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In some cases, doctors believe that the safest and most justified method of delivery for a pregnant woman will be a caesarean section. Therefore, a woman may have a logical question: how to set yourself up for a caesarean section? It must be remembered that under any external conditions it is important for a future mother to maintain a positive psychological state, since the health of the baby directly depends on this. That is why it is worth taking a responsible approach to preparing the birth of a child and starting it in advance.

Should I be afraid of a caesarean section?

As before any surgical intervention, a woman may have fears of an upcoming caesarean section. Undoubtedly, there is a certain risk of complications and even death. However, the percentage of failures after caesarean is minimal and fully justified by the prevailing number of women in labor who smoothly underwent this surgical intervention.

Therefore, we can definitely say that when choosing a good clinic and qualified obstetricians, you can discard all fears and calmly prepare for the long-awaited meeting with the baby.

Are you afraid of surgery?

YesA little

It must be remembered that this operation is prescribed primarily for the health of the baby and mother, as there is a clear list of medical indications, which obstetricians and gynecologists are guided by. Therefore, if operative delivery is necessary, the risk of death or any complications will be higher with natural childbirth.

Preparing for a caesarean section before hospitalization

Before entering the obstetric department, a woman should consult with the gynecologist who manages her pregnancy and familiarize herself with the main stages of the future operation in order to be fully aware of the features of the upcoming intervention. You should also prepare all the necessary things (clothes, diapers, diapers for a newborn, clothes and hygiene products for a pregnant woman).

A list of what a woman will need will be provided by a doctor or nurse at the antenatal clinic.

The following points are also important:

AT without fail the expectant mother must undergo all the prescribed laboratory and instrumental studies that are necessary for the obstetrician-gynecologist to determine the tactics of pregnancy management.
It is recommended to attend a family preparation school for childbirth together with the father of the child.
If in the background upcoming operation a pregnant woman has significant emotional disorders and breakdowns, it may be necessary to attend specialized courses or a psychologist who will tell you how to overcome the fear of a caesarean section.

Checklist: what you need to agree with your doctor in advance

Before the operation, the following points should be discussed with the obstetrician:

What method of anesthesia will be carried out, what sensations will you experience. Most often, the anesthesiologist chooses when the patient is conscious, but does not feel anything below the abdomen. For some, this may come as a surprise, since everyone associates surgery with general anesthesia, in which consciousness is completely turned off.
Is it possible for the future father to be present during a caesarean section. This also requires a preliminary discussion: in order to get into the operating room, you need to pass a bacteriological culture and undergo an x-ray of the chest cavity.
Will you see the baby immediately after the operation or will it happen later. It should be understood that in the event of unforeseen situations when the general condition of the baby is disturbed, it is not possible to immediately make direct contact with the newborn. However, this should not frighten the patient, since after examining the child by a neonatologist, this long-awaited meeting will immediately come true.

How to behave in the hospital before the operation?

Usually, before a caesarean section, a woman is in the hospital for a short time. This period is extremely important in terms of moral preparation, since the atmosphere medical institution gives the patient a full awareness of the reality of the upcoming operation. It is important at this time to feel supported and have a person nearby who can calm and maintain a positive attitude. Therefore, feel free to ask close people (husband, mother, sister, girlfriend) to visit you and not let you delve into painful experiences about the upcoming manipulation.

If a pregnant woman is concerned about something, she should immediately seek advice from a doctor or other hospital staff.

Correct attitude during surgery

In order for a woman to feel good during a cesarean section, direct moral preparation should begin a few hours before the scheduled operation. Relatives and medical staff should be involved in this. You need to set up a pregnant woman so that everything will go smoothly and easily.

The mood of the woman should be calm, as any manifestation of nervousness can complicate the work of the anesthesiologist and the operating team!

Also, relatives should explain to the expectant mother that doctors and midwives are her assistants and friends, and that everything they do is aimed only at the benefit of the baby and the giving birth. The girl should tune in to clearly follow all the instructions and instructions. medical staff. This will improve communication and speed up the work of doctors and nurses. It must be remembered that the right attitude during anesthesia and caesarean section will make the moment of meeting with the long-awaited baby unforgettable and happy.

