Pregnancy / Labour & Delivery

Caesarean Section

A Caesarean Section is a operation to remove the baby from the uterus.

This is done by a cut in the lower abdomen, followed by a cut in the uterus. The doctor then brings out the baby. Occasionally forceps may be needed to help the birth of the baby through the abdominal wound out of the uterus. The placenta will also be removed and the cord cut between the placenta and the baby.

Anaesthetic

See "About your anaesthetic" information sheet for information about the anaesthetic and the risks involved. If you have any concerns, talk these over with your anaesthetist. If you have not been given an information sheet, please ask for one. Please note that all herbal products, examples, raw garlic, Ginseng, non prescribed vitamin or natural medicines should be ceased at least 14 days prior due to potential problems with bleeding during and after the procedure.

General risks of a procedure

They include:

  • Small areas of the lungs may collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
  • Clots in the legs (deep vein thrombosis) with pain and swelling. Rarely part of this clot may break off and go to the lungs which can be fatal.
  • A heart attack because of strain on the heart or a stroke. Death is possible due to the procedure.

Specific risks of this procedure

  • Severe bleeding from large blood vessels about the uterus, which will need emergency surgery to repair the damaged blood vessels. A blood transfusion may be required to replace blood loss. Rarely, in severe cases, the uterus may have to be removed, preventing future pregnancies.
  • Infection in the operation site or pelvis or urinary tract. Treatment may be wound dressings and/ or antibiotics.
  • Bleeding into the wound from surrounding blood vessels. Treatment is with antibiotics and a drain into the wound for a few days.
  • Minor skin cut(s) to the baby, more common in breech births when the baby’s bottom is against the wall of the uterus, and the baby’s bottom, face or body may be cut when the uterus is cut. This usually heals quickly and is treated with a band-aid.
  • Injury to other organs such as the ureter(s) (tube leading from kidney to bladder) bladder or bowel. The rate of risk is about 1 in 140 women. Further surgery will be needed to repair the injuries. For bladder injuries, a catheter (plastic tube) may be put into the bladder to drain the urine away until the bladder is healed. For ureter injury, a plastic tube is placed in the ureter for some weeks and then removed by cystoscopy. If the bowel is injured, bowel resection and a possibility of a temporary or permanent colostomy.
  • The uterus does not contract properly after the operation. This may lead to excess vaginal bleeding, treated with hormone injection(s) to contract the uterus. In severe cases, it may be necessary to remove the uterus, preventing future pregnancies.
  • Bowel blockage after the operation. This may be temporary or in the longer term. If it doesn’t get better with initial treatment, bowel surgery may be necessary which may include a colostomy. This can be temporary or permanent.
  • Poor wound healing and the wound may burst open which may require long term wound care with dressings and antibiotics, or a hernia i.e. rupture can form in the long term. This may need repair by further surgery.
  • Adhesions (bands of scar tissue) may form and cause bowel obstruction. This can be a short term or a long-term complication and may need further surgery.
  • The scar may rupture in future pregnancies or labour. The risk is higher and if the cut is made down the uterus rather than across the lower part of the uterus. This can be fatal.

 

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