Caesarean section - “Caesarean section on request without indications. Is it possible to? My experience."

Surgical birth (caesarean section) is carried out according to indications when there is a threat to the health and/or life of the mother or baby. However, today many women in labor, out of fear, think about an auxiliary option for delivery, even in the absence of health problems. Is it possible to have a cesarean section at will? Is it worth insisting on surgical birth if there is no indication? The expectant mother needs to learn as much as possible about this operation.

A newborn baby who was born through surgery

A CS is a surgical method of delivery that involves removing the baby from the uterus through an incision in the abdominal wall. The operation requires certain preparation. The last meal is allowed 18 hours before surgery. Before the CS, an enema is given and hygiene procedures are carried out. A catheter is inserted into the patient’s bladder, and the abdomen is necessarily treated with a special disinfectant.

The operation is performed under epidural anesthesia or general anesthesia. If the CS is done according to plan, then doctors are inclined to use an epidural. This type of anesthesia assumes that the patient will see everything that is happening around, but will temporarily lose tactile and pain sensations below the waist. Anesthesia is given through a puncture in the lower back where the nerve roots are located. General anesthesia during surgical childbirth is used urgently, when there is no time to wait for regional anesthesia to take effect.
The operation itself consists of the following steps:

Abdominal wall incision. It can be longitudinal and transverse. The first is intended for emergency cases, because it makes it possible to get the baby as quickly as possible.
Muscle extension.
Uterine incision.
Opening of the amniotic sac.
Extraction of the baby, and then the placenta.
Suturing the uterus and abdominal cavity. For the uterus, self-absorbable threads must be used.
Applying a sterile dressing. Ice is placed on top of it. This is necessary to increase the intensity of uterine contractions and reduce blood loss.

In the absence of any complications, the operation does not last long - a maximum of forty minutes. The baby is taken out of the mother's womb in the first ten minutes.

There is an opinion that caesarean section is a simple operation. If you don’t delve into the nuances, it seems that everything is extremely easy. Based on this, many women in labor dream of a surgical method of delivery, especially considering the effort natural childbirth requires. But you should always remember that a coin cannot have one side.

When is a CS necessary?

The attending gynecologist will decide whether the woman in labor needs surgery

In most cases, a CS is planned. The doctor determines whether there are any threats to the mother and baby if the birth takes place naturally. The obstetrician then discusses delivery options with the mother. A planned CS is performed on a predetermined day. A few days before the operation, the expectant mother should go to the hospital for a follow-up examination. While the pregnant woman is scheduled to be in the hospital, the doctor monitors her condition. This allows us to predict the likelihood of a successful outcome of the operation. Also, the examination before the CS is aimed at determining the full-term pregnancy: using various diagnostic methods, it is revealed that the baby is ready for birth and there is no need to wait for contractions.

The operation has a number of indications. Some factors leave room for discussion about the method of delivery, others are absolute indications, that is, those in which ER is impossible. Absolute indications include conditions that threaten the life of the mother and baby during natural delivery. CS must be done when:

absolutely narrow pelvis;
presence of obstructions in the birth canal (uterine fibroids);
failure of the uterine scar from previous CS;
thinning of the uterine wall, which threatens its rupture;
placenta previa;
foot presentation of the fetus.

There are also relative indications for CS. Given these factors, both natural and surgical childbirth are possible. The delivery option is selected taking into account the circumstances, the health and age of the mother, and the condition of the fetus. The most common relative indication for CS is breech presentation. If the position is incorrect, the type of presentation and the gender of the baby are taken into account. For example, in the breech-foot position, ER is acceptable, but if they are expecting a boy, the doctor insists on a cesarean section to avoid damage to the scrotum. With relative indications for cesarean section, the correct decision regarding the method of birth of the baby can only be suggested by an obstetrician-gynecologist. The parents’ task is to listen to his arguments, because they will not be able to assess all the risks on their own.

Caesarean section can be performed on an emergency basis. This happens if labor began naturally, but something went wrong. An emergency CS is performed if bleeding begins during natural delivery, premature placental abruption occurs, or acute hypoxia is detected in the fetus. An emergency operation is performed if labor is difficult due to weak contractions of the uterus, which cannot be corrected with medication.

Elective CS: is it possible?

Happy mother with long-awaited daughter

Whether it is possible to perform a CS at the request of a woman in labor is a controversial issue. Some believe that the decision on the method of delivery should remain with the woman, while others are confident that only a doctor can determine all the risks and choose the optimal method. At the same time, the popularity of elective caesarean section is growing. This trend is especially noticeable in the West, where expectant mothers actively choose the method of giving birth to their own baby.

