It is not always recommended for a woman to give birth on her own. If there are a number of complications or characteristics of the body, childbirth is carried out using a planned caesarean section. This method consists in the fact that the baby is brought into the world through an incision in the peritoneum and uterus. This surgery is used in almost a third of births carried out in the country. Some of them are carried out not because of the doctor’s testimony, but because of the reluctance of mothers to endure pain during labor.

Indications for surgical intervention are divided into primary and secondary. The first are associated with physiological reasons. In this case, the need for a cesarean section is not even discussed. If there are secondary reasons, the doctor decides whether surgery should be performed or whether labor can proceed. naturally. However, when giving birth to a baby on your own, there is a high risk of complications.

Main indications:

Secondary indications:

Types of caesarean section

There are two types of caesarean section: emergency and planned.

Timing of planned caesarean section

In the absence of an urgent need for surgery and in good condition fetus, the first planned caesarean section is usually carried out at 39-40 weeks. By this time, the child has already become fully formed and is able to breathe independently.

A repeat cesarean section is scheduled a couple of weeks earlier than this date. It is usually performed at 38 weeks of pregnancy.

But there are often cases when, as a result of emergency events, for example, premature placental abruption, the doctor decides to perform the operation much earlier than the due date. This can also happen when sharp deterioration condition of the mother and her fetus. C-section can be carried out at 37 or even 35 weeks. The fetus is not yet full term, and the lungs may also not be developed. A neonatologist examines the baby after birth, identifies problems with breathing and pathologies, if any, and makes a decision for further actions with the baby. If necessary, the child is connected to a mechanical ventilation system and power supply through a feeding tube.

The duration of the operation is determined approximately by the surgeon. A week before giving birth expectant mother hospitalized and undergoes all necessary examinations. And only after receiving their data, the doctor sets a specific date and time.

Advantages and disadvantages of the method

The undoubted advantage of a caesarean section is that it saves the lives of two people, whereas a natural birth could lead to their death. Many mothers note that the speed of the operation is an undoubted advantage. There is no need to spend in the delivery chair long hours, suffering from contractions. Fast operation will relieve the woman in labor from unbearable pain and will only take about half an hour. In this case, the baby will be delivered into the world within the first 5-7 minutes. The rest of the time will be spent suturing. Also, this type of birth of a baby relieves the mother of the possibility of damage to the genital organs.

Unfortunately, this method of giving birth to a child has many disadvantages. Those who believe that a caesarean section is an excellent way to have a quick and painless childbirth are deeply mistaken.

The main disadvantage of a cesarean section is the appearance various complications after surgery.

Placenta previa in subsequent births, the possibility of hysterectomy due to placenta accreta, internal scars, heavy bleeding and inflammatory processes in the uterus, complications with the healing of sutures - this is an incomplete list of what a woman can get as a result of childbirth by cesarean section.

Many mothers often complain that after such a birth they do not feel a sufficient emotional connection with their child. They assume that what is happening is wrong and even become depressed. Fortunately, it doesn't last long. Constant contact with the baby brings the mother back to normal. But the limitation is physical activity in the first time after childbirth, including lifting the baby in your arms, is a serious problem for a young mother. After the operation, it is difficult for her to provide proper care for her newborn. Therefore, at this time, more than ever, she needs the help of her household.

A difficult recovery from anesthesia, weakness after surgery, an impressive scar, also few women will enjoy. Abstinence from intimate life in the first months can become a serious test for a married couple.

A caesarean section does not go unnoticed for the baby either. During an artificially induced birth, the baby may have residual amniotic fluid in the lungs, which can lead to complications in the future. Pneumonia is common in newborns born by caesarean section. Premature birth can also affect the baby's immunity and susceptibility to infections. Such children are easily susceptible to various diseases.

Before a cesarean section is performed, the expectant mother must give her consent and choose the method of anesthesia. Everything is documented. Even if it is necessary to perform emergency surgery directly during a natural birth, the doctor must obtain the consent of the woman in labor.

If there are no special indications for the operation, medical professionals recommend that women give birth on their own. But many naively choose a caesarean section, believing that they will get rid of painful and long contractions. But before you sign the consent to carry out the operation. You should think carefully about whether you are prepared for possible complications after such a birth? Maybe you shouldn’t risk your future health and give birth to your child without the intervention of a surgeon?

During childbirth, circumstances do not always turn out well. There are situations when a child cannot be born naturally. And then doctors have to interfere with the immutable laws of Mother Nature and do everything possible and impossible in order to save the life of the mother and baby. In particular, with the help of surgery.