Postoperative period

Now in medicine, the principle of early activation after caesarean section is welcomed. In the absence of contraindications, the puerperal is allowed to move and walk around the ward already on the second day after surgery. In this case, the doctor may prescribe a sedative to the woman to make it easier to endure the postoperative period.

Also in the postoperative period is not contraindicated, so the baby is applied to the breast in the first hours after the operation.

After a cesarean, a mother should take care not only of her well-being, but also of the child. In addition to breastfeeding, a woman is trained in the hygiene measures that a newborn requires immediately after birth.

Only a specialist will tell you exactly how to set yourself up for a caesarean section. Psychologists advise expectant mothers to change the focus of attention from the upcoming operation to meeting with the baby. It has been proven that if a woman, instead of imagining the cesarean itself, thinks about her child, about the first meeting with him, then her level of anxiety will significantly decrease, and emotional condition will be more stable. Such a simple trick will save you from many unpleasant psychological moments and will allow you to overcome the fear of a caesarean section.

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Pregnancy is one of the most beautiful periods in the life of every woman. A woman blossoms, feeling how she grows and develops in her. new life. However, it also happens that during these happy nine months, a woman faces more than one difficulty. And even before the moment of the first contractions, a decision is made about surgical delivery - a caesarean section. How not to get confused at such a moment and get the most positive emotions from the birth of a baby in this way?

Positive mood of the expectant mother

We will not consider situations when the mother herself decides that her baby will be born by caesarean section, supposedly making it easier for herself during childbirth. This is a huge misconception. Having gone through an operative childbirth, any woman can say with confidence that this is not at all easy way the birth of a baby and requires a huge expenditure of moral and physical strength. But in a situation where a cesarean section is prescribed based on the health of the mother or baby, and natural childbirth can be dangerous, you can and should set yourself up for positive thinking.

Absolute indications for caesarean section

There are not many absolute indications for caesarean section. If the mother is diagnosed with craniopelvic disproportion or a clinically narrow pelvis. This means that the baby's head is large and the pelvic bones are narrow. Most often, such a diagnosis is made already in the process of childbirth, when contractions are actively going on, but there is no progress. In this case, doctors resort to a caesarean section. Unsuccessful placement of the child in the uterus can serve as an indication for surgery. For example, the transverse position of the fetus, foot presentation, facial and frontal presentation. Also, emergency situations include: prolapse of the umbilical cord, placenta previa, placental abruption. These are situations that require an emergency caesarean section.

However, there are more and more situations when the operation is scheduled. Most often this occurs due to illness of the mother. Diabetes, diseased kidneys, bronchial asthma, symphysitis, hypertension, cardiac and other serious diseases. In such cases, in order to reduce the risks for mother and baby to a minimum, they decide on a planned caesarean section. A planned caesarean section has a number of clear advantages over an emergency one. Firstly, the mother has time to prepare mentally for this event, to get used to the idea of the need for an operative birth. Doctors will have the opportunity to analyze all the risks associated with a particular medical case, collect all the necessary tests and conduct examinations. In this case, the risks are minimized.

Relative indications for caesarean section is the weakness of labor activity, which is not amenable to medical correction. If the mother is over 30 years old and she is about to give birth for the first time, the doctor may recommend an operative birth, of course, if there are any concomitant pathologies. Chronic placental insufficiency, fetal hypoxia, multiple pregnancy, post-term pregnancy, prolonged infertility are relative indications for caesarean section. Also, in case of poor condition of the scar on the uterus from a previous operation, the doctor prefers operative delivery in order to minimize the risks.

Children after caesarean section

Many expectant mothers are afraid of a caesarean section because of the harm to the baby. There is a misconception that children born through surgery are characterized by poorer health, inability to overcome obstacles from children born naturally in the future.