Mothers in labor prefer surgical childbirth, guided by fear of pushing. In paid clinics, doctors listen to the wishes of expectant mothers and leave them the right to choose. Naturally, if there are no factors under which CS is undesirable. The operation has no absolute contraindications, however, there are conditions that increase the risk of infectious and septic complications after surgical childbirth. These include:

infectious diseases in the mother;
diseases that disrupt blood microcirculation;
immunodeficiency states.

In the CIS countries, the attitude towards elective CS differs from the Western one. Without indications, it is problematic to perform a cesarean section, because the doctor bears legal responsibility for each surgical intervention. Some women in labor, considering surgical childbirth a painless way to give birth to a baby, even invent diseases for themselves that could serve as relative indications for a CS. But is the game worth the candle? Is it necessary to defend the right to choose the way in which a child is born? To understand this, the expectant mother must understand the intricacies of the operation, compare the pros and cons, and study the risks that exist with any surgical intervention.

Advantages of CS at will

Why do many expectant mothers want to have a cesarean section? Many people are motivated to “order” surgery by fear of natural childbirth. The birth of a baby is accompanied by severe pain; the process requires a lot of effort from the woman. Some expectant mothers fear that they will not be able to complete their mission and begin to persuade the doctor to perform a cesarean procedure on them, even if there are no indications for surgical birth. Another common fear is that the passage of the baby through the birth canal is difficult to control and may pose a threat to his health or even life.

Fear of EP is common. But not all expectant mothers can cope with it. For patients who see a lot of threats in natural childbirth, the advantages of a “custom” CS are obvious:

An additional bonus is the ability to choose the baby’s date of birth. However, this alone should not push the woman in labor to insist on a CS, because, in fact, the date does not mean anything, the main thing is the health of the baby.

The reverse side of a “custom” CS

Many expectant mothers do not see anything wrong with a caesarean section if the woman wishes. The operation appears to them as a simple procedure, where the woman in labor falls asleep and wakes up with a baby in her arms. But those women who have gone through surgical childbirth are unlikely to agree with this. The easy path also has a downside.

It is believed that CS, unlike ER, is painless, but this is not true. In any case, this is an operation. Even if anesthesia or anesthesia “turns off” the pain during surgical delivery, it returns afterwards. Departure from the operation is accompanied by pain at the suture site. Sometimes the postoperative period becomes completely unbearable due to pain. Some women even suffer from pain for the first couple of months after surgery. Difficulties arise in “maintaining” oneself and the child: it is difficult for the patient to get up, take the baby in her arms, and feed him.

Possible complications for the mother

Why is caesarean section performed in many countries solely according to indications? This is due to the possibility of complications after surgery. Complications affecting the female body are divided into three types. The first type includes complications that may appear after surgery on internal organs:

Major blood loss. With CS, the body always loses more blood than with EP, because when tissue is cut, blood vessels are damaged. You can never predict how the body will react to this. In addition, bleeding occurs due to pregnancy pathology or disruption of the operation.
Spikes. This phenomenon is observed during any surgical intervention; it is a kind of protective mechanism. Usually adhesions do not manifest themselves, but if there are a lot of them, then a malfunction of the internal organs may occur.
Endometritis. During the operation, the uterine cavity “comes into contact” with air. If pathogenic microorganisms enter the uterus during surgical childbirth, a form of endometritis occurs.

After a CS, complications often appear on the sutures. If they appear immediately after the operation, the doctor who performed the CS will notice them during the examination. However, suture complications do not always make themselves felt immediately: sometimes they appear only after a couple of years. Early suture complications include:

Late complications after cesarean section include ligature fistulas, hernias, and keloid scars. The difficulty in determining such conditions lies in the fact that after some time women stop examining their stitches and may simply miss the formation of a pathological phenomenon.

disruptions in the functioning of the heart and blood vessels;
aspiration;
throat injuries from insertion of a tube through the trachea;
a sharp decrease in blood pressure;
neuralgic complications (severe headache/back pain);
spinal block (when using epidural anesthesia, severe spinal pain occurs, and if the puncture is incorrect, breathing may even stop);
poisoning by toxins from anesthesia.

In many ways, the occurrence of complications depends on the qualifications of the medical team that will perform the operation. However, no one is immune from mistakes and unforeseen situations, so a woman in labor who insists on a caesarean section without indication should be aware of the possible threats to her own body.

What complications can a child have?

