You are about to give birth by cesarean section, the date is approaching, and you feel worried. Questions about this particular surgical procedure arise. You should know that the procedure for a scheduled cesarean section is generally identical from one patient to the next and is perfectly mastered by the medical profession.
This operation is scheduled in advance, if it is a choice made by the mother or the doctor. It can also be decided in emergency when the delivery is complicated.
When scheduled, the steps of the cesarean section are always the same, except in the case of complications.
Before the cesarean section
The cesarean section is a surgical operation that takes place in the operating room and lasts about an hour. The gynecological surgeon, the nurse anesthetist, two nurses, the midwife and the operating assistant are in charge of the operation.
The mother is transferred from her room to the operating room via the entrance lock. Checks are made on the data in the file: name, possible allergies, type of anesthesia, etc. The father or the accompanying person are invited to go to the changing room to change and put on a gown, which is required to attend the operation.
Once the mother-to-be is on the operating table, the monitoring equipment is set up: blood pressure monitor and scope to measure all vital parameters during the operation. The epidural is administered by the anesthesiologist, before the mother is laid on the table. The belly is coated with an antiseptic, and then the sterile operating field is placed to protect the operating area.
The father or the person accompanying him can attend the caesarean section, if he wishes. He is allowed to enter when the operation begins, and is seated next to the mother.
During the cesarean section
When the operation begins, the gynecological surgeon makes a horizontal incision several centimeters above the pubic bone. He or she opens several layers of tissue before accessing the uterus.
The obstetrician proceeds to the exit of the baby, once the water bag is opened. The obstetrician extracts the newborn from the mother’s womb, clamps the umbilical cord twice to avoid the risk of hemorrhage, and then cuts the cord between the two clamps to detach the baby from the mother. This act can be entrusted to the father, or to the accompanying person, according to his desire.
After the cesarean section
The newborn is then handed over to the midwife who proceeds with the first usual examinations on a dedicated and heated table: evaluation of the apgar score, guthrie test, measurement of the cranial perimeter, weighing, measurement of the baby’s size, presence and constitution of the fontanelles, taking the temperature, placing the bonnet, palpation of the external genitalia, walking test, and evaluation of the motor functions… If necessary, she performs an airway obstruction, using a small suction probe.
These examinations last a few minutes and the baby is brought directly back to the mother in order to be put, as quickly as possible, in skin-to-skin contact to regulate his temperature and to be able to start breastfeeding as soon as possible if the mother wishes.
During the midwife’s examination of the baby, the obstetrician gynecologist performs the “delivery”: the removal of the placenta, as well as the uterine revision to ensure that the placenta has not been fragmented. The surgeon also visually examines the placenta to make sure it is complete.
Once this examination is complete, the gynecologic surgeon sutures the internal tissues with absorbable tissue and then sutures the external skin.
Post-operative monitoring
Monitoring of the baby and the mother is done during the two hours that follow, in the birth room. Monitoring in the recovery room can be done if the condition of the mother or the baby does not contraindicate it.
The transfer to the initial room is then carried out, when the medical body agrees. The mother, the child and the father or the accompanying person can thus find themselves in a calm environment and enjoy the first moments of this new life.
