- Shorter hospital stays
- Lower infection rates
- Quicker recovery
You may require a planned c-section if:
- You’ve had a previous cesarean or more than one previous c-section. Both of these significantly increase the risk that your uterus will rupture during a vaginal delivery.
- If you’ve had only one previous c-section with a horizontal uterine incision, you may be a good candidate for a vaginal birth after cesarean, or VBAC.
- You’ve had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids).
- You’re carrying more than one baby. (Some twins can be delivered vaginally, but most of the time higher-order multiples require a c-section.)
- Your baby is expected to be very large (a condition known as macrosomia). This is particularly true if you’re diabetic or you had a previous baby of the same size or smaller who suffered serious trauma during a vaginal birth.
- Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)
- You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).
- You have an obstruction, such as a large fibroid, that would make a vaginal delivery difficult or impossible.
- The baby has a known malformation or abnormality that would make a vaginal birth risky, such as some cases of open neural tube defects.
- You’re HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral load.
Note: Your surgery will be scheduled for no earlier than 39 weeks,unless there is a medical reason to do so in order to make sure the baby is mature enough to be born healthy.
- In the first week after operation, always keep the dressing clean and dry.
- If it gets wet, visit the nearest GP clinic/ polyclinic to change it.
- Removal of dressing is to be advised by nurses or as indicated by your doctor.
- Removal of stitches depends on the type of sutures used and is to be done according to the doctor’s instructions.
- Observe for bleeding, redness or pus around the wound area, which may suggest wound infection. Please return to the hospital if you have any of these symptoms and/ or fever.
- Do not lift heavy objects for at least two months.
- Avoid strenuous activity that may cause injury or pain. This will allow your wound to heal promptly.
The perineum is the skin between the vagina and the anus, which thins out and stretches as the baby is delivered. Some women will need stitches to repair any tears or cuts (episiotomy) of the perineum that occur during childbirth. It usually heals in two to three weeks, depending on the size of the incision and the type of sutures used to close the wound.
- Keep the wound clean by washing with water, dry and dab gently after every toilet visit.
- Change sanitary pads every two to three hours.
- Reduce discomfort by:
- Using Epikool (pads with cooling gel)
- Lying on the bed or resting on your side every few hours. Avoid sitting for long periods.
- Taking prescribed painkillers to help control any pain.
- Use a sitz bath:
- Add two teaspoons of salt into cool/ lukewarm water in the sitz bath basin.
- Ease yourself in the basin until water touches your perineum.
- Immerse yourself for approximately 20 minutes, three times a day.
- The stitches will dissolve on their own and do not need to be removed.
- Pus-like/ foul-smelling discharge from vagina
- Bleeding from episiotomy wound
- Fever and/ or chills
- Severe or increased perineal pain
- Allows you to rest if your labor is prolonged.
- By reducing the discomfort of childbirth, some women have a more positive birth experience.
- Normally, an epidural will allow you to stay alerted and remain an active participant in your birth.
- If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery.
- When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience.
Some women describe an epidural placement as creating a bit of discomfort in the area where the back was numbed, and a feeling of pressure as the small tube or catheter was placed.
Typically epidurals are placed when the cervix is dilated to 4-5 centimeters and you are in true active labor.
Your epidural can cause your labor to slow down and make your contractions weaker. If this occurs, you may be given the medicine to help speed up labor.
How much of an effect these medications will have is difficult to predetermine and can vary based on dosage, the length of labor, and the characteristics of each individual baby.
The nerves of the uterus should begin to numb within a few minutes after the initial dose. You will probably feel the entire numbing effect after 10-20 minutes. As the anesthetic dose begins to wear off, more doses will be given–usually every one to two hours.
You might not be able to tell that you are having a contraction because of your epidural anesthesia. If you can not feel your contractions, then pushing may be difficult to control. For this reason, your baby might need additional help coming down the birth canal. This is usually done by the use of forceps.
For the most part, epidurals are effective in relieving pain during labor. Some women complain of being able to feel pain, or they feel that the drug worked better on one side of the body.
- You use blood thinners
- Have low platelet counts
- Have an infection in the back
- Have a blood infection
- If you are not at least 4 cm dilated
- Epidural space can not be located by the physician
- If labor is moving too fast and there is not enough time to administer the drug.