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Question
Posted by: curious | 2004/01/09

Questions regarding a caesar

I need some information. I am 4 months pregnant. I have also, after extensive reading and approaching other women with children, decided to opt for a planned Caesar. I am happy with my decision and will not change my mind (I know there are a lot of women who are pro normal birth – thank you, but please do not try to change my mind). However I would appreciate some more information regarding this. What are the medication options when having a Caesar? How long does the procedure take? How big is the cut? I had an emergency appendix op two years ago and the scar is just below my bikini line and is around 7cm’s long – will they be able to cut over that scar? Does having a Caesar affect the ability to breastfeed? I would like to breastfeed and I have heard many reports that if you do not let the baby latch on immediately, you may battle with getting him to latch on later. I am assuming that the after effects of the operation will be similar to the appendix op I had – that being I will be able to walk but it will be painful to stretch any of the torn muscles? I also could not lift anything, but I did recover rather quickly, so that does not really scare me. I am however, scared that I will see what the doctors are doing – I would not be able to handle that. What are the chances of me feeling any pain during the op? One last question – this was a completely unplanned pregnancy and I have no further intentions of having more children. I would assume I am too young to be sterilized – I am 26 – I have no idea how eager a doctor would be to sterilize me, but if not, is it safe to use contraception pills while I am breastfeeding?

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Our expert says:
Expert ImageGynaeDoc

I am not sure what you mean by the medical options when having a Caesar. The avearge Caesar takes 30 - 40 minutes. If you appendix scar is below the bikini line (not the usual place for an appendix scar) then the Caesar could be done through the same scar. The cut will probably be a bit longer as the diameter of a baby's head is about 9 - 10cm. The operation will not interfere with breastfeeding and you are right about the after effects.
If you are scared of seeing what the doctors are doing, I presume that you are opting for an epidural. A screen is placed betweenyou and the surgeon, so you will not see the operation. If you do feel pain, the epidural will be converted to a general anaesthetic. usually all you feel is the pulling, much like at the dentist.
Most doctor would not be keen to sterilise you at your age. You cannot use the combined pill while breastfeeding but you can use the mini-pill.

Best wishes

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Our users say:
Posted by: curious | 2004/01/15

Thank you all for helping me out with this information. I feel a lot better about my decision now, and I am still opting for a caesar. My appendix scar is below the bikini line, horizontally, on the right side. I have no idea why - the doctor that attended to me says he prefers to do it low down and neat. I feel a lot better about the breastfeeding as well, and I am (finally) looking forward to this baby.

Thank you.

Reply to curious
Posted by: Inc | 2004/01/09

I've had 3 Caesars... the first two were under general anaestetic and the last one was a spinal block... if I knew how easy the last one was... I would have done that with the first two kids as well! I had no side effects and the pain management was much better! However... if I had the choice, I would do the normal birth thing... Natural birth is a natural process... a Caesar is a major operation... you take longer to heal ... they cut through your stomach muscles... it's hard to get that flat stomach back again! With an epidural, you can have quite a painless normal birth!... In the end, it's still your choice. As for the sterilization... talk to your doc... that too is ultimately your decision. Or you can take a mini pill while you are breastfeeding.

Reply to Inc
Posted by: Belle | 2004/01/09

Hi curious

When you have the caeser they will cut along the old scar from your last op, they will remove all of the old scar tissue from the area before they sew you up again so that the scar is still thin and neat and does not become overly hard. The procedure is very quick taking only a few minutes. Since you are opting for the caeser you can do some research on what pain reduction route to go. As kate says the spinal is probably best. I had an emergency caesar so they did it with the edidural that was already inserted. The only problem was that I still had strong feeling in my left side and could feel everything that they were doing. Very painfull. Usually you only get to hold your baby for a minute or two after the birth then they take it to do all the tests. During this time you are put into recovery to make sure that you are not bleeding excessively and to warm you up. (You are usually freezing afterwards and they put this realy neat blanket over you that actually heats up). Afterwards you go to your room and can ask for your baby immediately. They will assist you with the breast feeding as it is not easy and you will have to experiment for a comfy position. I found that sitting on a chair with a pillow next to me and the baby lying on it under my arm with its legs going almost behind me was best because lying it on your tummy is painful. At the first feed it will probably get a few ml's of colostrum which is enough for it as it is very rich. After this milk will slowly start to be produced. If you want to breast feed for a few months then dont make the mistake that I made. My breasts were sore so I gave him a bottle to give my breasts a chance to heal. After that he refused to take the breast again. Rather try to find a breast feeding clinic and let them help you with any problems. Try to get up the next morning and move around. The longer you stay in bed the stiffer you get and the more painfull it is.

