TYPES OF BIRTH

CAESAREAN SECTION

Why might you need a caesarean?

It might be because:

• your baby's exit is blocked by the placenta (placenta praevia)
• your baby is large in relation to your pelvis
• or isn't growing properly
• or you have a serious medical condition.

You don't always have to give birth by caesarean if you fall into one of these categories, but your consultant might well suggest an ELECTIVE CAESAREAN which means that a date is fixed for your operation before you go into labour.

You might need an EMERGENCY CAESAREAN if monitoring before or during labour shows your baby is in distress.

What happens when you have a caesarean?

Before the operation, you will have to:

• sign a consent form
• remove your jewellery
• take out your contact lenses
• drink some medicine to neutralise the acid in your stomach.

You will have a couple of centimetres of pubic hair shaved off, a drip put into your arm, a catheter into your bladder and heart monitors fixed to your chest.

Your anaesthetic will either be a local (spinal or epidural) which means that you'll be awake for the operation, or a general. General anaesthetics aren't very common nowadays.

There will be around eight doctors, midwives and other staff assisting at your caesarean. You won't be able to see anything because there will be a screen across your chest. The surgeon makes the cut on the `bikini line' (the scar won't show when your pubic hair grows back). It takes about ten minutes for your baby to be delivered and during this time you will hear the clinking sound of surgical instruments and lots of sucking noises as the amniotic fluid is suctioned out. You'll feel strange (not painful) sensations - as if someone is rummaging around inside you! After your baby is born, the paediatrician will check him over and then he will be given to you to cuddle while your operation is completed which takes about 40 minutes.

AFTER YOUR CAESAREAN

After you have had a caesarean it is important not to compare recovery with friends who have had vaginal births. Remember that you have had major abdominal surgery and think of getting better in terms of weeks rather than days.

Pain

During the operation you may have been given strong morphine-like painkillers but you will need more pain relief after the surgery.

You may be offered pain-killing injections (morphine-like drugs that will make you feel dopey)

• a small pump containing strong pain-relieving drugs you can operate yourself
• suppositories
• tablets
• a TENS machine.

If you are in pain, ask for help and more, or different, painkillers.

Other treatment

You will have a drip in during surgery which will usually be left in for some time afterwards and you will be monitored carefully over the next day or two.

You will have had a catheter inserted to keep the bladder emptied, which may be left in place for 24 hours after the operation.

You may need iron tablets.

You may have a lot of trapped wind and this can be uncomfortable. Because of the surgery, it will be difficult to stand upright at first. Try standing bent over at first, and gradually get more upright day by day. It can get very achey and you will feel tired for some time. However, you will be encouraged to get up and move around to improve circulation and recovery. (Ask for help if needed.)
You shouldn't lift anything heavier than your baby for about six weeks and you won't be able to drive either for about six weeks, depending on your insurance

Making yourself comfortable

• To get out of bed - wriggle to the edge of the bed and draw your knees up to your chest. Using your hands, push yourself into a sitting position. When you are sitting on the side of the bed with your legs touching the floor, and feel steady, stand up.
• Whether sitting or lying, experiment with pillows to support you and your baby so that you're both comfortable.
• Keep the pressure off your scar with high-waisted knickers (available from NCT Sales 0870 112 1120)
• Some people find peppermint tea (or ginger) helps release trapped wind.
• Ring your bell and ask for help if you are in pain and when you need to reach or hold your baby.

Your feelings

It may help for you to understand why you had a caesarean. In most cases,it will have been due to a specific problem which will not affect future births. It may help to ask you midwife to go through your notes with you so you know exactly what happened. You can ask for a copy of your notes to take home.

If you have had a caesarean, or have been told that you will need to have one and feel unhappy, then you can talk to someone by contacting the National Childbirth Trust Enquiry Line on 0870 444 8707. Or call the Birth Crisis Network on 020 7485 4725.