All this does not pass without consequences, and often with repeat pregnancy it is necessary to schedule a second caesarean section to eliminate the risk of rupture of the suture on the uterine wall. However, contrary to myths, surgery in this case is not indicated for everyone.

The doctor makes a decision about reoperation only after a thorough analysis of the wide variety of factors accompanying pregnancy. Everything matters here, mistakes are unacceptable, since the life and health of the woman and child are at stake. Here are the most common indications for a second cesarean section, which usually result in surgical intervention during labor.

Woman's health status:

• diseases such as hypertension, asthma;
• serious vision problems;
• recent traumatic brain injury;
• oncology;
• pathological disorders of the cardiovascular or central nervous systems;
• very narrow, deformed pelvis;
• age after 30 years.

Seam features:

• longitudinal suture placed during the first cesarean section;
• doubtful if there is a threat of its discrepancy;
• availability connective tissue in the scar area;
• abortions after the first caesarean section.

Pregnancy pathologies:

• malpresentation or large size fetus;
• multiple births;
• After the first operation, too little time has passed: up to 2 years;
• post-maturity.

If at least one of the above factors occurs, a cesarean section a second time is inevitable. In other cases, the doctor may allow the woman to give birth naturally. Some of the indications for reoperation are already known in advance (the same chronic diseases), and the young mother knows that she cannot avoid repeated surgery. In this case, she should prepare for such a crucial moment in order to prevent everything dangerous consequences and reduce risks to a minimum.

If you are assigned planned second caesarean section (i.e. indications for its performance were identified during pregnancy), you should know how to prepare for this difficult operation. This will allow you to calm down, set yourself up for a successful outcome, and put your own body and health in order.

This is very important, since in 90% of cases, a young mother’s careless and too frivolous attitude towards repeated surgery leads to dire consequences. As soon as you find out that you are having a second CS, be sure to take the following steps.

During pregnancy

1. Attend prenatal classes that specifically focus on caesarean sections.
2. Get ready for what's coming long time stay in hospital. Think in advance about who you will leave your older children, pets, and home to during this period of time.
3. Think about the issue of partner childbirth. If they do it to you local anesthesia during the second cesarean and you will be awake, you may be more comfortable if your spouse is nearby at this moment.
4. Regularly undergo examinations prescribed by your gynecologist.
5. Ask the doctors all the questions you are interested in (what tests are prescribed, at what time the second planned caesarean section is performed, what medications are prescribed to you, if there are any complications, etc.). Don't be shy.
6. There are cases when during the second cesarean section a woman loses a lot of blood (due to placenta previa, coagulopathy, severe preeclampsia, etc.). In this case, a donor will be required. It would be nice to find him in advance from among your close relatives. This is especially true for those who have rare group blood.

1-2 days before surgery

1. If by the time of the planned date you are not in the hospital, prepare things for the hospital: clothes, toiletries, necessary papers.
2. Two days before the second cesarean section you will need to give up solid food.
3. Get a good night's sleep.
4. You cannot eat or drink for 12 hours: this is due to the anesthesia that is used during cesarean section. If you vomit while under anesthesia, the contents of your stomach may end up in your lungs.
5. The day before your second cesarean section, take a bath.
6. Find out what kind of anesthesia you will be given. If you do not want to miss the moment your baby is born and want to stay awake during this time, ask for local anesthesia.
7. Remove makeup and nail polish.

The preparatory stage for the second caesarean section is very important, as it helps the woman focus on her own body and get her health in order. This usually leads to successful outcome childbirth For her own peace of mind, the expectant mother can find out in advance how this operation is performed, so as not to be surprised during the process and to adequately respond to everything that the doctors suggest to do.

Stages: how the operation works

Typically, women going for a second caesarean section do not ask how it goes. this operation because they have already experienced all this. The procedures differ little from each other, so there is no need to be afraid of any surprises or anything supernatural. The main steps remain the same.

Preoperative stage

1. Medical consultation: the doctor should once again discuss the reasons why a second cesarean section was prescribed, its advantages, disadvantages, risks, consequences, and also answer all your questions.
2. You will be asked to change into a special robe.
3. The nurse will conduct a mini-examination: check the mother’s blood pressure, pulse, temperature, breathing rate, and the baby’s heartbeat.
4. Sometimes an enema is given to empty the stomach.
5. They suggest drinking an antacid drink to prevent regurgitation during surgery.
6. The nurse will prepare (shave) the pubic area. This is necessary to ensure that hair does not get into the abdomen during surgery, as it can provoke an inflammatory process.
7. Installation of a drip through which antibiotics (cefotaxime, cefazolin) will enter the body to prevent infection and fluid to prevent dehydration.
8. Insertion of a Foley catheter into the urethra.