Caesar babies are no different from babies born naturally

Doctors do not undertake to perform a caesarean section at will (in the absence of indications) due to the likelihood of complications in the baby. CS is a proven operation that is often resorted to, but no one has canceled its complexity. Surgical intervention can affect not only the female body, but also affect the health of the baby. Complications of cesarean section concerning the child can be of varying degrees.

With the natural method of birth, the baby goes through the birth canal, which is stressful for him, but such stress is necessary for the baby to adapt to the conditions of a new life - extrauterine. With CS there is no adaptation, especially if the extraction occurs according to plan, before the onset of contractions. Violation of the natural process leads to the fact that the baby is born unprepared. This is a huge stress for a fragile body. CS can cause the following complications:

depressed activity from drugs (increased drowsiness);
breathing and heartbeat disturbances;
low muscle tone;
slow healing of the navel.

According to statistics, “caesareans” often refuse to breastfeed, plus the mother may have problems with the amount of milk. We have to resort to artificial feeding, which leaves its mark on the baby’s immunity and its adaptation to the new environment. Children born by cesarean section are more likely to suffer from allergic reactions and intestinal diseases. “Caesareans” may lag behind their peers in development, which is due to their passivity during labor. This manifests itself almost immediately: it is more difficult for them to breathe, suck, or scream.

Weigh everything

The CS has truly rightfully earned the title of “easy delivery.” But at the same time, many people forget that surgical childbirth can have consequences for the health of both “participants in the process.” Of course, most complications in a baby can be easily “removed” if you pay maximum attention to this issue. For example, a massage can correct muscle tone, and if the mother fights for breastfeeding, the baby’s immunity will be strong. But why complicate your life if there is no reason for this, and the expectant mother is simply driven by fears?

You should not do a caesarean section on your own. Naturally, a woman should have the right to choose, but it is not without reason that this operation is performed according to indications. Only a doctor can determine when it is advisable to resort to cesarean section and when natural delivery is possible.

Nature has thought of everything herself: the process of childbirth prepares the baby as much as possible for extrauterine life, and although the mother in labor bears a large load, recovery occurs much faster than after surgery.

When there is a threat to the fetus or mother and the doctor insists on a cesarean section, refusing the operation is strictly prohibited. The doctor always determines the risks taking into account what is safer for the life of the mother and baby. There are situations when cesarean section is the only option for delivery. If the method is negotiable, it is always recommended to seize the possibility of a natural birth. The momentary desire to “cut” in order to avoid pain must be suppressed. To do this, just talk to your doctor about the possible risks and likelihood of complications after surgery.

It is one hundred percent impossible to predict how the CS will go in each specific case. There is always a possibility that something will go wrong. Therefore, doctors advocate for natural childbirth whenever possible.

If the expectant mother herself cannot overcome her own fears associated with the upcoming moment of the baby’s birth, she can always turn to a psychologist. Pregnancy is not a time for fear. You need to let go of all bad thoughts, not be led by momentary desires, and clearly follow the recommendations of the gynecologist - from correcting the regimen to the method of delivery.

New fashion for childbirth.

Women who are soon expecting the birth of a baby, thinking about the process of childbirth, go through various options for the outcome. Reviews confirm that recently in Moscow more and more pregnant women prefer caesarean section without indications for it over natural childbirth and the reason for this is the relief of their own suffering. Fear of pain overshadows the possibility of negative consequences.

But fear is far from the only reason to go under the knife, there are a variety of them, and there are simply absurd ones, such as the desire for a child to be born on a certain date, because it’s so cool to control the fate of the future little person.

It is generally accepted that the fashion for surgery was introduced by the rich and famous. But this type of procedure cannot be considered as simply a safe birth without pain. In any case, this is an operation that can have serious consequences in the form of unforeseen situations and complications.

Is it possible to have a caesarean section without indications?

For a caesarean section, you must have strict medical indications. True, if you try, you can find them in almost every pregnant woman.

There are two types of indications for surgery:

Absolute indications for cesarean section:
- clinically narrow pelvis
- transverse or oblique position of the fetus
- complete placenta previa
- various rough scars
- severe gestosis
- extragenetic pathology
Relative indications for cesarean section:
- myopia
- diabetes
- arterial hypertension
- various infections
- late first birth.

Consequences of “painless childbirth”

Perhaps a caesarean section is not the most difficult intervention, but it is still an abdominal operation that can affect not only the mother, but also the baby itself.

Of course, this type of childbirth is less painful than natural ones, however, the postoperative period is exactly the opposite, therefore, in the first days, communication between mother and child is incomplete, because after the operation you need to recover.

