planned.
The difference between EX and PKS
Since it is impossible to plan an EX, an experienced gynecologist in late pregnancy may suggest that such an outcome of pregnancy is possible, but there is still a chance to give birth independently or higher than expected, then in the direction it will be written that EX is possible.
If a planned cesarean section is expected, then this will be indicated in the direction, the reasons leading to such a decision will also be indicated, the direction itself will be issued on a specific date. In addition, some directions are issued not to a specific maternity hospital, but with an open “place” so that the woman in labor can choose the hospital where she will give birth, after meeting with obstetricians and anesthetists, and sometimes with specialized doctors, such as cardiologists or traumatologists .
The difference between EX and PCD is sometimes traced in the way the incision is made. If the birth is very difficult, there are some serious problems, then the doctors do not reflect on the aesthetic appearance of the incision. Accordingly, it can take place anywhere in the abdomen, where it is convenient and as safe as possible. With PCD, the incision usually passes hardly above the pubis and most often even without the use of cosmetic sutures is hardly noticeable to strangers.
Planned cesarean section is also safer for subsequent pregnancies and childbirth. Emergency cop, on the contrary, is less safe for women's health. After an EX, a caesarean section is almost always prescribed during subsequent births to avoid uterine ruptures and other complications.
Indications for cesarean section
There are not always indications for such operations. But it happens that a woman herself is afraid to give birth, then the expectant mother herself informs the doctors about her desire. Closer to the time when a planned cesarean section is prescribed, careful preparation is required.
In addition to personal factors, there are also reasons directly or indirectly related to health. Thus, in the presence of immunodeficiency diseases, cancer, diabetes mellitus, diseases associated with the heart and blood vessels, and with any other diseases affecting the functioning of the internal organs, as well as with severe edema associated with pregnancy, PCS will be prescribed, and the possibilities a woman will not give birth on her own. Of course, if only the woman in labor will not hide her diseases and put her life and the life of the child at risk.
A planned cesarean section will also be performed if bone problems appear before or during pregnancy. A common cause of PCD is a strong divergence of symphysis (symphysitis).
Possible indications may be organs insufficiently prepared at the time of delivery, for example, an insufficiently opened uterus with already withdrawn waters. Then the doctors decide to administer oxytocin, but if it does not help, an EX is done.
In what cases do EX
EKS is done if the pregnancy proceeded normally, the woman in childbirth is healthy, the fetus too, but circumstances have arisen that can lead to injuries and other bad consequences. In this case, the operation is performed for a period of 38-42 weeks.
Usually, ECM is performed if during childbirth the baby begins to choke in the womb or there are obvious problems with blood flow in the fetus or mother. In such situations, the COP may be for a period of 36 weeks or earlier. Also, an emergency delivery takes place if the water has already passed for several hours, and the uterus has not opened enough for the baby to pass. Most often, such situations occur on periods from 36 to 40 weeks.
There are also cases when a child is simply stuck in the birth canal. This happens if the fetal head is too big. In this case, doctors are also forced to resort to ECS to exclude risks.
Less often, they resort to ECS during pregnancy prolongation, when more than 42 weeks have passed since the start of the last critical days, as well as when the fetus is improperly positioned, for example, with frontal insertion of the fetal head.
How long do PKS do
It is impossible to say unequivocally at what period a planned cesarean section is done, since each woman has her own pregnancy. The difficulty in correctly determining the term lies in the fact that the pregnancy lasts 38-42 obstetric weeks. However, they do not demonstrate the actual age of the fetus. If it is a question of natural fertilization, the actual terms can differ from obstetric up to 4 weeks, and this is a rather long period. At the same time, the doctor needs to know how much the child is formed, whether his life support systems are working, and even ultrasound will not be able to show it.
Partly because of the above reason, a planned cesarean section is prescribed at 39 weeks and later, if there are no additional indications, which include circumstances affecting the health of the woman in labor with a longer pregnancy. That is, for some types of diabetes mellitus, CS is prescribed for a period of 36 obstetric weeks, and sometimes even earlier, since it is more profitable for doctors not to risk the life of the woman in labor and the child, removing the already heavy burden from the woman’s health and shifting it to devices for further and better development baby, so doctors save many lives.