Surgical stage

1. Many people are interested in the question of how the incision is made during the second caesarean section: exactly along the seam that was made the first time.
2. To avoid blood loss, the doctor cauterizes the torn blood vessels, sucks amniotic fluid from the uterus, takes out the baby.
3. While the baby is being examined, the doctor removes the placenta and sutures the uterus and skin. This lasts about half an hour.
4. Applying a bandage over the suture.
5. Administration of the drug for better contraction of the uterus.

After this, you may be given a sedative or sleeping pill so that your body can rest and gain strength after the stress. During this time, the baby will be looked after by professional and experienced medical staff.

It must be borne in mind that any surgical intervention depends on many factors, so each of them can take its own path, different from the others. And yet, there are certain features of this operation: what is important for a woman in labor to know about the second cesarean?

Features: what is important to know?

Despite the fact that the woman has already gone through all the stages of a cesarean section during her first pregnancy, the second operation has its own characteristics, which it is better to know about in advance. How long the operation lasts, when it is performed (timing), whether it is necessary to go to the hospital in advance, what anesthesia to agree to - all this is discussed with the doctor 1-2 weeks before the operation. This will avoid unpleasant consequences and shorten the recovery period.

How long does it last?

The second cesarean lasts longer than the first, since the incision is made along the old seam, which is a rough area and not a complete one skin, as before. In addition, repeated surgery requires much more caution.

What anesthesia is used?

During the second caesarean section, more powerful drugs are used for pain relief.

How long does it take to do it?

The most important feature caesarean section scheduled for the second time - the timing of how many weeks the second planned caesarean section is performed. They shift significantly to minimize risks. The larger the belly of the woman in labor, the larger the fetus, the stronger the walls of the uterus will be stretched, and in the end, if you wait too long, it may simply rupture at the seam. Therefore, the operation is performed around 37-39 weeks. However, if the baby’s weight is small, the doctor is quite satisfied with the condition of the suture, he may prescribe more late dates. In any case, the planned date is discussed in advance with the expectant mother.

When should you go to the hospital?

Most often 1-2 weeks before the second Caesarean woman They are admitted to a hospital for conservation in order to avoid unforeseen situations. However, this is not always practiced. If the condition of the mother and baby does not cause concern, she can last days spend at home before giving birth.

How long does it take to recover?

It is imperative to keep in mind that recovery after a second cesarean section not only takes longer, but is also much more difficult. The skin has been excised in the same place repeatedly, so it will take longer to heal long term than the first time. The stitch may be sore and oozing for 1-2 weeks. The uterus will also contract longer, causing unpleasant, uncomfortable sensations. It will even be possible to remove the belly after the second caesarean section only after 1.5-2 months through minor physical exercise(and only with the doctor's permission). But if you stick to it, everything will go faster.

The above listed features of the second cesarean section need to be known to the woman in labor so that she feels calm and confident. Her state of mind before childbirth is very important. This will affect not only the outcome of the operation, but also the duration recovery period. Another important point is the risks associated with repeated surgery.

Consequences

Doctors don't always tell to the expectant mother why a second cesarean section is dangerous, so that she is prepared for the possible undesirable consequences of this operation. Therefore, it will be better if you find out about this yourself in advance. The risks are different and depend on the state of health of the mother, the intrauterine development of the baby, the course of pregnancy, and the characteristics of the first cesarean section.

Consequences for the mother:

• menstrual irregularities;
• , inflammation in the suture area;
• intestinal injury, bladder, ureters;
• infertility;
• after the second cesarean section, the frequency of complications such as thrombophlebitis (most often pelvic veins), anemia, endometritis increases;
• removal of the uterus due to severe bleeding;
• high risk of complications in the next pregnancy.

Consequences for the child:

• violation cerebral circulation;
• because of long-term exposure anesthesia (the second cesarean lasts longer than the first).

Any doctor, when asked whether it is possible to give birth after a second caesarean section, will answer that it is not advisable because large quantity complications and negative consequences. Many hospitals even offer women sterilization procedures to prevent future pregnancies. Of course, there are happy exceptions when “Caesareans” are born for the third and even fourth time, but you need to understand that these are isolated cases that you don’t need to focus on.

