A cesarean section, also known as a c-section, is a surgical procedure usually performed when a traditional vaginal birth is not possible because of complications risking the health of the mother or the baby. In this surgery, the baby is delivered through surgical cuts made through the skin in the abdomen and the uterus wall of the mother. The size of the cut is a bit bigger than the size of the baby's head. Once the baby is carefully delivered, the surgeon removes the placenta and stitches the uterus.
Types of C-section delivery
C-section delivery can be divided into different types based on the reason for c-section or the direction of the incision.
Based on the reason for c-section
A C-section delivery can be classified as planned or elective based on whether the c-section is planned or occurs due to sudden complications while the woman is in labour.
Some women have planned c-section delivery as it gives them the liberty to control the date, they will give birth without worrying about the stress and pain of going into labour. The most common reasons for a woman choosing to have a planned c-section include:
Previous c-section deliveries.
Odd position of the baby
Having multiple babies
2. Emergency C-section
An emergency c-section is performed when complications occur during labour, and there is a danger to a mother or baby's health through vaginal birth. A caesarean is the only option left for doctors when labour fails to progress properly even after a long time. It may also be performed when the baby's size is too big to pass through the woman's pelvis or when there is an issue with the baby's heartbeat or when baby passes meconium and there is the risk of meconium aspiration.
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Based on the direction of the incision
C-section delivery can also be divided into two types based on the direction of the incision made to deliver the baby.
Classical/Traditional Uterine Cesarean section
The traditional Cesarean section is when a long, vertical incision is made in the midline of the lower abdomen. Depending on the size of the baby's head, the length of the incision is decided to allow a large amount of space for a comfortable delivery. Once the incision is made through the skin, the uterus is also cut vertically, and the baby is delivered.
However, the traditional c-section is not preferred by surgeons due to the post-surgical risks associated with it. These complications include weakening of abdominal muscles and an increased risk of hernia post-delivery. Moreover, the possibility of a vaginal birth delivery becomes unsafe for future pregnancies after a traditional c-section as there is a high chance for the scar to give away during next pregnancy.
The lower uterine segment c-section, more popularly known as the bikini cut, is when the doctor makes a horizontal incision above the public hairline over the bladder from one side of the abdomen to the other. The incision cuts through the skin and the uterus as well. Once the incision is made, the surgeon inserts their hand into the uterus and delivers the baby.
This is the most popular form of c-section delivery used in today's day and age. A doctor typically performs a LUSC surgery when a woman faces complications such as severe pre-eclampsia or non-progress of labour. Since the incision is made at a women's bikini line, it does not show and looks better than the traditional surgery. Furthermore, the risks and complications are minimal in this type of delivery. The incision causes less pain and heals after the surgery more easily. It is also possible to choose a vaginal delivery for future pregnancies as the incision cut has a smaller chance of reopening.
A c-section is a safe procedure for the baby and the mother. Even if you have not planned for a c-section, certain situations can occur during labour that may leave you with no choice but to undergo a caesarean surgery. Therefore, it is always recommended to be well-prepared for the surgery. You can read books to educate yourself, talk to other women who have had the same experience, and have open communication with your doctor. This will help you feel in control even if you have to deliver through a c-section. Lastly, do not forget to enjoy the memorable birthing experience!
The article is contributed by Dr Thejaswini J, Consultant - Obstetrician & Gynaecologist, Motherhood Hospitals, Electronic City, Bangalore.