There are no defined boundaries. How long does a planned cesarean section take? Increasingly, doctors are looking at concomitant circumstances and how much a child can be formed. But such conditions only work in the case of natural fertilization.
At the same time, if fertilization was artificial, then from the moment of IVF, the doctors will know the timing of the planned cesarean section, if the operation arises.
How often can I have PCD?
How often can a planned cesarean section be performed and for how long? It can be done many times. But we must remember that CS is an operation on the uterus, the incision from which, of course, heals, but a scar remains. Thus, every second planned cesarean section is another scar on the uterus, which means that after two or three operations, the flexibility and strength of the tissues are significantly reduced, there is a danger of premature birth, tears and many other problems.
Due to the consequences of uterine deterioration, doctors try to resort to CS as little as possible if there is no particular indication. Also, the practice is more and more prevalent when, after PCD, obstetricians try to deliver a woman in a natural way, and only if the attempt does not materialize, an ECM is performed.
Between COP and repeated pregnancy should take place at least a year. Nevertheless, women often become pregnant during the first six months after a planned cesarean section. The second birth is again surgical intervention. CS is repeated again after a year and a half after the first operation, which negatively affects the health of the woman in labor.
How to prepare for PKS
Before starting the preparation, you need to find out from the gynecologist what period the planned cesarean section is done in the particular case when the direction will be given, and proceed in the next steps precisely from the doctor’s decision.
After the gynecologist determines the indications and the term, he can recommend the most suitable maternity hospital or give a referral to the specialized maternity hospital if there is evidence. Usually, in the presence of immunodeficiency diseases in a woman in labor, she is sent to give birth to specialized institutions.
Having received a referral, a woman can either wait when she needs to go to the hospital, or go get acquainted with obstetricians and anesthetists. The second approach is considered the most comfortable, because a few weeks before the cop, a woman in labor will tell everyone and show, if there is concern, then she can visit other institutions and also go to a psychologist. Thus, the stress from the upcoming operation will be reduced.
How is PKS
Depending on whether the Caesarean section is planned and for how long, the complexity of the operation for the child and his mother will depend. In a standard framework, namely at 38–40 weeks of gestation, PKS passes quickly and without fear for a woman in labor.
During the operation, an incision is made in the abdominal wall and uterus, the baby is removed, the umbilical cord is cut, the last is removed. After this, the fabrics are sutured.
But if the PCD was scheduled for one date, but for some reason the birth began before the COP and complications appeared, then the operation will take longer. It will be coupled with other procedures or operations to maintain health and life. But such a combination of circumstances is incredibly rare, and all because doctors send women to the hospital one to two weeks before PCS.
Operation duration
It is the operation that lasts from 20 to 40 minutes, but preparation and subsequent manipulations are beyond the scope of this time period. The preparation includes the introduction of anesthesia, disinfection of the place prepared for the operation, the connection of the necessary equipment.
After surgery, a woman may be conscious, or may be under anesthesia. It also has its own nuances. Each person has a different time for withdrawal from anesthesia, however, anesthetists do not always give preference to serious medications, and then during a SC the woman in labor is conscious, although she does not feel pain. In this case, there is no need to remove from anesthesia.
Also, the operation often ends with a “refrigerator”, then the woman from the birth is taken to a room where the temperature is constantly kept low. This is done to eliminate possible bleeding. In the "refrigerator" a woman can spend several hours.
PCA Recovery
If the doctors performed the SC on time, correctly sutured, removed the placenta and did not leave blood clots, then partial recovery after cesarean takes place within two weeks, during which time the woman may already stop experiencing pain and discomfort from the suture, begin to lift without problems and help baby in her arms. Within three months, the seam is already completely overgrown, respectively, the discomfort associated with the seam disappears and the stiffness of movements, problems with the stool disappear.
The psychological state after CS can also change as the physiological one. Therefore, women after surgery are recommended to use the help of a psychologist.