OB/GYN Explains C-Sections: Why You Might Need One Emergently + Tips to Prepare and Recover After

Summary

In this episode, Drs. Kurt and Sarah Bjorkman, a physician couple, share their expertise on C-sections, combining professional knowledge with personal experience. They cover common reasons for both planned and unplanned C-sections, what to expect before, during, and after surgery, and tips for a smooth recovery. They emphasize the importance of pain management, post-op care, and staying informed about your options, while also addressing emotional well-being during the process. Whether it's a planned procedure or an emergency, this episode offers valuable insights for anyone preparing for a C-section.

Takeaways

• 😀 C-sections are one of the most common surgeries in the United States, with 1 in 3 babies born via C-section.
• 😀 Unplanned C-sections occur often, with about 50% of first-time C-sections being unplanned, and 25% being emergent due to fetal distress.
• 😀 Emergency C-sections can be required for reasons like fetal distress, failure to progress, or medical complications like uterine rupture.
• 😀 Your OB-GYN or midwife will do their best to help you achieve a vaginal birth, but a C-section may be necessary for safety reasons.
• 😀 Some common reasons for a C-section include breech babies, multiples, abnormal placentation, and health conditions that make vaginal birth unsafe.
• 😀 Planned C-sections are typically scheduled between weeks 39 and 40 of pregnancy, and it’s important to review medications and birth control options beforehand.
• 😀 The day before a C-section, patients are advised to refrain from solid foods for 8 hours, but clear liquids like water and apple juice are generally allowed up to 2 hours before surgery.
• 😀 Before the surgery, you’ll be prepped with an IV, a fetal monitor, and a catheter, and your doctor will review anesthesia options to ensure you're comfortable during the procedure.
• 😀 During a C-section, a spinal or epidural anesthesia is used to numb you from the chest down, and the goal is for you to remain awake during the procedure.
• 😀 After the surgery, pain management is crucial. Expect a combination of Tylenol, Motrin, and sometimes opioids. You’ll also be given medications to manage constipation and nausea.
• 😀 After discharge, take your pain medications as prescribed, limit heavy lifting, and avoid strenuous activity for six weeks. Always contact your OB-GYN if you experience signs of infection or complications, such as fever or excessive bleeding.

Q & A

What is a c-section and why is it performed?

A c-section (cesarean section) is a surgical procedure used to deliver a baby through an incision in the mother's abdomen and uterus. It is typically performed when a vaginal delivery is not possible or safe for the mother or baby, such as in cases of fetal distress, failure to progress, or certain medical conditions.

What are some common reasons for needing an unplanned c-section?

Unplanned c-sections can occur due to reasons like fetal distress (when the baby shows signs of not tolerating labor), failure to progress (when labor stalls), or emergencies like a prolapsed cord, placental abruption, or uterine rupture.

What are the goals of an OB or midwife during labor and delivery?

The primary goal of an OB or midwife is to ensure a healthy mom and baby. They will do everything they can to achieve a vaginal delivery if possible, but will recommend a c-section if it becomes necessary for the safety of the mother or baby.

What is a 'gentle c-section' and how is it different from a standard c-section?

A 'gentle c-section' refers to a more personalized approach to a c-section, where the environment is tailored to the mother's preferences, such as using a clear drape to allow the mother to see the baby being born, or ensuring immediate skin-to-skin contact with the baby in the operating room.

How can pain management be handled after a c-section?

Post-c-section pain is typically managed with a combination of medications. This includes acetaminophen and ibuprofen around the clock, sometimes IV medications like Toradol, and possibly opioids for breakthrough pain. Efforts are made to minimize opioid use due to their side effects, such as constipation.

What are some steps a woman should take before her planned c-section?

Before a planned c-section, a woman should review her medications with her doctor, discuss birth control options (like tubal ligation or IUD), stay active and healthy, and discuss pain management options. It’s also important to understand how the incision will be closed (staples, sutures, or glue).

What are some important preoperative instructions before a c-section?

Preoperative instructions include fasting from solid food for 8 hours before surgery, limiting clear liquids to 2 hours before surgery, and avoiding shaving the abdomen or pubic area. Also, a special antiseptic wipe is often used to clean the skin before surgery to reduce infection risk.

What should a patient expect on the day of the c-section surgery?

On the day of surgery, a patient will likely be hooked up to fetal monitors and have an IV inserted. Anesthesia will be administered, either through an epidural or spinal block. Afterward, the operating room staff will ensure everything is sterile and prepare for the incision. The partner is usually invited into the OR once preparations are complete.

How soon can a woman get up and move around after a c-section?

Most women are encouraged to begin moving around, eating, and using the bathroom within a few hours after a c-section. Recovery time in the hospital typically lasts 2-3 days, depending on the individual and any complications.

What are some signs that a woman should contact her OB/GYN after going home from a c-section?

A woman should contact her OB/GYN if she experiences a fever over 100.4°F, excessive redness or drainage from the incision site, headaches, vision changes, severe pain in the right upper abdomen, dizziness, or heavy vaginal bleeding (especially if blood clots increase in size).