Did you find out that you are having a second cesarean section? Do not panic: if you work closely with your doctor, follow all his recommendations and properly prepare, the operation will proceed without complications. The main thing is the life that you managed to save and give to the little man.

A planned caesarean section is a type of surgical delivery that is announced by the doctor in advance.

A planned caesarean section is carried out based on the testimony of the attending physician; the doctor can make a decision about such births long before the end of the pregnancy. Mothers in labor are very often worried about such an operation, and this is not surprising, since its timing often becomes known at the last moment. Therefore, it is not possible to find out the specific date or at what time doctors will perform a planned caesarean section.

Previously, it was customary not to wait for labor and to operate at 40 weeks. Now doctors have moved away from this approach and allow the baby to independently determine the time of appearance. After all, the most important thing is to preserve the health of the child and his mother. Experts say that the first contractions are the ideal moment for a cesarean section, so it is important not to miss it. This approach promotes natural lactation, the one that occurs after normal childbirth. Also, a cesarean section at this stage allows the baby to quickly adapt to life outside the placenta.

In some cases, surgery is prescribed earlier, without waiting for the first contractions, in order to avoid undesirable consequences. Also, the day of a planned cesarean section may be scheduled depending on the work of the maternity hospital. Some hospitals carry out such operations, for example, on Tuesday and Thursday. The workload of doctors or anesthesiologists can also delay the timing of the operation; there are also force majeure situations when there are no places in the intensive care unit. In such cases, if there is no danger to the mother and fetus, it is better to keep the woman in labor for a couple of days in the ward. Sorry to say exact date Caesarean is impossible, one can only guess here. The recommended cesarean delivery is 40 weeks, but it can be a week earlier or later; an exclusively individual approach is required here.

But, still, the question arises, in what week do maternity hospital doctors perform a planned cesarean section? If we consider exclusively planned surgery, then it can be prescribed no earlier than 38 weeks. This is due to the fact that before the 38th week the fetus is too small and quite weak, so early appearance may have a negative impact. As already described above, doctors try to prescribe a cesarean section at 40 weeks, since there is a possibility that precise definition gestational age.

Today, caesarean section is not a rare procedure and, according to experts, it is not more difficult to remove appendix, so no need to worry.

A second caesarean section, if planned, will also be performed at around 38 weeks. If the first birth was carried out via cesarean section, then the second one will also be carried out in this way. Therefore, in this situation it will be known long ago at what time the second caesarean section will occur.

Recommendations for planned implementation caesarean section can be different: from physiological state baby up various pathologies at mom's. Most often, this type of birth is carried out in the presence of placenta previa. This means that the placenta completely or partially blocks the fetus from leaving the uterus, therefore, natural childbirth is impossible and even dangerous. Sometimes prescribed for multiple pregnancies.

Important points during caesarean section. Planned caesarean

If the doctor has established an approximate date for the planned cesarean section, then the following points must be observed:

• A woman in labor should not shave her abdomen and pubic area. Shaving may cause irritation and inflammation, which can be quite dangerous during surgery. Pimples or pustules that arise can cause infection. Shaving or epilation is necessary before the operation itself by the medical staff.
• Don't forget to prepare purified water for drinking. In the first 24 hours you cannot eat, but you need to drink about 1.5 liters of water.
• Also, after a cesarean section, a bandage will be useful; it is also advisable to prepare it in advance;
• Additionally, you will need hygiene products: pads, diapers, diapers, some medications and other materials. The list should be compiled directly by your attending physician.

There are a number of cases when, while preparing for a natural birth, there is a need for an emergency cesarean section. There could be many reasons for this. There is no point in talking about what week an emergency caesarean section will be required. This may be 38 weeks or earlier if any pathologies were discovered that threaten the life of the mother and child. Note that a second caesarean section can also be an emergency and at what time it will have to be done is not always known.

This operation is performed with the consent of the woman, with the exception of the incapacity of the woman in labor. Then the consent of her close relatives will be required.

A planned cesarean section differs from an emergency one in the type of anesthesia used. Emergency caesarean section requires quick action, so they use general anesthesia. This type of anesthesia allows you to be completely unconscious.

However, in lately, spinal anesthesia is increasingly being used.

It is carried out using anesthesia between the lumbar vertebrae into the spinal canal, the effect of the drug begins within 5 minutes. This allows you to proceed to an emergency caesarean section as soon as possible. This anesthesia only relieves pain bottom part body, so the woman is conscious and can observe the progress of the operation. Note that in this case the incision will be made from the navel area to the pubic part, i.e. longitudinal. In case of emergency cesarean section, such an incision best provides access to the pelvic organs.