In today's world, it's safe to say that this is a myth. In recent years, all adverse factors affecting the child due to caesarean section have been taken into account and are neutralized even during childbirth. Increasingly, the operation is performed under epidural anesthesia, which solves the problem of anesthesia products entering the baby’s bloodstream. Fluid from the lungs of the baby is squeezed out with a special device, and the operation itself is increasingly carried out with the onset of natural labor. During the operation under local anesthesia, the baby is immediately applied to the mother's breast, which gives the mother a full sense of her participation in the process of childbirth and avoid severe postpartum depression.

This is how nature works, that during pregnancy, the expectant mother is haunted by fears - first for herself and the safety of the fetal egg, then for the correct development of the child, for her heredity, health, etc. Usually, the last trimester of this amazing condition is accompanied by fears of the upcoming delivery - caesarean or natural childbirth - which is preferable? Is the risk of natural childbirth justified? Is it worth thinking about a caesarean section if the attending physician has not found indications for it? If, after all, a caesarean section - how will this affect the child?

Many future mothers, preparing for the birth of their first child, do not yet know what they will face, therefore they are looking for the easiest ways of delivery. They are even ready to pay a lot of money to fall asleep pregnant, and wake up with a pretty baby next to them. No pain, contractions, responsibility in childbirth. Beautiful, isn't it? Why give birth then? And why do doctors always set up a woman for natural childbirth to the last? Probably there are explanations for this.

About natural childbirth

The benefits of natural childbirth are many. Firstly, there is no penetration into the body of a woman, and, therefore, the risks inherent in operative delivery are absent. Secondly, a woman has been preparing for nine months to pass the main exam in her life, and, having passed it - having given birth to a child in a natural way, receives complete satisfaction from the successful completion of the pregnancy. Thirdly, in natural childbirth, a woman, by her own actions, helps the baby to be born, and he, in turn, goes through the path he needs for further proper development and growth. An even closer bond is created between mother and baby.

There is no need for anesthesia, although it is acceptable. After natural childbirth, it is easier to recover - only 2-3 weeks, instead of two to three months, as in the case of surgery.

Risks and negative aspects of natural childbirth

The first is the pain that not every woman can endure. Fortunately, no one forbids the use of painkillers here. Doctors, observing the condition of the woman in labor, decide whether anesthesia is needed or not.

Many pregnant women begin learning techniques early in pregnancy to help manage and control pain. These are muscle exercises, and various breathing exercises, etc. And pain is no longer a problem.

Many believe that natural childbirth is more traumatic for the mother and her baby. As the doctors themselves say, those mothers who listen to midwives and do everything as they are told give birth to healthy babies without breaks. It is quite possible to believe this, because, often, when listening to stories about childbirth, many mothers themselves say that they could not and did not want to listen to anyone and nothing, they all the time pushed, if only it would end as soon as possible. What for? If you have already come to "take the exam", do it "excellently"!

Psychological moment - childbirth takes place in the "company" of completely unfamiliar people. Even easier - persuade your husband to give birth together.

You can dig and look for a bunch of other negative aspects in natural childbirth. The main thing is to understand your own mood: if it is positive, then everything will go smoothly, if the mood is negative, there will definitely be some “buts”.

It is natural for a woman to give birth to children - nature has taken care of this. Therefore, you should not paint everything in gloomy colors, you need to believe that the birth will go well, and carefully prepare for this.

Of course, you can’t plan everything “from and to”. You need to be prepared that a non-standard situation can happen when you cannot do without an operation. Is it scary? No, it's scary to be in a similar situation at home, and with a good doctor there is nothing to worry about.

Caesarean section - two sides of the coin

A caesarean section is an abdominal operation, therefore, it is characterized by the risks of a conventional operation. In addition, doctors must remove the baby, and do it quickly and accurately. Everything seems simple, but there are both positive and negative sides. And if we compare them with natural childbirth, the preference of all doctors in favor of natural childbirth is fully justified.

Cons and pros

The main advantage of this method is the safety of the life of the child and his mother when, during natural delivery, there is a risk of losing at least one of them. During pregnancy, doctors monitor the woman and the fetus, conduct screenings, and identify risks. Although, quite often, a cesarean section is performed urgently - the decision is made already in the hospital, when there are some deviations in labor.

