The journey towards welcoming your baby is filled with anticipation, and every expectant parent hopes for a smooth and safe delivery. While a vaginal birth is a common goal for many, there are times when a Caesarean Section (often called a C-section) becomes the safest, and sometimes necessary, path to bring your little one into the world. Understanding this procedure can help alleviate anxieties and empower you with knowledge.
My name is Dr. Vrushali Pillai, and as a Senior Consultant Obstetrician & Gynaecologist at Borneo Hospital, Thane – part of the Borneo Hospitals group serving families across Thane, Nashik, Chhatrapati Sambhaji Nagar, and Raipur City – my priority is always the health and well-being of both mother and child. We are committed to providing expert care for all types of deliveries, ensuring informed choices and the best possible outcomes.
This article aims to provide a clear and comprehensive overview of Caesarean Section deliveries. We’ll explore what a C-section is, the common reasons why it might be recommended (either planned in advance or becoming necessary during labour), give a general idea of what the procedure involves, discuss its benefits in certain situations, and touch upon the recovery period. Our goal is to demystify the Caesarean Section and foster a better understanding of this important medical procedure.
What is a Caesarean Section (C-Section)?
A Caesarean Section is a surgical procedure in which your baby is delivered through an incision (a cut) made in your abdomen and then a second incision in your uterus (womb). This is different from a vaginal birth, where the baby travels through the birth canal.
A C-section can be:
- Planned (Elective): Scheduled before labour begins, due to known medical reasons or specific circumstances concerning you or your baby.
- Unplanned (Emergency): Becomes necessary due to unforeseen complications that arise during labour or late in your pregnancy, requiring prompt delivery for the safety of you or your baby.
It’s important to know that C-sections are one of the most common major surgical procedures performed globally and are generally very safe when medically indicated, thanks to advancements in surgical techniques and anaesthesia.
When is a Planned (Elective) Caesarean Section Recommended?
Sometimes, your obstetrician at Borneo Hospital may recommend a planned C-section if specific factors suggest it would be safer for you or your baby than a vaginal birth. These decisions are always made after careful assessment and discussion with you. Common reasons include:
1. Foetal Position:
Breech Presentation: If your baby is positioned bottom-first or feet-first towards the end of your pregnancy, and attempts to turn the baby head-down (a procedure called External Cephalic Version, or ECV) have been unsuccessful or are not advisable for you.
Transverse Lie: If your baby is lying sideways across your uterus and cannot be turned.
2. Placental Issues:
Placenta Praevia: If the placenta is lying very low in your uterus and partially or completely covering your cervix (the opening to the womb). A vaginal birth in this situation could cause severe bleeding.
3. Multiple Pregnancies (Sometimes):
While some twin pregnancies can be delivered vaginally, a Caesarean Section is often recommended for triplets or more. For twins, a C-section might be advised if the first baby is not in a head-down position, if there are other complications, or based on your doctor’s assessment of the safest approach.
4. Previous Caesarean Section(s):
If you’ve had one previous C-section, a Vaginal Birth After Caesarean (VBAC) might be an option for you, and we can discuss this at Borneo Hospital. However, a repeat Caesarean Section is often recommended, especially if you’ve had two or more previous C-sections, if your previous uterine incision was of a specific type (e.g., a ‘classical’ vertical incision), or if there are other factors that increase the risks associated with a VBAC trial. Your preference after thorough counselling also play a role.
5. Certain Maternal Medical Conditions:
- If you have an active genital herpes infection at the time of labour, a C-section can prevent transmission to your baby.
- Certain severe maternal heart conditions might make the physical stress of labour too risky.
- Large uterine fibroids that obstruct the birth canal or pose a significant risk during vaginal delivery.
6. Known Large Baby (Macrosomia):
If your baby is estimated to be very large (macrosomic), and your doctor believes that a vaginal delivery might be difficult or pose risks of injury to you or your baby (such as shoulder dystocia).
7. Maternal Request (After Comprehensive Counselling):
In some situations, after detailed discussion about the risks and benefits of both vaginal birth and Caesarean Section, and exploring all alternatives, a woman may request a planned C-section. This is always based on informed choice.
