In their most hopeful moments, women visualize giving birth gracefully, breathing through the pain, perhaps even smiling as they make that last push to give their babies the miracle of life. Many work hard to ensure that they can deliver naturally by choosing providers with low cesarean delivery rates, taking childbirth classes, exercising during pregnancy, maintaining a moderate weight gain, and perhaps even hiring a doula to accompany them to the delivery room. Yet the U.S. cesarean rate is higher than it has ever been--26.7 percent--even though few women imagine that they will need one.
Handling the emotions. No matter how many preventive steps you've taken or how healthy and low-risk your pregnancy has been, things do happen that might cause you to have an emergency cesarean. You will feel disappointed. You might even feel like a failure. However, it's important to maintain perspective. It's true that a cesarean delivery carries the inherent risks of any major surgery, such as internal bleeding, blood clots, infection, or damage to your organs. Some babies also have brief respiratory problems following a cesarean. However, thanks to improved anesthesia and surgical techniques and better antibiotics, cesareans carry fewer risks than ever, and having a healthy baby is far more important, in the long run, than delivering vaginally.
Causes. One of the most common reasons for an emergency cesarean is a surprise breech baby (one that's positioned feet or buttocks over your cervix) or a baby that's lying sideways in labor. Another is arriving in labor with heavy bleeding and concern that the placenta has separated or a previa has begun to bleed. The most common cause of an emergency cesarean is that the baby doesn't tolerate labor; if the fetal heart rate pattern shows cause for alarm, a cesarean may be the quickest and safest way to deliver the baby.
Procedure. It can be a chaotic scene with everything happening at once. You'll have your lower abdomen prepped for surgery. It will be washed and perhaps shaved, and you'll be given antibiotics and other fluids through an IV. You will either have your labor epidural dosed up to cesarean level or have a quick spinal or even general anesthesia. If you have an epidural or spinal anesthesia, you will be numb from your chest down; you will be awake, but you won't feel the doctor make the incision. You probably won't see it either because there is typically a surgical drape to shield your abdomen from your view--and because your baby is out before you know it!
Originally published in You & Your Baby: Pregnancy.
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