Brennan Anderson, DO

C-section incisions can be up-and-down (vertical), from belly button to lower abdomen or side-to-side (horizontal), across the lower abdomen. Side-to-side incisions are more frequently used. After the exterior incisions are made, the doctor then cuts into the uterus and amniotic sac and delivers the infant and cuts the baby's umbilical cord. The mother receives medicine to expel the placenta and the doctor helps to safely remove it. Finally, the doctor uses sutures to seal the uterus and tissue incisions. The initial C-section skin incision is also closed with sutures or staples.

C-sections are typically performed with regional anesthesia, which inhibits pain in the lower half of the body, but allows mothers to be awake. However, some mothers may receive general anesthesia, where they are put to sleep during the surgical procedure.

C-sections may be planned or unplanned, depending on the circumstances of the birth.

Pre-existing conditions like heart disease, high blood pressure, herpes, and HIV may prompt a doctor to prescribe a C-section. Other situations for C-section include:

• A large baby or birth to multiple children
• Pelvic fracture or limited birth canal
• Baby in the "breech position," where a baby is positioned feet or bottom first in the uterus
• Baby with a developmental disorder
• Irregular fetal heartbeat
• Mother with a history of previous C-sections

Other mothers may require a C-section due to complications arising during delivery. These unplanned, emergency C-sections allow for a healthy birth even when complex complications are present. Problems during labor which may necessitate a C-section include:

• Labor not progressing
• Fetus switching position during labor
• Distressed infant
• Blockage of the cervical opening by the placenta
• Prolapsed umbilical cord

Mothers should expect about a six-week recovery period following a C-section, including an initial hospital stay of two to three days. While in the hospital, mothers may spend time with their baby and begin breastfeeding. After returning home, mothers should limit strenuous activities such as lifting, reaching, and exercise, and should make sure to get plenty of rest.

If surgery is necessary, hysteroscopy is often used along with laparoscopy, a kind of surgery performed through small incisions in the abdomen. Tiny tools are passed through the incisions, and the hysteroscope guides the doctors while surgery is performed.

Treatments vary based on the severity of the incontinence. Mild to moderate leakage may be controlled by doing pelvic floor exercises, avoiding foods that can irritate the bladder, or taking medication. For severe incontinence, however, surgery may be necessary. The most common procedures for stress urinary incontinence are bladder suspension, artificial urinary sphincter surgery, and sling surgery.

Each of these procedures takes about an hour to an hour and a half. Patients will likely wake up with a catheter, a tube that drains urine, as swelling after surgery makes it difficult to urinate. Taking slow, short walks to keep the blood flow moving is usually encouraged within hours of the surgery. Although patients may return to work within seven to ten days after certain procedures, strenuous activities such as running and working out are not recommended for at least four to six weeks. In addition, patients should avoid lifting objects over 15 pounds for three months after any of these operations.