Another weighty argument not in favor of cesarean without indication is the planned date. Expectant mothers continue to think only about themselves, forgetting about the baby. After all, contractions are the main signal of readiness to be born. A sudden operation can cause irreparable damage to an already frightened baby. Often a peacefully sleeping baby is removed from the uterus. It is difficult to imagine what a newborn may experience at this moment.

There is an opinion that when being born naturally, a child experiences stress, but this is not so. After all, everything is laid down by nature itself. As it passes through the birth canal, fluid comes out of the baby’s lungs, making breathing stable quite quickly. This process affects the longer adaptation of the “Caesarean” to the world around him.

Many mothers note that children born through a cesarean section are more passive than their peers, more closed, and have a harder time making decisions. More often, these are just prejudices that are associated with psychological trauma, when the mother feels inferior because she was unable to give birth on her own.

Before you decide to take such a step as voluntarily undergo a caesarean section without indication and go under the knife, you need to carefully consider all the nuances and consequences. Give up your selfishness, start learning to think not only about yourself, but also about your own child. Many women dream of giving birth on their own when scheduled for a caesarean section, but, alas, fate decreed otherwise. The final decision needs to be made by 37–38 weeks, because that is when the surgery date is set.

It should also be noted that everyone’s body and health are different and have hidden capabilities. For some pregnant women, cesarean is not a choice, but a necessity, the only chance to become a mother. At this moment, you should not be afraid of surgical intervention, nature is on the side of the mother in labor, she will help the baby take its first breath.

Much has been said about the possible harm of drugs used during a cesarean section, as well as the consequences of neglecting the need for the child to pass through the birth canal. But some mothers still think that it is easier to “give birth” on the operating table, thanks to the incision made by the doctor in the abdominal wall. Only a few go to the doctor to ask for a CS. Meanwhile, there are clear indications for caesarean section in the 2019 official list.

In the CIS countries, which includes Russia, Ukraine, and Belarus, there are unified medical protocols that clearly define absolute and relative indications for prescribing a caesarean section. In most cases, they refer to situations where natural childbirth poses a threat to the health and life of the mother and fetus.

If a doctor recommends a CS, you cannot refuse it, because, as they say, all the rules are written in blood. There are states in which the mother herself decides how to give birth. This happens, for example, in England. We do not have such a practice, however, as well as laws prohibiting a woman from going under the knife without clear evidence.

Moreover, all these indications are conditionally divided into 2 groups:

Absolute - they are not discussed, since if they are detected, the doctor simply prescribes the day and time of the operation. Ignoring his recommendations can cause serious harm to the body of the mother and baby, even death.
Relative. There are cases in which natural childbirth is still possible, although it can also be harmful. What to do with relative indications is decided not by the woman, but by a council of doctors. They weigh the pros and cons, making sure to explain the possible consequences to the expectant mother, and then come to a common decision.

And that is not all. There are unplanned situations in which other factors are identified during pregnancy or during childbirth, on the basis of which surgery may be prescribed.