Another advantage of caesarean section is the absence of ruptures in the genitals, as well as the absence of damage in the pelvic organs. After a caesarean section, women are much less likely to have problems with sexual activity in the future.

In addition to this - speed. The operation lasts 20-30 minutes, then a short-term rehabilitation, and no long waiting for the full opening of the paths. A child born by surgery is less at risk of birth injuries, as well as hypoxia.

One of the main negative aspects of this operation is the emotional mood of the mother. Most often, she feels guilty about the baby, because what should end naturally ends in an operation. And the baby has not completely gone the way that should be. Many doctors in the future impose a “stamp” on such children, referring to cesareans, not as ordinary children, but as not quite full-fledged. Nonsense. A mother who gives a baby life is already performing a miracle, and it does not matter how the child was born, it is important that he is alive and well! Is it possible to feel guilty here? You carried a child! The doctors helped a little, but the most important thing was done by my mother herself!

The question of the development of cesareans is also controversial. In a kindergarten group of 20 people, not a single super-specialist will ever be able to accurately determine who was born naturally, who was born surgically.

Attitudes towards this operation range from enthusiastic to extremely wary.

Children born "not on their own" develop worse than their peers

Perhaps this is the most common fear, which includes several completely different aspects. Some fear that the child's health may be adversely affected by too abrupt transition from one environment to another. Others believe that a baby who has not made any effort to be born will have a weak character in the future. Still others fear hyperactivity, attention deficit disorder, and other psychological problems that are often attributed to "Caesarites".

In order to soberly assess the listed risks, you need to remember the similar dangers of natural childbirth. The rapid transition from one environment to another can be contrasted with prolonged natural childbirth, during which the baby's brain may experience oxygen starvation. And hyperactivity and attention problems are much more likely to be the result of rapid labor or birth trauma.

As for character, psychologists have long proven that its features directly depend on upbringing. Although, of course, it would be great if all people who were born “naturally” automatically acquired a strong-willed character!

Loss of former shape and attractiveness

Temporary restrictions on physical activity, which include rocking the press, exercising on simulators and other types of exercise, make some women afraid that after a caesarean section their stomach will hang down sadly without any prospect of becoming flat and elastic again.

However, new mothers after natural childbirth, as a rule, do not run to the gym the next day. Therefore, those two or three months during which recovery takes place after the operation can hardly be considered a serious period that prevents a return to a seductive form.

Those who are concerned not so much with the figure as with the scar remaining after the operation can be advised to carefully study the issue of modern technologies performing a caesarean section. If we compare modern jewelry-made seams with scars that “decorated” the bellies of women of the previous generation, the difference will be enormous! Approximately the same as the aspect ratio mobile phones early 90s and late 2000s.

Seam divergence during the next pregnancy

This fear has purely psychological roots, since no woman who is not an expert in this matter knows all the subtleties. The divergence of the seam on the uterus seems to young mothers to be something like “creeping” tights or a blouse cracked under the arm.

In fact, any gynecologist knows perfectly well what condition a woman's body should be in in order to endure a pregnancy after a cesarean section. If you carefully approach the issue of family planning and listen to the opinions of experts, no problems will arise.

The appearance of adhesions and subsequent infertility

Unfortunately, this fear is well founded, since adhesions are a common complication after any soft tissue surgery. They appear as scars between the internal organs related to the pelvis and abdominal cavity. After a caesarean section, a connective tissue scar forms at the site of the wound. On the one hand, it performs an important protective function, preventing the spread of infection. On the other hand, the adhesive process can affect not only the uterus, but also neighboring organs (for example, the intestines, ovaries, fallopian tubes).

By limiting the nutrition of these organs, adhesions prevent them from functioning normally, resulting in pain or discomfort. In addition, adhesions in the pelvis can prevent the onset of the next pregnancy.

Despite the potential for these side effects, a caesarean section should not be taken as a crippling procedure. After all, such an operation is not a whim of doctors or the woman herself, but the only possible way to give birth to a baby with minimal losses in the current situation.