As to the sterilisation, many doctors dont like to sterilise such young women though if you insist probably will. Rather think of using the mirena. It lasts for 5 years at a time and requires no maintenance. Go to "w w w . f e m a l e l i f e . c o . z a" for more info. Just take out the spaces.

Reply to Belle
Posted by: Kate | 2004/01/09

I am also having an elective caeser on the 2nd March. I am much more comfortable with this decision than the prospect of vaginal delivery. I am very grateful that we have the right to chose.

As this will also be my first, I can only tell you what I have learnt so far. They should be able to cut over your scar. You will be able to try breastfeeding once out of recovery and with most drug assisted births (epidurals, spinals etc) your baby may be drowsy from the drugs and not want to latch straight away, so don't worry about this. I don't want my first time trying to breastfeed being in front of all the doctors etc. I think it would be too stressful and will try after recovery.

As far as I am aware once the caeser begins it is about 5 minutes until the baby is born. The use of spinal blocks is preferred to epidurals for elective caesers. The difference is that the epidural is inserted between the vertebra whereas the spinal is into the spinal column. The spinal wears off quicker and by the time you are in recovery you will feel the pins and needles feeling of it wearing off. Which means you can control over your body sooner. You will be offered pain killers staright away and I have been advised to take them soon. The doctors will prod and pinch you all over before they cut to make sure you will not feel anything. So don't worry about having pain during the op.

You won't walk for the rest of the day/evening and will be encouraged to get out of the bed the next morning. Although this will be sore, it is important to get up then and makes recovery easy as far as I have heard. I think you must be so excited to see baby that you will get up anyway! You can ask for baby to be brought to you too.

There will also be a gynae, paed, asst, aneth, nurse and your birth partner in the room with you when you have a caeser. You will be wearing a hospital gown and your breasts can be covered at all times. No need to lie naked. Your gown will be lifted up to your ribs and a screen will be place between your chest and your tummy so you won't see what is happening. They will lift the baby over to you after it has been born. Your bottom half will be covered with a hospital cloth and only your tummy exposed. Apparently once the placenta has been removed you will have sanitary towels placed on your vagina as you will start bleeding as normal. Then you go into recovery for about 30 minutes - 2 hours.

I would suggest you do not have a sterilisation straight afterwards. You are still very young and that is very final. Rather use condoms whilst breastfeeding as you cannot take the pill. Then continue with the pill afterwards. Let your child get to the age of two before you decide. It is a very emotional time between falling pregnant and your child turing two so don't make such a final decision now. You never know, after this experience, you may decide that you would like a playmate for your child. You don't know what the future holds.

I hope this helps. Best of luck!

Reply to Kate
Posted by: Kippie | 2004/01/09

Hi there
There are alot of question and I will only be able to provide you some answers based on my experience.

I am also now 18 w 5 d pregnant with my 3rd child and had ceasars with both my other children, which was 14 and 11 years ago!
I was put down compeletely out of own choice, those years the needles were quite long and scary for an epidural. Being in pain and uncomfortable for about another 2 hours after the op, I only started breastfeeding then and I had no problems with it.
With my second baby I opted to bottlefeed her, and once again no problem with bonding or anything else. This time round I will bottlefeed once again as I am not pro breastfeeding - no matter what the government says!!!
Yes the op is major surgery which will take time for you to recover from, but nothing that you cannot overcome.
I am also going for a ceasar end of May. The scar is about 10cm in length on the bikini line, and for a second ceasar they do cut over the old scar - I do not know what they will do with your apendix scar.

I haven['t answered much of your questions, but I'm sure other ladies will also let you know re their experience and you will be able to make something out of all that.

Good luck !!

Reply to Kippie

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