Absolute maternal and fetal indications

Placenta previa. The placenta is a child's place. The diagnosis is made when it blocks the entrance to the uterus from the vagina. During childbirth, this condition threatens severe bleeding, so doctors wait until 38 weeks and prescribe surgery. They may operate earlier if bleeding begins.
Its premature detachment. Normally, everything should happen after the baby is delivered, but it also happens that detachment begins during pregnancy. Due to the fact that everything ends in bleeding, which threatens the life and health of both, an operation is performed.
An irregular scar on the uterus, which is the result of another operation in the past. An incorrect one is understood as one whose thickness does not exceed 3 mm, and whose edges are uneven with inclusions of connective tissue. The data is determined by ultrasound. Caesarean sections with a scar are also not permitted in cases where, during its healing, there was an increase in temperature, inflammation of the uterus, and the suture on the skin took a long time to heal.
Two or more scars on the uterus. It is worth noting that not all women decide to have a natural birth after a cesarean section due to fear of scar dehiscence. Doctors can explain the pros and cons of the procedure, but nothing more. There is an order from the Ministry of Health, according to which a woman can write a refusal of ER in favor of a cesarean section even with a normal scar, and she will have to undergo surgery. True, the question of EP is not even raised if there were several scars. Even before labor begins, the woman is simply operated on.
Anatomical narrowing of the pelvic bone to 3 – 4 degrees. The doctor takes the measurements. In such conditions, water may break in advance, contractions will weaken, fistulas will form or tissue will die, and finally, the baby may develop hypoxia.
Deformations of the pelvic bones or tumors - they can prevent the baby from entering the world peacefully.
Malformations of the vagina or uterus. If there are tumors in the pelvic area that close the birth canal, surgery is performed.
Multiple uterine fibroids.
Severe gestosis, untreatable and accompanied by convulsive seizures. The disease entails disruption of the functions of vital organs and systems, in particular the cardiovascular and nervous systems, which can affect both the condition of the mother and the condition of the baby. If doctors fail to act, death occurs.
Cicatricial narrowing of the uterus and vagina that appeared as a result of previous births and surgical interventions. In such conditions, stretching the walls to allow the child to pass through threatens the life of the mother.
Severe heart disease, nervous system disease, diabetes mellitus, thyroid problems, myopia with changes in the fundus of the eye, hypertension (it can affect vision).
Genitourinary and enterogenital fistulas, sutures after plastic surgery on the vagina.
History of 3rd degree perineal rupture (sphincter and rectal mucosa are damaged). They are difficult to suture, and it can also end in fecal incontinence.
Breech presentation. In this condition, the risk of birth injuries, including head trauma, increases.
Transverse position of the fetus. Normally, the baby should lie head down immediately before birth. There are times when he turns several times, especially for small children. By the way, it is not recommended to give birth on your own, even for low birth weight babies (weighing less than 1,500 kg). Do you know why? It turns out that under such conditions, passage through the birth canal can compress the head or testicles (in boys), which will lead to the development of infertility.
Indication by age. Late pregnancy in first-time mothers in combination with other pathologies. The fact is that after 30 years in women, the elasticity of the vaginal muscles deteriorates, resulting in severe tears.
Death of a woman in labor. If for some reason a woman’s life cannot be saved, doctors fight for her baby. It has been proven that he is able to remain alive for several hours after death. During this time the operation should be performed.
Threatening uterine rupture. Its causes can be either numerous previous births, which have thinned the walls of the uterus, or a large fetus.

Dear mothers! You should not regard absolute medical indications for a caesarean section as a death sentence, much less be angry with the doctor. These are simply the prevailing circumstances that leave him no choice.

Relative indications from mother and fetus

There are situations when, when making a decision, doctors consult with the woman. Interestingly, in 80% of cases, they agree to surgery unconditionally. And this is not just a matter of worry about the child, although this also plays a vital role.

Mothers weigh the pros and cons, taking into account the qualifications of modern surgeons, the quality of the suture material, and finally, the conditions for performing operations, and consciously try to reduce any risks to nothing.

List of relative indications for CS:

There are situations when a woman going for a natural birth still ends up on the operating table. This happens if problems arise during the process itself.

Indications for emergency caesarean section

The decision to operate is made in the active stage of labor when:

Absence of labor (if after 16 - 18 hours the cervix slowly opens).
Umbilical cord prolapse. It can shrink, which will impede the flow of oxygen to the baby.
When hypoxia is detected. In such conditions, the child may suffocate during contractions.

An emergency caesarean section can also be performed in other cases that pose a threat to the life and health of the woman in labor and her baby.

Note! Umbilical cord entanglement is not a clear indication for CS, although doctors may offer this method to a woman in labor. It all depends on the length of the umbilical cord itself, and the type of entanglement (tight, loose, single, double).

A cesarean section has not only disadvantages, but also...

Is caesarean section performed without indication?

Because a caesarean section is a major operation with enormous risks to the mother's health, it is never performed voluntarily. Neither fear, nor tears, nor hemorrhoids that worsened on the eve of childbirth will help a woman dissuade doctors.

Everything will pass, and this too will pass. The main thing is to pull yourself together and give birth. After all, there is no turning back!

Just recently I became a mother for the third time. The third son is now five months old.

It so happened that this child was unplanned; the youngest child at that time was only 1.3 years old. But there was no option not to give birth, so now I am a mother of many children)))

As soon as I saw two lines on the test, I immediately knew: I would not give birth myself. The memory of the last birth was too fresh.

I must say that I decided to have a second child only 10 years after the first. For 10 years I tried to forget this nightmare)))

Readers may think that I had a terrible birth with serious complications, but no. The only peculiarity of my birth is that it is rapid. Those. I sit, watch a movie, and after 1.5-2 hours I already have a child))) Well, all the bonuses of a rapid birth - an episiotomy to avoid ruptures, broken necks in children and, in general, the shock that it’s all so fast. The stitches hurt, you can’t sit, it hurts to wear pants.

Basically, I wanted a caesarean section. I reasoned like this: there will be seams anyway, so it’s better that they be where they can be properly processed. Well, plus, avoid pain from contractions. And I won’t break a child’s neck. Such strange reasoning, yes...

