C-Section - Complications and Recovery After a C-Section
A High Risk Option
A Cesarean delivery, or a c-section as it is commonly referred to, is considered to be a relatively safe surgery. However, it is major surgery and as such poses a much higher risk of complications than a vaginal delivery. Recovery from a c-section is much longer than from a vaginal birth, and the chance for a vaginal delivery after a c-section is minimized after the first surgery. If multiple c-sections are performed, then there will not be a chance for a vaginal attempt. The potential issues for a woman who has had multiple c-sections are myriad.
Complications of Cesarean Births for Mothers
C-section complications for the mother include the higher incidence of infections, both internally and at the incision site. Heavy blood loss is also more common with c-sections. There is a potential for blood clots that could lodge in the lungs or in the legs, causing a thrombosis. Since this surgery is abdominal, the intestines stop moving causing constipation. Headaches, nausea and vomiting, mostly related to the anesthesia, are very common after delivery. Other anesthesia related complications include pneumonia and fluid in the lungs as well as unanticipated allergic or physiological responses to the anesthesia - such as a sudden drop in blood pressure. Maternal death, while quite rare, is at 6 in 100,000 for planned c-sections, and 18 in 100,000 for emergency c-sections.
Additionally, there are long-term risks associated with cesarean sections. If a woman has had more than one cesarean delivery there are increased risks which multiply exponentially with each additional c-section. These risks include uterine rupture, where the scar breaks open during a later pregnancy or during labor. Placenta previa, a situation in which the placenta lies low in the uterus covering the cervix, requires the birth to be cesarean because of the high risk of severe blood loss and the potential death of the baby. Placenta accreta, placenta increta, and placenta percreta, listed from least to most serious, are problems that occur when the placenta grows deeply into the uterine wall, and in placenta percreta, grows through the uterus and attaches to other organs. These conditions lead to heavy bleeding after childbirth and often require a hysterectomy to deal with them.
Risks of C-Sections for Babies
The risks to the baby in the case of a cesarean delivery include such things as a premature birth. If the due dates were not calculated properly, it is possible for the baby to be taken before the correct time. Babies born by cesarean are more likely to develop breathing difficulties, like fast breathing (transient tachypnea) shortly after birth. Low Apgar scores are common with babies born by cesarean. This is probably due to anesthesia or the birth by surgery - or if the baby was already in distress to begin with. Although this is rare, there is a danger of fetal injury by the surgeon's knife.
Recovering from a c-section is quite different than recovery from a vaginal birth. After the c-section procedure is complete, the mother is taken away from the surgery and carefully monitored for about an hour to ensure no complications arise from the surgery. The baby is taken to the intensive care nursery for observation. The mother may or may not see her baby that day, especially since she's recovering from surgery and the baby is affected by the anesthesia administered to the mother. The effects of the drugs and the aftermath of surgery can leave a new mom feeling less than enthusiastic about nursing her newborn, and the newborn may feel less than enthusiastic about nursing as well.
Gas builds up in the abdomen after this kind of surgery, so the mother will be encouraged to get up and walk around within 24 hours of the cesarean. Walking also reduces the likelihood of blood clots in the legs - a very dangerous phenomena. It takes about four to six weeks for the incisions on both the uterus and the outside of the abdomen to heal completely. Most women experience tenderness for a longer period afterward.
Much like a vaginal delivery, a woman recovering from a cesarean birth will feel the contractions of the uterus, like being in labor, as it shrinks back to pre-pregnancy size. There will be bleeding for a few weeks after the delivery as well. Extra help will be needed post-surgery, especially since it is not recommended that anything heavier than the baby be lifted up. Driving will be out for a while as will stairs.
Although things may seem overwhelming after a cesarean, with some time and perspective, life will return to normal and things will pick up again.