After a caesarean section, you can not give birth on your own in the future

So thought our grandmothers and those doctors who observed them. In modern medical practice, there are a huge number of cases that refute this opinion. If the interval between childbirth is more than three years and the woman has no other contraindications to natural childbirth, except for a cesarean section that was once transferred, doctors are in no hurry to grab a scalpel.

Indications for caesarean section can be identified both during pregnancy and directly during childbirth (even if the pregnancy was uneventful). Thus, for one reason or another, any pregnancy can end with an operation, and every expectant mother should be prepared for the fact that the baby will be born as a result of a caesarean section. Possession of information about indications for surgery, types of anesthesia, about the surgical intervention itself and recovery after it will help a woman overcome her natural fear of a caesarean section and interact with doctors in a coordinated manner. In this case, the recovery period is also easier.

When is an operation needed?

A caesarean section is a surgical operation in which the baby is removed through an incision in the uterus and anterior abdominal wall. To date, in various maternity hospitals, the frequency of cesarean section ranges from 10 to 25?% of the total number of births.

This operation can be planned and emergency (if complications arise directly in the process of natural childbirth, an emergency caesarean section is performed). If indications for caesarean section are detected during or before pregnancy (this may be a pathology not directly related to pregnancy, such as eye disease), the operation is performed as planned.

An obstetrician-gynecologist who leads her pregnancy, or doctors of other specialties (therapist, ophthalmologist, neuropathologist) directs the patient to a planned caesarean section. The final decision on the need for a planned caesarean section and the timing of its implementation is made by the obstetrician-gynecologist in the maternity hospital.

Some expectant mothers ask the doctor to perform a caesarean section at their request (for example, a woman is afraid of complications of natural childbirth or pain). In fact, during this operation, the woman in labor is exposed to the same risk of possible complications as in any other abdominal operation, and strict indications are required for a caesarean section. Therefore, at present, at the request of a woman, in the absence of any medical indications, this operation is not performed.

Indications for caesarean section are divided into absolute and relative.

Absolute readings- these are situations when a child cannot be born through the birth canal or this will threaten the life of the mother:

transverse or stable oblique position of the fetus;
placenta previa (the placenta completely or partially blocks the exit from the uterus) and its premature detachment;
discrepancy between the size of the pelvis of the woman and the head of the fetus, when the head of the baby is larger;
significant narrowing of the pelvis of the woman in labor;
severe degree of preeclampsia (a complication of the second half of pregnancy, manifested by an increase in blood pressure, the appearance of protein in the urine, edema), if drug therapy is ineffective;
failure of the scar on the uterus - thinning of the uterine wall at the site of a previous operation (previous caesarean section, myomectomy - removal of myomatous nodes);
tumors of the pelvic organs that make childbirth difficult (eg, large fibroids, large ovarian tumors);
severe varicose veins of the vulva (external genitalia) and vagina;
diseases of various organs (for example, pathology of the fundus, in which the ophthalmologist gives a conclusion about the exclusion of the straining period).

Relative readings occur when the birth of a child through the birth canal is possible, but can lead to serious complications for the mother and fetus. In this situation, several factors are taken into account:

incorrect insertion of the fetus - the head is inserted into the pelvic cavity in such a way that it can get stuck when passing through the pelvic bones;
prolonged infertility;
in vitro fertilization (IVF);
the age of the primipara is over 35 years;
breech presentation of the fetus (the pelvic end of the fetus is adjacent to the exit from the uterus - the buttocks, knees, feet of the baby);
aggravated obstetric history (presence of miscarriages, abortions, malformations of the uterus in the past);
multiple pregnancy with transverse or pelvic presentation of the first or both fetuses;
preeclampsia of mild or moderate degree;
large fruit (more than 4 kg);
severe chronic diseases (for example, diabetes mellitus, diseases of the cardiovascular system, kidneys, hypertonic disease);
chronic hypoxia (lack of oxygen) of the fetus, intrauterine growth retardation.