But I also understood that no one would perform a caesarean section on me without indications. So, I’ll come up with a testimony, I decided.

I didn’t have to think long, I had symphysitis during my second pregnancy, but the discrepancy was small and I gave birth myself.

This time I complained a lot, did an ultrasound of the pubic symphysis, there was a discrepancy, it exceeded the norm, but it was far from a ban on natural childbirth. I didn’t give up))) I went to the orthopedist, portrayed agony, pain and suffering, and literally begged for a recommendation for surgical delivery.

But the maternity hospital did not agree with this and convinced me to give birth myself.

But I cried, stood my ground, begged, and in the end, the manager gave the go-ahead. But, because At this time, my pregnancy was 37-38 weeks, the date of the operation was not assigned to me.

And then the May holidays began and planned operations were not carried out.

And then those with a longer term were included in the plan.

And I still lay there and waited for at least the date of the operation.

I hated the whole world and everyone who called and wrote, asking one question - WHEN???

As a result, on May 3, at 38 weeks, at the next CTG I was diagnosed with contractions, and during examination, the opening was 6 cm.

The planned CS did not happen, it was an emergency one.

Well, now, actually, about the CS operation itself.

Preparation for the operation included examination by an anesthesiologist, an enema and catheter installation. Oh, and anti-emetic medicine, I took it in the morning)))

Having a catheter inserted is the most terrible memory.

I had an epidural anesthesia; I didn’t feel the injection into my spine at all. The anesthesia took effect quickly and I felt so good, just a buzz, nothing hurt, nothing bothered me, I felt calm)))

I felt only light touches, it seemed to me that they were just touching my stomach with a finger.

When they took the child out, they pressed hard on the stomach and ribs, so it was a little unpleasant.

My son was taken out 20 minutes after the start of the operation and was stitched up for another 30 minutes. The baby was immediately put to the breast.

Then they put me on a bed and took me to the intensive care unit. The child was there before me)))

At first it was good, I was resting. But soon the anesthesia began to wear off and my stomach began to ache. I asked for an injection, they numbed me and the pain went away. From time to time they kneaded my stomach; it was sensitive, but not painful. I didn’t feel cold, I didn’t have a headache, I felt really good!

The legs took a long time to come back, they were like strangers.

Also, a heparin injection is given in the stomach to prevent blood clots. After that, his stomach became covered with bruises and petechiae from being constantly poked.

After 6 hours they picked me up and took me to the toilet. To be honest, getting up for the first time hurts. The feeling of contractions appeared and my abdominal muscles were very sore. In a bent state, I went to the toilet.

And I slipped in the toilet😱😵

Here sparks flew from my eyes, I felt bad, I almost fainted. The nurse managed to pick me up, sit me down and give me ammonia.

Well, from that moment on, in principle, the postpartum period was no different from the period after natural childbirth. I took care of the child myself. The milk came quickly, the baby was not even fed formula.

My stomach hurt, but it was tolerable; if I didn’t lie down for a long time, I could even walk straight. But if you lie down, it’s hard to get up. That's why I didn't go to bed.

A day later we were transferred to the postpartum ward. It was more difficult there because the beds were uncomfortable and one day I couldn’t get out of bed quickly and missed dinner. She was lying around like a bug on her back.

For 3 days I was given painkiller injections, antibiotics and oxytocin. After two natural births, I was also injected with oxytocin and antibiotics. There is no difference here.

The seam on the abdomen was treated twice with a spray. All. The stitches were not removed, they are self-absorbing. They were ready to discharge me on the 5th day, but unfortunately, the child and I ended up in pathology. I didn’t remember about the operation there at all.

This is what my stitch looked like after 24 hours.

This is how it is now, 4 months later.

The only problem is that the skin around the seam is still not sensitive.

By the way, although the operation was emergency, the incision was horizontal, the skin was cut, the muscles were not cut, but moved apart, and then the incision was already on the uterus.

I would like to summarize my review and highlight the pros and cons for myself personally.

No contractions
No crotch tears
Less risk of birth injuries for the baby
A stitch on the abdomen is easier to care for than stitches on the perineum.

The postpartum period is more painful.

I was injected with antibiotics and oxytocin both after a natural birth and after a cesarean section, there is no difference.

The child was with me immediately after a natural birth and after a cesarean section, there is no difference here either.

Based on my feelings, I will say this: it was easier for me to endure a caesarean than a natural birth, I recovered faster. The third child, the only one of all, does not have a crooked neck.