The danger of an emergency cesarean section is the risk of infection. Therefore, during the operation and after it, the woman in labor must take antibiotics, which will be prescribed by the attending physician.

It should also be noted psychological side emergency Caesarean section After all, what is planned is discussed in advance, thereby the woman is ready for it and does not consider it as a disaster. When an emergency caesarean section causes anxiety and fear, since the woman in labor was ready for a natural birth. For many, such childbirth is a shock, which requires additional attention to the woman from medical personnel.

Doctors advise that someone close to you be in this situation: husband, sister, mother, perhaps even a psychologist. A woman, being in a state of anxiety and fear, cannot always adequately assess situations. That's why close person it is simply necessary nearby, in particular, to remind you that this operation is important for the baby’s health, and worries here are unnecessary.

Indications for caesarean section

Note that a caesarean section can be performed at any stage, depending on the condition of the mother and fetus. But, nevertheless, there are a number of indications that cannot be ignored. These include the following:

• too narrow pelvis women in labor, which makes it impossible for the fetus to pass through;
• previous cesarean section with a vertical incision;
• multiple pregnancy, more than 3 babies;
• severe maternal pathologies, in particular diabetes of any type;
• the fruit is too large;
• the presence of injuries of varying severity in the hip area;
• placental presentation (placental enlargement, obstruction of the outlet);
• when diagnosing HIV infection, AIDS, hepatitis;
• incorrect placement of the fetus.

For many decades, this operation - caesarean section - has been saving the life and health of a mother and her baby. In the old days, such surgical intervention was performed extremely rarely and only if something threatened the life of the mother in order to save the child. However, caesarean sections are now being used more and more often. Therefore, many specialists have already set themselves the task of reducing the percentage of births performed through surgical intervention.

Who should perform the operation?

First of all, you should understand how a caesarean section is performed and what consequences await the young mother. Childbirth itself surgical method safe enough. However, in some cases, surgery is simply not practical. After all, no one is protected from risk. Many expectant mothers ask for a caesarean section only out of fear of strong painful sensations. Modern medicine In this case, it offers epidural anesthesia, which allows the woman to give birth without pain.

Such births are performed - caesarean section - by a whole team medical workers, which includes specialists of a narrow profile:

• Obstetrician-gynecologist - directly removes the baby from the uterus.
• Surgeon - makes cuts in soft tissues and muscles abdominal cavity to reach the uterus.
• A pediatric neonatologist is a doctor who delivers and examines a newborn baby. If necessary, a specialist in this profile can provide first aid to the child, as well as prescribe treatment.
• Anesthesiologist - performs pain relief.
• Nurse anesthetist - helps administer anesthesia.
• Operating nurse - assists doctors if necessary.

The anesthesiologist should speak with the pregnant woman before the operation to clarify which type of anesthesia is preferable for her.

Types of caesarean section

Indications for caesarean section can be completely different, and the operation is performed differently in certain cases. Today there are two types of childbirth performed with the help of surgical intervention:

Emergency surgery is performed if any complication arises during childbirth that requires urgent removal of the baby from the uterus. A planned caesarean section is performed in situations where the doctor is concerned about the progress of labor due to complications that arose during pregnancy. Let's take a closer look at the differences between the two types of operations.

Planned caesarean section

Elective surgery (caesarean section) is performed with epidural anesthesia. Thanks to this method, a young mother has the opportunity to see her newborn baby immediately after the operation. When performing such a surgical intervention, the doctor makes a transverse incision. The child usually does not experience hypoxia.

Emergency caesarean section

As for an emergency caesarean section, general anesthesia is usually used during the operation, since the woman may still be having contractions, and they will not allow a puncture for epidural anesthesia. The incision for this type of surgery is mainly longitudinal. This allows you to remove the baby from the uterine cavity much faster.

It is worth noting that when emergency surgery the child may already be experiencing severe hypoxia. At the end of the cesarean section, the mother cannot immediately see her baby, since a cesarean section is performed in this case, as already mentioned, most often under general anesthesia.

Types of incisions for caesarean section

In 90% of cases, a transverse incision is made during the operation. As for the longitudinal one, they are currently trying to do it less often, since the walls of the uterus are greatly weakened. During subsequent pregnancies they may simply become torn. A transverse incision made in the lower part of the uterus heals much faster and the sutures do not break.