When is an Unplanned (Emergency) Caesarean Section Necessary?
Even if you plan for a vaginal birth, circumstances can change during labour or late pregnancy, making an unplanned or emergency Caesarean Section the safest option. The medical team make this decision to protect you and your baby.
1. Labour Not Progressing (Failure to Progress / Dystocia):
This is one of the most common reasons. It means your labour has slowed down or stopped – perhaps your cervix isn’t dilating (opening) despite strong and regular contractions, or your baby isn’t descending through the birth canal as expected.
2. Foetal Distress:
If there are clear signs during labour that your baby is not coping well and may be lacking oxygen – for example, significant or persistent abnormalities in your baby’s heart rate pattern (as monitored by a CTG machine) that don’t improve with other measures.
3. Placental Abruption:
This is a serious condition where the placenta prematurely separates from the uterine wall before the baby is born. It can cause severe bleeding and reduce oxygen supply to the baby, requiring immediate delivery.
4. Umbilical Cord Prolapse:
A rare but critical emergency where the umbilical cord slips down into the vagina ahead of the baby. The cord can then get compressed, cutting off the baby’s vital oxygen and blood supply, necessitating an immediate Caesarean Section.
5. Uterine Rupture (Rare but Serious):
A tear in the wall of the uterus. This is a rare complication, most often (though still infrequently) occurring in women who are attempting a VBAC if they have a scar from a previous C-section.
6. Sudden, Severe Maternal Complications:
Conditions such as severe pre-eclampsia or eclampsia (seizures) that develop or worsen significantly, or sudden severe maternal bleeding (Postpartum Haemorrhage or antepartum haemorrhage), may require immediate delivery via C-section for the mother’s safety.
7. Failed Instrumental Delivery:
If attempts to assist a vaginal delivery using forceps or a vacuum extractor are unsuccessful or deemed not to be the safest option.
The Caesarean Section Procedure: What Generally Happens
Understanding the basics of the procedure can help reduce anxiety.
1. Preparation:
Before the surgery, you’ll have an intravenous (IV) line placed in your arm for fluids and medications. You’ll receive anaesthesia – for most planned and many unplanned C-sections, this is a regional anaesthetic (spinal or epidural), which numbs the lower half of your body so you are awake and comfortable for your baby’s birth. General anaesthesia (where you are asleep) is used less commonly, usually only for very urgent emergencies or if regional anaesthesia isn’t suitable. A urinary catheter (a thin tube) will be inserted to keep your bladder empty during the surgery, and your abdomen will be cleaned with an antiseptic solution.
2. The Surgery:
Your obstetrician will make an incision through your abdominal wall and then another incision through the uterine wall to deliver your baby. The most common type of skin incision is a horizontal one, just above your pubic hairline (often called a ‘bikini cut’), which usually heals very well. The delivery of the baby during a Caesarean Section is often quite quick, just a few minutes once the surgery begins. After the baby is born, the placenta is delivered, and then the obstetrician carefully closes the incisions in your uterus and abdomen with stitches, which often dissolve on their own, or sometimes staples.
3. Baby’s Immediate Care:
A paediatrician or neonatal nurse from Dr. Santosh Madrewar’s team at Borneo Hospital is usually present at a Caesarean Section to provide immediate care for your baby as soon as they are born. We strongly encourage skin-to-skin contact between you and your baby in the operating theatre or recovery room as soon as it is medically safe for both of you.
4. Duration:
The actual birth of the baby is quick. The entire surgical procedure, including closing the incisions, typically takes around 45 to 60 minutes.
5. Reassurance:
It’s important to remember that a Caesarean Section is a very common and well-practised surgical procedure. At Borneo Hospital, it is performed by experienced obstetricians like myself, supported by a full surgical team including skilled anaesthetists and nurses, in a sterile, modern operating theatre environment.
Benefits of a Caesarean Section (When Medically Indicated)
When a Caesarean Section is performed for clear medical reasons, its benefits are significant:
- It Can Be Life-Saving: This is the most important benefit. It can be a life-saving intervention for the mother, the baby, or both when vaginal delivery poses serious risks.
