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As I mentioned in a previous unit I recently have had some close friends give birth for the first time. Unfortunately because of Covid-19 I was unable to attend the actual birth of either baby. I am thankful for technology and its advancement in the way that we have the ability to facetime throughout the experience. Now both of my friends gave birth in different ways so I was able to see the pro and cons of both processes. Natural birth is beautiful and extremely hard, but so are cesarean-sections (C-section). They both have their hardships. In my STEM project today I want to talk about the surgical process that occurs when a women goes through a c-section.
A cesarean section is a very common, well-established operation that many women have when delivering a child. In fact, rate is about a third of all births in the United States of America. This procedure is performed for many reason, including prolonged labor, high risk pregnancy, large babies, multiples, fetal distress, breech presentation, a previous c-sections where vaginal birth after cesarean (VBAC) is not advised or desired, placenta previa, and cord prolapse. When the decision to have a cesarean can arise before labor, it is often called a planned or scheduled c-section. The decision might also happen in labor. Knowing what to expect may help you feel more comfortable with the procedure. It is important to ask or have the doctor to explain all your options.
Before the surgical process begins for a cesarean, you will receive anesthesia, which is usually a regional pain block such as an epidural or spinal block. A regional anesthesia allows them to feel no pain during the surgery while also remaining awake to witness the birth of the child. In some cases of emergency, a general anesthesia is used, which means the women will be asleep.
While the anesthesia is being administered, the room will be busy as the other nurses and doctors are preparing the room with instruments and the warmer for the baby. Anesthesia can take about 20 to 30 minutes to administer. The powerful numbing will happen quickly and effectively.
Depending, arms will be strapped down in a T-position away from the sides. This is done to prevent you from accidentally interfering with the surgery. Something to remember is they may also have a urethral catheter placed. There will be a drape placed at your abdomen to keep you from seeing directly into the incision. However, you will be able to see the doctors, and most importantly, the baby when they are delivered. In most cases, the patient’s partner or support person will be able to be in the operating room and will be positioned near their head to provide support/witness the birth.
The first layer that the surgeon will have to go through after skin is disinfected and prepped, is skin. The skin will often be shaved prior to the incision which in most cases, is horizontal (across the lower abdomen, below the belly button and just above or below the start of pubic hair). After skin, comes fat and fascia, a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. Next the abdominal muscle which in the video is shown to be cut, but oftentimes it is separated from the peritoneum -the membrane lining the cavity of the abdomen and covering the abdominal organs- to access the uterus. Once to the uterus there is a final incision into the anmiotic sac or the fluid-filled sac that contains and protects a fetus in the womb. Now suction must begin to clear the fluid out of the way to see the baby. Once that’s done remove the fetus, clamp the umbilical cord, cut (sometimes partners or support people are allowed to cut the cord), move the baby aside, and remove the placenta. This structure provides oxygen and nutrients to your growing baby and removes waste products from your baby’s blood. It is important that the whole placenta comes out after pregnancy. If any fragments of the placenta stay inside, they will have to be surgically removed to prevent bleeding and infection. Finally while baby nurses for the first time the surgeons work together to close up the incision. This is the longest part of the process usually lasting 30 to 60 minutes depending on the method of sutures used. While the uterus is typically sewn closed with dissolving stitches, the doctor can choose to close the abdominal incision with either staples or stitches. Once closed, the wound will be covered with a bandage. Now it is off to healing and enjoying the new life you created.
Source:
Bhargava, Hansa D. “C-Section (Cesarean Section): Why It’s Done & What To Expect.” WebMD, WebMD, 16 July 2020, www.webmd.com/baby/what-happens-during-c-section#1.
HillsMBBS, Dr Frances. “Caesarean Section: Step by Step.” O&G Magazine, 9 Dec. 2018, www.ogmagazine.org.au/18/4-18/caesarean-section-step-step/.
Courtney looked further in caesarean sections through her steam project. The median she chose was modeling clay. Courtney did an excellent job portraying the surgical steps of performing a caesarean section. She created a stop-motion video of each layer that is cut through in order to retrieve the infant. I especially liked the portrayal of suctioning out the amniotic fluid with a dropper. That is an important step and Courtney addressed it creatively.
Caesarean sections are incredibly common, accounting for roughly one-third of all births in the United States. There are many reasons to perform a C-section rather than a natural birth. Some complications are known ahead of time, giving the mother time to mentally prepare for a caesarean section, and some can arise rapidly during labor. Being a surgical procedure, anesthesia will need to be administered prior to beginning. It can take between 20 and 30 minutes for the anesthesia to kick in which allows the doctors and nurses time to get the other necessary equipment set up and ready. The anesthesia used is typically a local anesthetic which allows the mother to be awake and witness the birth of her child. In rare cases a general anesthetic is necessary and unfortunately these cases do not allow for the mother to be a witness. Courtney covers the different layers that need to be cut through in order to reach the infant through a caesarean section. It is critical to ensure all bleeding has stopped and the placenta has been fully delivered before the incision is stitched shut.
Overall, Courtney’s steam project was creative, informative, and very well done. The Claymation of the surgery was a great visual description of the process. It paired very well with the essay. I learned much more about caesarean section surgeries, including just how frequently they actually occur.