A longitudinal incision is made along the midline of the abdominal cavity from bottom to top. To be more precise, to a level slightly below the navel from pubic bone. Making such an incision is much easier and faster. Therefore, it is usually used during an emergency caesarean section in order to remove the newborn baby as quickly as possible. The scar from such an incision is much more noticeable. If doctors have the time and opportunity, then during the operation a transverse incision can be made slightly above the pubic bone. It is practically invisible and heals well.

As for the repeated operation, the suture from the previous one is simply excised.
As a result, only one seam remains visible on the woman’s body.

How does the operation proceed?

If an anesthesiologist performs epidural anesthesia, the site of the operation (incision) is hidden from the woman by a septum. But let's look at how a caesarean section is performed. The surgeon makes an incision in the wall of the uterus and then opens amniotic sac. After which the child is removed. Almost immediately, the newborn begins to cry heavily. Children's doctor cuts the umbilical cord, and then carries out all the necessary procedures with the child.

If the young mother is conscious, the doctor immediately shows her the baby and may even let her hold it. After this, the child is taken to a separate room for further observation. The shortest period of the operation is the incision and removal of the child. It only takes 10 minutes. These are the main advantages of a cesarean section.

After this, doctors must remove the placenta, thoroughly treating all the necessary vessels so that bleeding does not start. The surgeon then stitches up the cut tissue. The woman is placed on a drip, giving a solution of oxytocin, which speeds up the process of uterine contractions. This phase of the operation is the longest. From the moment the baby is born until the end of the operation, approximately 30 minutes pass. In terms of time, this operation, a caesarean section, takes 40 minutes.

What happens after childbirth?

After the operation, the new mother is transferred from operating unit to the intensive care unit or ward intensive care, since a caesarean section is performed quickly and with anesthesia. The mother should be under the vigilant supervision of doctors. At the same time, she is constantly measured blood pressure, breathing rate, pulse. The doctor must also monitor the rate at which the uterus contracts, how much discharge there is and what nature it has. The functioning of the urinary system must be monitored.

After a caesarean section, the mother is given antibiotics to prevent inflammatory process, as well as painkillers to relieve discomfort.

Of course, the disadvantages of a cesarean section may seem significant to some. However, in some situations, it is precisely such childbirth that allows a healthy and strong baby to be born. It is worth noting that the young mother will be able to get up only after six hours, and walk on the second day.

Consequences of surgery

After the operation, stitches remain on the uterus and abdomen. In some situations, diastasis and suture failure may occur. If such consequences occur, you should immediately consult a doctor. Complex treatment dehiscence of the edges of the suture located between the rectus muscles includes a set of exercises specially developed by many specialists, which can be performed after a cesarean section.

Of course, there are consequences to this surgical intervention. The very first thing worth highlighting is the ugly seam. You can fix it by visiting a cosmetologist or surgeon. Usually to make the seam aesthetically pleasing appearance procedures such as smoothing, grinding and excision are performed. Enough a rare occurrence Keloid scars are considered - reddish growths form above the suture. It is worth noting that the treatment of this type of scars takes a very long time and has its own characteristics. It must be carried out by a professional in his field.

Much for a woman condition is more important the suture that was made on the uterus. After all, it depends on him how it will go next pregnancy and what method the woman will give birth to. A suture on the abdomen can be corrected, but a suture on the uterus cannot be corrected.

Menstruation and sex life

If no complications arise during the operation, then menstrual cycle begins and passes in the same way as after childbirth naturally. If a complication does arise, the inflammatory process can last for several months. In some cases, menstruation may be painful and heavy.

You can begin sexual activity after childbirth with a scalpel after 8 weeks. Of course, if the surgery went without complications. If there were complications, then start sex life This is possible only after a thorough examination and consultation with a doctor.

It is worth considering that after a caesarean section, a woman should use the most reliable contraceptives, since she cannot become pregnant for about two years. It is undesirable to carry out operations on the uterus within two years, as well as abortions, including vacuum ones, since such an intervention makes the walls of the organ weaker. As a result, there is a risk of rupture during a subsequent pregnancy.

Lactation after surgery

Many young mothers who have had surgical intervention, they are worried that it is difficult to establish breastfeeding after a cesarean section breast milk. But this is absolutely not true.

A young mother produces milk in the same time frame as women after natural childbirth. Of course, establishing breastfeeding after surgery is a little more difficult. This is primarily due to the characteristics of such genera.