Caesarean section is a topic that leaves no expectant mother indifferent. From the time of its inception to the present day, the surgical method of delivery has been the cause of fears, misconceptions and heated debate.

Recently, a large number of supporters of cesarean section have appeared. Many pregnant women seriously believe that surgery is just one of the options for childbirth that can be chosen at their own request, such as vertical birth or water birth. Some even argue that a caesarean section is a more modern, less burdensome and painless option for giving birth to a child; it is supposedly easier and safer for mother and baby than the long and complex process of natural childbirth. Actually this is not true; operative delivery is a special type of obstetric care, indispensable in cases where natural childbirth for a number of reasons is impossible or even dangerous to the life of the mother or fetus. However, “cesarean” cannot be called a less painful or safer method of childbirth. Like any other surgical intervention, surgical delivery is associated with significant risks to the mother’s health both during the operation itself and in the postoperative period. That is why a caesarean section is never performed simply “at the request” of the patient, without real medical indications.

Indications for cesarean section, list

Indications for surgical delivery are divided into absolute and relative. Absolute indications include situations in which vaginal delivery is fundamentally impossible or dangerous to the life of the mother and/or fetus. Here are the most common absolute indications for delivery by cesarean section:

Complete placenta previa– attachment of a child’s place in the lower segment of the uterus, in which it completely covers the area of the internal os of the cervix. In this case, childbirth through the natural birth canal is impossible: the placenta simply blocks the baby’s exit from the uterus. In addition, at the very first contractions, accompanied by dilatation of the cervix, the placenta will begin to peel off from the area of the internal os; this can lead to the development of massive bleeding, which poses a real threat to the life of mother and baby.

Transverse position of the fetus- such a position of the baby in which its movement along the birth canal becomes impossible. In the transverse position, the fetus is located horizontally in the uterus, perpendicular to the mother’s spine. In this case, there is no presenting part of the fetus - the head or buttocks - which normally should put pressure on the cervix during contractions, helping it open. As a result, during childbirth in the transverse position of the fetus, the cervix practically does not open, and the walls of the contracting uterus put pressure on the transversely located spine of the baby, which is fraught with severe birth injuries.

Narrow pelvis is an absolute indication for surgical delivery if the third or fourth degree of a uniformly narrowed pelvis (a decrease in all dimensions by more than 3 cm) or an obliquely displaced pelvis is detected - a narrowing of the internal dimensions with mutual displacement of the bones forming the small pelvis due to injury or rickets. With such a degree of narrowing, childbirth through the natural birth canal is impossible, regardless of the size and location of the fetus.

Large fruit is not always an absolute indication for operative childbirth: with normal pelvic sizes, even a large baby can be born naturally. Newborns weighing more than 3600 g are considered large. However, if the fetus weighs more than 4500 g, even a normal pelvis may be too narrow for the fetus, and natural birth may be risky for health.

Repeated entanglement of the umbilical cord leads to a significant shortening of its length and a deterioration in the blood supply to the fetus. In addition, numerous, more than three, loops of the umbilical cord interfere with the normal position of the fetus in the uterus and prevent the movements necessary for the normal biomechanism of childbirth. Biomechanism is the totality of the baby’s own movements during birth, which help him adapt to the size and shape of the mother’s pelvis. If the fetus is not able to perform the necessary movements - for example, bending, unbending and turning the head, birth injuries are inevitable even with normal sizes of the pelvis and the fetus itself.

Maternal diseases, accompanied by a violation of muscle tone and nervous regulation of the pelvic organs. Such diseases are few and far between. Childbirth through the natural birth canal is impossible in this case, since with these pathologies productive labor does not develop. An example of such an absolute indication for “cesarean” is paralysis and paresis (partial paralysis) of the pelvic organs, as well as multiple sclerosis - a lesion of the nervous system, characterized by a violation of the transmission of nerve impulses to organs and muscles.

Complications of pregnancy and childbirth, which pose a real threat to the life of the mother and fetus, are the main absolute indications for emergency surgical delivery.

In fact, the operation, called a “caesarean section,” was first performed specifically for the purpose of saving lives. “Life-saving” indications include acute disturbance of the cardiac activity of the mother and fetus, placental abruption, severe forms of late toxicosis (preeclampsia), disturbance of placental blood flow of the 3rd degree, threat of uterine rupture or old postoperative scar on the uterus.