- Reduces Risk of Certain Birth Injuries: In specific situations, such as a baby in a difficult breech position or severe foetal distress, a C-section can reduce the risk of certain types of birth trauma to the baby.
- Planned Timing: For some families, an elective C-section offers a degree of predictability in the timing of birth, which can reduce anxiety for some mothers.
Understanding Potential Risks and Complications
Like any major abdominal surgery, a Caesarean Section carries potential risks, although it is generally a very safe procedure, especially when planned.
- For the Mother (Short-term): Risks include infection (of the wound, uterus, or urinary tract), increased blood loss or haemorrhage compared to an uncomplicated vaginal birth, blood clots (Deep Vein Thrombosis – DVT) in the legs or lungs, reaction to anaesthesia, a longer hospital stay, and a more extended recovery period with more initial pain and limitations on mobility.
- For the Mother (Longer-term): Potential for internal scar tissue (adhesions), and slightly increased risks in future pregnancies, such as placenta accreta spectrum (where the placenta attaches too deeply into the uterine wall) or a slightly higher chance of uterine rupture if attempting a VBAC.
- For the Baby (Generally Low Risk): Occasionally, newborns delivered by C-section might experience transient tachypnoea of the newborn (TTN), which is temporary fast breathing that usually resolves quickly. Accidental nicks to the baby during the incision are very rare.
- Balancing Risks and Benefits: Your obstetrician always carefully weighs these potential risks against the benefits of performing a Caesarean Section in your specific situation. The decision is always made with the primary aim of ensuring the safety and health of both you and your baby.
Recovery After a Caesarean Section (A Brief Overview)
Your recovery will be closely monitored.
- Hospital Stay: Typically, you’ll stay in the hospital for about 3 to 5 days after a C-section.
- Pain Management: Effective pain relief medication will be provided to keep you comfortable.
- Wound Care: You’ll receive specific instructions on how to care for your incision site to promote healing and prevent infection.
- Gradual Return to Activity: Gentle movement, like short walks, is encouraged early on to aid recovery and prevent blood clots. However, you’ll need to avoid heavy lifting and strenuous activity for about 6 weeks, or as advised by your doctor.
- Postnatal Check-up: Your 6-week postnatal check-up with your obstetrician is very important for assessing your overall recovery.
Borneo Hospital’s Approach to Caesarean Deliveries
At Borneo Hospital, our approach to all deliveries, including Caesarean Sections, is centred on safety, expertise, and compassionate care.
- Prioritising Safety & Informed Choice: Our primary commitment is to the safety and well-being of every mother and baby. Decisions regarding the mode of delivery are always made based on sound medical evidence and in thorough consultation with you, ensuring you are fully informed.
- Expert Team & Modern Facilities: Our branches in Thane, Nashik, Chhatrapati Sambhaji Nagar, and Raipur City are equipped with state-of-the-art operation theatres. We have teams of skilled obstetricians (like myself, Dr. Pillai), experienced anaesthetists, dedicated paediatricians (led by our Founder, Dr. Santosh Madrewar), and compassionate nursing staff available 24/7. Our advanced Neonatal Intensive Care (NICU) facilities are always ready should your baby require any specialised care.
- Family-Centred Approach: We strive to make the Caesarean Section experience as family-centred as possible. This includes encouraging partner presence in the operating theatre where appropriate and medically safe, and facilitating early skin-to-skin contact between you and your baby, as well as supporting breastfeeding initiation as soon as possible.
A Caesarean Section is a vital medical procedure that, when indicated, plays a crucial role in ensuring a safe delivery and healthy outcome for many mothers and babies. Understanding when and why a C-section might be planned, or become necessary during labour, can help demystify the process and reduce any associated anxiety.
The decision to perform a Caesarean Section is always made with the utmost consideration for the health and safety of both you and your child. Open communication with your obstetrician at Borneo Hospital is key to understanding your individual circumstances, your birth options, and feeling prepared and confident for your baby’s arrival, whichever path it takes. It can still be a beautiful and joyful experience, welcoming your precious baby into the world.