Many doctors fear that the baby may receive some of the antibiotic through mother's milk. Therefore, in the first week the baby is fed formula from a bottle. As a result, the baby gets used to it and it becomes much more difficult to wean him to the breast. Although today babies are often put to the breast immediately after surgery (on the same day).

If you do not have an indication for delivery by cesarean section, then you should not insist on surgery. After all, any surgical intervention has its consequences, and it is not for nothing that nature has come up with a different way for the birth of a child.

Almost every woman faces the most difficult and at the same time the happiest day of her life. Namely, happy birthday to your baby. Childbirth is considered a natural process that ends the pregnancy period by freeing the uterine cavity from the fetus and placenta, with the help of birth canal. Childbirth, which is physiologically considered to be at term, is if it occurs during pregnancy at a period from 37 weeks to 41-42 weeks.

The duration of labor is strictly individual. As a rule, for a woman who gives birth for the first time, the duration of labor is slightly longer than for a woman giving birth repeatedly. So, on average it is considered normal:

• primiparous women - up to 11 hours;
• multiparous - up to 8 hours.

If labor lasted less than 6 hours for a primiparous woman, and less than 4 hours for a multiparous woman, then such labor is considered rapid. Childbirth is divided into several periods:

• the first is disclosure;
• the second is the birth of the child itself;
• the third is the release of the placenta.

The baby can also be born by caesarean section. Caesarean section refers to the surgical intervention of artificial delivery. In this case, the uterine cavity is freed from the fetus and placenta through an incision in the anterior abdominal wall and the body of the uterus.

A caesarean section is prescribed when a woman cannot give birth naturally for medical reasons or in emergency cases. A caesarean section may also be prescribed if intrauterine death child, with heavy bleeding, to save the woman. Indications for caesarean section differ from planned and emergency.

Planned ones include:

• narrow pelvis in relation to the size of the fetus;
• abnormal placenta previa;
• gynecological diseases that can interfere with the natural process of childbirth, these include, for example, uterine fibroids;
• scar on the uterus (after surgery, after cesarean section);
• existing diseases that are not related to pregnancy; These include: pathology of the organs of vision, diseases of the cardiovascular system, genitourinary system (kidneys);
• severe medical history during pregnancy - gestosis;
• incorrect presentation of the fetus;
• multiple pregnancy;
• infection with genital herpes in the 3rd trimester of pregnancy;
• varicose veins of the lower extremities;
• oncology;
• previously received traumatic brain injury.

TO emergency indications include:

• sluggish labor;
• complete cessation of labor;
• premature placental abruption;
• threat of uterine cavity rupture;
• acute fetal hypoxia;
• complications during childbirth that can threaten the life and health of both the woman and the fetus.

Second caesarean section

A second caesarean section is prescribed for both planned and emergency indications. Same as for the first cesarean intervention. These include: first delivery by caesarean section.

Currently, in medicine, there are more and more cases when a woman, after her first cesarean section, with a second pregnancy, is prescribed natural childbirth.

A second caesarean section is prescribed after a thorough examination of the pregnancy history and after a complete examination of the woman. The woman's age is also taken into account. Recommendations for reoperation are considered:

• age over 35 years;
• features of the postoperative suture;
• general health of the woman;
• abortions between cesarean and real pregnancy;
• features of the course of pregnancy.

If there are no indications for surgery, then the woman is allowed to give birth naturally.

Is it possible to give birth on your own after your first caesarean section?

Currently, it is legal to give birth on your own after your first caesarean section. For this it is necessary thorough examination pregnant woman. There are a number of indicators that are favorable conditions for natural childbirth. These include:

• the first caesarean section was at least 3 years ago;
• the scar is completely wealthy;
• thickness in the seam area is more than 2 mm;
• there are no complications during pregnancy monitoring;
• directly the desire of the woman.

But we should not forget that at present not all births at home are able to carry out delivery naturally, after the first cesarean section. That is why, if you want to give birth on your own. Then you need to prepare in advance, talk about this topic with your doctor, and choose a birth center that specializes in this issue.

Introduction of pregnancy

If you are registered for your second pregnancy, then do not forget that there cannot be two absolutely identical pregnancies. Monitoring the second and subsequent pregnancies after the first cesarean section occurs a little differently.

Additionally, the following examinations are introduced for women:

• Ultrasound examination is prescribed more than 3 times during the entire pregnancy;
• more frequent diagnosis in the 3rd trimester of pregnancy;
• constant control of the uterine scar.