Relative indications include situations in which surgical delivery is preferable to natural childbirth:

the woman’s age is under 16 or, on the contrary, over 40 years old;
pathologies of vision, cardiovascular and neuroendocrine systems;
slight narrowing of the pelvis or increase in fetal weight;
breech presentation - the position of the baby in the uterus, in which the buttocks or legs are located below;
complicated course of pregnancy - late toxicosis, disturbance of placental blood flow;
the presence of general and gynecological chronic diseases.

To decide on the need for surgical intervention, one absolute or a combination of several relative indications is sufficient.

Surgery or childbirth?

Why is a caesarean section performed only when indicated? After all, the operation is much faster than a natural birth, completely anesthetizes and eliminates the risk of birth injuries for mother and baby. To answer this question, you need to learn more about the features of operative delivery.

1. Caesarean section is an abdominal operation; this means doctors must open the abdomen to extract the fetus. Of all types of surgical interventions, abdominal operations are associated with the greatest number of risks to the life and health of the patient. This includes the risk of developing intra-abdominal bleeding, the risk of infection of the abdominal organs, the risk of divergence of postoperative sutures, rejection of suture material, and many others. In the postoperative period, the postoperative woman experiences significant abdominal pain, requiring drug pain relief. Recovery of the mother's body after surgical birth takes longer than after natural delivery, and is associated with a significant limitation of physical activity. If we compare the traumatism of “natural” and “artificial” childbirth, then, of course, abrasions, perineal incisions and even ruptures of the birth canal are incomparable with the traumatism of abdominal surgery.

2. To extract the fetus, doctors have to cut the anterior abdominal wall, the aponeurosis - a wide tendon plate connecting the abdominal muscles, the peritoneum - a thin translucent serous membrane that protects the internal organs of the abdominal cavity and the wall of the uterus. After the fetus is removed, sutures are placed on the uterus, peritoneum, aponeurosis, subcutaneous fat and skin. Modern suture material is hypoallergenic, aseptic, i.e. does not cause suppuration, and completely resolves over time, however, the consequences of surgical intervention still remain forever. First of all, these are scars - areas of connective tissue formed at the site of the suture; Unlike real organ cells, connective tissue cells do not perform any specific functions necessary for the normal functioning of the organ. The tissue formed at the site of the suture is less durable than the organ’s own tissue, so subsequently, if stretched or injured, a rupture may occur at the site of the scar. The risk of uterine scar rupture always remains during all subsequent pregnancies and births. Throughout pregnancy, if there is a postoperative scar on the uterus, the woman is under especially careful medical supervision. In addition, surgery limits the ability to have more than three children: during each subsequent operation, the old scar tissue is excised, which reduces the area of the anterior wall of the uterus and creates an even higher risk of rupture in the next pregnancy. Another unpleasant consequence of any surgical intervention in the abdominal cavity is the formation of adhesions; these are connective tissue cords between the organs and the walls of the abdominal cavity. Adhesions can disrupt the patency of the fallopian tubes and intestines, causing secondary infertility and serious digestive problems.

3. The main disadvantage of operative delivery for a baby is that during a caesarean section, the fetus does not pass through the birth canal and does not experience the pressure difference to the extent that it needs to “launch” autonomous life processes. For various pathologies of the fetus and mother, it is this fact that is the advantage of cesarean section and determines the choice of doctors in favor of the operation: pressure drops over a long period of time become an additional burden for the baby. If we are talking about saving the life of the mother and baby, surgical delivery is also preferable due to the temporary advantage: on average, no more than 7 minutes pass from the start of the operation to the extraction of the fetus. However, for a healthy fetus, this difficult path through the birth canal, oddly enough, is preferable to quick extraction from the surgical wound: the baby is genetically “programmed” for just such a birth scenario, and surgical extraction is additional stress for him.

In the process of moving through the birth canal, the fetus experiences increased pressure from the birth canal, which promotes the removal of fetal - intrauterine - fluid from its lungs; this is necessary for uniform straightening of the lung tissue during the first inhalation and the beginning of full pulmonary breathing. No less important is the difference in pressure that the baby experiences during natural childbirth, and for the independent functioning of his kidneys, digestive and nervous systems. The passage of the baby through the narrow birth canal is of great importance for the full start of the cardiovascular system: the launch of the second circle of blood circulation and the closure of the oval window, the opening between the atria, which functions in the fetus during pregnancy, largely depends on this.

A cesarean section is an additional surgical intervention of the maximum volume for obstetrics and is associated with a significant risk to the health of the mother; it is never performed at the request of the patient. Caesarean section should not be considered as an alternative birth option; This is an additional intervention in the natural process, performed strictly for medical reasons. The final decision on the need for surgery can only be made by a doctor who observes the expectant mother during pregnancy and during childbirth.