Childbirth

Cesarean delivery: when is it expected?

Cesarean delivery is chosen when natural delivery is not possible. It can be a planned caesarean section, when the date is established in advance, or an emergency when it is necessary to intervene due to complications to save the mother and the child.

Cesarean section is usually performed with the modified Stark method to avoid excessive blemishes. Nowadays, in fact, it consists of a 7-8 cm cut just below the pubic hair which should not leave obvious traces over time. It is also referred to as a “soft” caesarean section.

Planned cesarean delivery

Cesarean delivery is scheduled when:

  • the child is presented in the breech position
  • when there is a certain disproportion between the size of the fetus and the birth canal of the mother
  • in case of previous cesarean section even if it is not always necessary
  • the umbilical cord is twisted around the neck and would not allow the baby to channel itself without risk
  • in some cases of twin pregnancy
  • in case of placenta previa

Emergency cesarean delivery

All caesarean sections that are not planned in advance but are decided on the spot are called emergency caesars .

In fact, it may happen that despite the pregnancy taking place in the best possible way, the future mother has to face an unplanned caesarean section. The sentence “let’s do the cesarean” can be lived with mixed feelings by the mother. In fact, for those who hope to experience natural childbirth, the forced choice of a caesarean section could be painful, for some an affront.

There are situations in which an emergency caesarean section cannot be avoided to safeguard the health of the mother and the unborn child.

The most frequent cause of emergency CT is the alteration of the fetal heartbeat. In case of fetal distress, the baby is delivered in a few minutes and the mother is given spinal anesthesia. An epidural is not done in this case because spinal analgesia has a faster action and therefore is more suitable for emergencies. Furthermore, spinal anesthesia can be practiced by all anesthesiologists and not only by the “dedicated” ones as happens for the epidural .

General anesthesia is rarely used.

Another situation that requires an emergency caesarean section is when the labor does not proceed.

There is also an emergency when the umbilical cord (or cord) prolapses. In these cases it is practiced to avoid crushing the cord and therefore interrupting the baby’s oxygenation.

Other emergency situations occur with placental abruption or in the case of preeclampsia . Placental abruption can occur due to a sudden rise in blood pressure, an immune disease or for no foreseeable reason: you feel severe pain, the uterus contracts and bleeding begins. Immediate intervention is required, the consequences of which depend on the gestational age. The later the pregnancy is, the less risk there is for the baby.

Unnecessary use of cesarean delivery

Cesarean delivery is often used in unnecessary circumstances and in fact Italy is one of the European countries where the percentage of interventions is very high, reaching 35% (2012 – Istituto Superiore di Sanità ) of births. A number beyond any logic given that according to the World Health Organization, a country like ours should resort to it in a maximum of 15% of cases.

Conclusion

Surely a “normal” birth is preferable, without major hitches that goes between one contraction and another towards the happy event. An emergency caesarean is an unexpected event which, however, fortunately allows us to achieve the same goal. Recovery times are quite fast , not so different from those of a normal birth with episitomy , and generally after 4 days you can go home.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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