During childbirth, the following complications may occur:

premature detachment of a normally located placenta;
threatening or beginning uterine rupture;
anomalies of labor activity (discoordination, weakness) with ineffective conservative therapy;
acutely developed intrauterine hypoxia (oxygen deficiency) of the fetus;
prolapse of umbilical cord loops with unprepared birth canal (unopened cervix).

In these cases, even with a normal pregnancy, doctors will perform an emergency operation.

Preparing for the operation

Approximately at a period of 34–36 weeks, the issue of indications for a planned caesarean section is finally resolved. The gynecologist of the antenatal clinic sends the pregnant woman to the maternity hospital 1–2 weeks before the expected date of the operation, if it is necessary to carry out drug treatment of the identified changes in the health of the mother and fetus (for example, correction of fetoplacental insufficiency), while a preoperative examination is also prescribed.

Additional examinations carried out in the hospital include ultrasound, fetal cardiotocography (monitoring of the heartbeat), dopplerometry (study of the fetal-placental-uterine blood flow). The expected date of delivery is specified and the day as close as possible to the date of delivery is selected. If there is no need to stay in the maternity hospital in advance (for example, with a transverse position of the fetus), then a preoperative examination can be done at the antenatal clinic. After that, the woman should visit the doctor of the maternity hospital, discuss the date of the operation with him and go to the hospital on the eve of the expected date.

Before a planned caesarean section, a pregnant woman is sent for the following tests:

Complete blood count and coagulogram(study of the blood coagulation system). Determination of the blood group and Rh factor is necessary for a possible blood transfusion during surgery with large blood loss.

ultrasound, dopplerometry(study of fetal-uterine-placental blood flow) and cardiotocography (CTG - study of fetal cardiac activity) to assess the condition of the baby.

After consulting an obstetrician-gynecologist and an anesthesiologist, the patient gives written agreement for surgery and anesthesia. On the eve of the operation, it is necessary to take a shower, you can drink a sedative (only on the recommendation of a doctor). In the evening, a light supper is needed; On the morning of the operation, you can no longer eat or drink.

2 hours before the operation, a cleansing enema and shaving of the perineum and, if necessary, the lower abdomen, where the incision will be made, is performed. Immediately before the start of the caesarean section, a catheter is inserted into the bladder, which is removed a few hours after the end of the operation. This measure helps to prevent injury to the filled bladder during surgery.

Anesthesia

To date, the safest method of anesthesia for both mother and fetus is regional (epidural, spinal) anesthesia. In modern maternity hospitals, more than 95?% of operations are performed using these types of anesthesia. With epidural anesthesia, pain medications are injected into the epidural space (the space between the hard shell of the spinal cord and the vertebrae) through a catheter, and with spinal anesthesia, the medication is injected directly into the spinal canal. The puncture is made in the lumbar region. Thus, the anesthetic anesthetizes the spinal nerves that innervate the pelvic organs and the lower body.

During the operation, the woman is conscious and can communicate with the medical staff, and also hears the first cry of her baby and sees him immediately after birth. With this type of anesthesia, the drugs do not enter the mother's circulatory system, and the fetus is not exposed to the drug.

Much less often, general anesthesia is used when the woman is under anesthesia throughout the operation: this occurs in cases where there are contraindications for epidural or spinal anesthesia, or when an emergency caesarean section is necessary and there is no time for regional anesthesia.

Epidural anesthesia begins to work 10-20 minutes after injection medicines, and spinal - after 5-7 minutes, while a woman is immersed in general anesthesia immediately after intravenous administration of drugs. This is important, for example, when urgent surgery is needed in case of severe bleeding (placental abruption) or acute hypoxia (lack of oxygen) of the fetus - this condition threatens the life of the baby. In addition, a woman may have contraindications to epidural or spinal anesthesia: low blood pressure (this type of anesthesia further reduces pressure, which can lead to impaired blood supply to the fetus and feeling unwell mother); severe deformities of the lumbar spine (hernias, injuries), in which it is impossible to accurately puncture and trace the spread of the drug. The disadvantage of general anesthesia is that anesthetics penetrate the mother's blood and can have a negative effect on the fetus.