Introduction of pregnancy is the key to successful childbirth

How to prepare

If you already know for sure that you are scheduled for a caesarean section, then you need to approach the procedure correctly. at this moment. Proper preparation will allow you not only to prepare your body for the difficult upcoming operation, but also to prepare yourself psychologically. All these are important facts for a successful operation. For proper preparation recommended:

During pregnancy

• Regularly attend school for expectant mothers, especially on the topic “Caesarean section”.
• Prepare to remain in the hospital for at least 6 days after the operation. That is why plan in advance with whom and where you can leave your older children. If there are animals, who will take care of them.
• Think over the question of how you will give birth. You may want your husband to be present at the operation. What kind of anesthesia will you be given?
• Visit your doctor regularly.
• Don’t be shy and ask your doctor about all your questions.
• You need to agree in advance with 2.3 people. In order for them to donate blood at a blood transfusion station. Since every operation carries a risk of bleeding and this requires donor blood.

A few days before surgery

• Prepare all the necessary things for the hospital for yourself and your unborn child. For yourself, this is all standard: a robe, clothes, hygiene items, postpartum pads, breast pads, replacement shoes. And for the baby, you need to look on the website for the home where you will give birth.
• For 2 days you need to give up solid foods and fried foods. From foods that can lead to bloating.
• Get a good night's sleep and rest.
• Do not take any food or water for 12 hours.
• Shave thoroughly.
• Prepare non-carbonated water.
• Charge your phone fully.

Preparing for a second cesarean section provides an opportunity to get your body in order and prepare it for surgery.

How is the operation performed?

The woman who has already passed this procedure usually asks: “Is there a difference in the procedures of the 1st cesarean section and the 2nd cesarean section?” — No, all stages of the operation remain the same.

Operation stages:

Prenatal period:

• cleansing enema;
• consultation with an anesthesiologist;
• consultation with an obstetrician-gynecologist;
• changing into special clothes;
• measurement of blood pressure, fetal CTG;
• the nurse examines the pubic area and shaves if necessary;
• a catheter is installed in a vein, a catheter is installed in the urethra;
• administration of anesthesia.

Surgical stage:

• an incision is made along the seam from the previous cesarean section;
• cauterization of ruptured vessels;
• suction of amniotic fluid;
• fetal extraction;
• suturing the uterus and skin;
• applying a bandage;
• administration of drugs to contract the uterus;
• applying ice to the stomach.

After this, a sedative is usually administered and sleeping pills, which help a woman to rest after surgery.

At this time, the baby is examined by a neonatologist and medical staff.

Timing of cesarean section for singleton and multiple pregnancies

In this situation, the operation is prescribed individually. Since multiple pregnancy is always a big risk. Many factors and individual characteristics are taken into account. Generally, surgery is scheduled between 34 and 37 weeks. Doctors usually don’t wait longer than 37 weeks. So this is a huge risk that rapid emergency labor may begin.

When determining the timing of the second cesarean section, doctors take into account what week the operation was performed during the first pregnancy - 1-2 weeks are “subtracted” from this value. If the first time a cesarean was performed at 39 weeks, now it will happen at 37-38.

How to make a suture during a second caesarean section

With a planned repeat cesarean section, the suture is made exactly along the suture that was previously. This way there will be no visible second seam. But the incision of the uterus itself is directly selected in new area reproductive organ.

Recovery period

After the operation, the woman is observed for 12 hours in the intensive care unit. After 12 hours you can already get up and walk. Breastfeeding is allowed within 24 hours. I recommend that a woman put her baby to her breast more often.

1. Every day, medications are prescribed to contract the uterus. Painkillers are administered 2-3 days after surgery. Drink plenty of plain, non-carbonated water.
2. Doctors recommend immediately putting on a postpartum bandage.
3. Every day the gynecologist examines you and palpates your stomach.
4. On days 5-6, the bandage is removed, the stitch is examined, an ultrasound is performed, and then it is decided when to prepare you for discharge.

Uterine discharge continues until 1-2 months after birth. After discharge, it is recommended to see a gynecologist 10 days later to examine the suture. And after 1 month, do a control ultrasound of the pelvic organs.

If, after being discharged from the maternity hospital, your temperature has risen and your discharge has begun to increase, then you should immediately consult a doctor.

Possible complications

With each new operation the risks of complications increase. But this does not mean that they will necessarily exist. Complications can occur both after the first and after the second cesarean section. They are no different from each other.

Complications include:

• scar dehiscence;
• adhesive process;
• poor uterine contraction;
• inflection of the uterus;
• inflammatory process of the pelvic organs;
• large blood loss;
• endometritis.