Operation progress

After anesthesia, the woman is lubricated with an antiseptic and covered with sterile sheets. The operating field itself, as well as the doctors who will perform the operation, the woman does not see, since a barrier is installed at the chest level.

The skin incision is made along the upper edge of the pubic hairline or in a straight line slightly higher. After moving the abdominal muscles away, a transverse incision is made on the uterus (such an incision heals better), then the fetal bladder is opened. The doctor inserts his hand into the uterine cavity, removes the child by the head or pelvic end, then crosses the umbilical cord between two clamps placed on it.

The baby is handed over to the midwife, who measures and weighs him, after which the child is examined by a pediatrician. Then the doctor removes the placenta by hand, and the incision on the uterus is sewn up with a thread, which dissolves after 3-4 months. Next, the abdominal wall is restored in layers. Stitches are applied to the skin, and a sterile bandage is placed on top.

Currently, the so-called cosmetic suture is increasingly being used, when a self-absorbable thread passes intradermally and is not visible from the outside. Such a seam does not need to be removed, and the scar after a cesarean section is almost invisible: it is a “thin thread”.

The duration of the operation is on average 20–40 minutes (depending on its technique and complexity), while the child is removed already at 5–10 minutes.

Upon completion of the surgical intervention, an ice pack is placed on the lower abdomen for 2 hours: this helps to contract the muscles of the uterus and quickly stop bleeding.

An emergency caesarean section follows the same pattern as a planned one. Sometimes during an emergency operation, not a transverse, but a longitudinal incision is made on the skin - from the navel down to the pubis: this speeds up the process of entering the abdominal cavity. In addition, in this case, better access to the pelvic organs is provided, which is necessary for some complications in childbirth. But a transverse incision on the skin is preferable, since the scar forms better and heals faster.

If the operation is performed under regional anesthesia, when the woman is conscious, then after the birth of the baby, the midwife shows her the baby and, if it is in a satisfactory condition, leans the newborn against the mother's cheek. This is the first contact between mother and baby.

Recovery period

in the maternity hospital

control of the woman's condition. After a caesarean section, the patient is transferred to the intensive care unit (intensive care unit), where her condition is monitored around the clock during the day: blood pressure is measured, breathing and heart rate are monitored, the general well-being of the woman in labor, the effectiveness of uterine contraction, the amount of discharge from the genital tract, the condition postoperative suture, the amount of urine.

A few hours after the operation, it is allowed to move a little in bed, bend your knees, and turn slightly on your side. After 6 hours, you can slowly get out of bed: with the help of the medical staff, the woman first sits down, then gets up and can stand for a while. And after the transfer of the puerperal to the postpartum department after 12-24 hours, she can move slowly.

Baby care. On the first day, the newborn is in the children's department. In the absence of complications, after a day the baby is transferred to the ward of joint stay with the mother. Early activation of a woman after a caesarean section is very important for better contraction of the uterus and restoration of intestinal motility (contractions). In addition, in the joint room, a woman can feed and care for a child.

In the first 2-3 days after the operation, the young mother feeds the baby with colostrum, a very valuable and useful product for the child, which fully provides his body with all the necessary substances. A few days later (usually on the 4-5th day after the operation), the woman has milk. With cesarean section, milk usually comes a little later than in the case of natural childbirth, when it appears on the 3rd day. This is due to the fact that the hormone that triggers lactation is released into the blood a little later due to the lack of early attachment to the breast (during natural childbirth, the baby is applied to the breast a few minutes after birth - in the absence of contraindications). But this does not affect the health of the child in any way - colostrum fully provides for his energy needs.

The most comfortable position for breastfeeding for mother and baby during this period is the side lying position: this reduces the pressure on the postoperative suture. Almost all modern maternity hospitals are focused on the joint stay of a woman with a child, which is extremely necessary to establish full lactation and psychological connection between mother and baby. If there is no such opportunity in the maternity hospital, the child is regularly brought to the mother, and she has the opportunity to feed him.

Medical therapy. After the operation, painkillers are prescribed, their dosage and frequency of administration depend on the intensity of the woman's pain, usually they are required in the first 2-3 days after the operation. Drugs are also introduced that promote intensive contraction of the uterus. Antibiotics are prescribed as indicated. Physiological saline (0.9?% NaCl solution) is also administered intravenously, since a woman loses more blood during a cesarean section than during natural childbirth. All drugs administered are compatible with breastfeeding. On the 2nd day, a cleansing enema is prescribed to improve intestinal motility and better contraction of the uterus: after the operation, the intestines function poorly, overflow, which interferes with normal uterine contraction and the discharge of blood clots.

Seam processing. Every day, the nurse treats the postoperative suture with an antiseptic solution (iodine, potassium permanganate) and applies a sterile bandage. In addition, the woman is sent for physiotherapeutic procedures for the speedy healing of the suture. The skin scar is formed 5-7 days after the operation, so if non-absorbable sutures are applied to the skin, they can already be removed at this time. If a cosmetic suture has been applied, it is not removed. On 3-4, less often - 4-5 days after cesarean section, ultrasound is performed; it helps to clarify whether the uterus contracts normally and what is the condition of the postoperative suture.

Wearing a bandage. It is necessary to purchase a bandage in advance: it will greatly facilitate movement around the ward and reduce pain in the area of the postoperative suture, and will also help restore stretched abdominal muscles. The bandage is recommended to be worn for at least 1 month after the operation for several hours a day.

Food. On the first day after a caesarean section, doctors are allowed to drink only mineral water without gas. In the following days, the use of fermented milk products (kefir, ryazhenka) is recommended, as they restore intestinal function well, as well as boiled meat, vegetable broths, cereals. You should not eat raw vegetables and fruits, as well as foods that are a source of allergies in a child (honey, nuts, chocolate) and lead to increased gas formation in the intestines of mother and baby (cabbage, grapes, radishes, radishes, flour products and sweets).

After discharge

If the mother and baby have no complications, they are discharged 6-8 days after the operation. During the first month, a woman may be disturbed by pulling pains in the area of the postoperative wound and in the lower abdomen. This is due to uterine contractions and healing of the uterine and skin scar.

If discharge, swelling, redness and swelling appear in the area of the scar, a woman should definitely contact the doctor of the antenatal clinic or the maternity hospital where the operation was performed. These changes in the suture indicate the possible development of an inflammatory reaction as a result of the addition of an infection, which requires mandatory treatment. In addition, a specialist's consultation is necessary when abundant or cloudy discharge with an unpleasant odor from the genital tract appears, fever, sharp pains in the lower abdomen: all this may indicate the development of postpartum endometritis (inflammation of the inner layer of the uterus). After caesarean section, endometritis is more common than in the case of natural childbirth. This is due to the fact that the uterus contracts worse after the operation than after natural childbirth, since it has a seam. It can cause retention of blood clots in the uterine cavity, which are a favorable breeding ground for the reproduction of microorganisms that cause inflammation of the inner layer of the uterus.

In a women's clinic or medical center a woman after a caesarean section is regularly monitored by a gynecologist for 1–2 years.

At home, if possible, you need to limit intense physical activity - lifting weights (more than 2 kg), sharp slopes. The seam until complete healing can be washed under a warm shower with soap, but in no case rub with a washcloth. In the first few months, it is also not recommended to take a bath. This is due to the fact that in the postoperative period, the uterine cavity is a wound surface, and taking a bath can provoke infection and the development of endometritis. After 6-8 weeks, new cells of the uterine lining will form, and the woman will be allowed to take a bath.

You can apply sterile dressings to the seam area - then the clothes will irritate the seam less. At home, it is recommended not to use a bandage so that the seam "breathes".

Sexual intercourse after surgery can be resumed after 6-8 weeks, after consulting with a gynecologist.

On the uterus, a full-fledged scar is formed 2-3 years after the operation, by this time the general recovery of the body after childbirth occurs. Therefore, planning the next pregnancy is recommended precisely through this time period. The possibility of spontaneous childbirth after caesarean section is decided individually, but recently women are increasingly giving birth through the natural birth canal (in the case of a well-formed scar on the uterus) under the strict supervision of specialists.