According to the United Nations Children’s Fund (UNICEF), Brazil is the 2nd country that most performed cesarean sections in the world. This type of operation represents 57% of births in the country, when the recommended by the World Health Organization (WHO) is 15%.
In the public network (SUS), this type of surgery represents 40% of deliveries and, in the private network, the rate reaches 84%.
The five Brazilian states that do the most cesarean sections are:
- Goiás (68%);
- Espírito Santo (67%);
- Rondônia (66%);
- Paraná (63%);
- Rio Grande do Sul (63%).
The Ministry of Health recognizes that there are cases in which cesarean delivery will be the only chance to save the life of the woman and the child. But in general, normal delivery is the healthiest and safest for the mother and baby.
What is cesarean delivery?
Cesarean delivery is a procedure that consists of making a cut on the belly to remove the baby.
Today, surgery can be done if there are emergency situations or if a pregnant woman requests the procedure.
However, the option may pose risks to the mother and baby such as infections and bleeding.
How is cesarean delivery?
Caesarean section, like all surgery, has a preparation, duration and recovery stage. Learn more about each of them:
It is always important to remember that cesarean section is a surgery and therefore needs small preparations.
For example, to avoid seasickness and vomiting during the process, the pregnant woman should be fasting for 8 hours of solid food and 4 hours of fasting for liquid food, including water.
Another preparation is to talk to the doctor about all doubts and the type of anesthesia, for example.
Upon arriving at the operating room, the woman receives anesthesia which, in normal cases, is applied to the lower back. The sting is not painful, but it can cause some discomfort.
The reaction time varies between 2 and 10 minutes depending on the type of anesthesia. The duration of the drug lasts for 3 hours, on average.
As soon as the anesthetic effect begins, the pregnant woman is positioned and the medical team begins to prepare for delivery.
A cut of approximately 10 cm is made in the pelvis region (below the navel and above the groin), which breaks 8 layers of skin, fat and muscle.
Thus, the obstetrician has access to the baby, which is pulled out by the same cut.
Once outside, the umbilical cord is cut and the baby is evaluated by doctors, who check oxygenation and other vital functions.
Meanwhile, another member of the medical team takes care of cleaning the mother’s belly, removes the placenta and begins to stitch each layer that has been cut with stitches.
This whole procedure, if it happens as expected, takes around 1 hour.
Those who have never had or seen a cesarean section may not know that the woman, even though she is anesthetized, will not be sleeping during the surgery. On the contrary, if she wishes, the medical team can position her to see the baby’s withdrawal.
It is normal that after surgery, the woman will have mild pain in her belly, feel sleepy or have difficulty moving or walking.
Swelling, nausea, dizziness or a feeling of weakness are also common and can be side effects of anesthesia.
The pains and these other symptoms should take about 5 to 7 days to ease or cease.
It is recommended that the woman rest between 6 and 12 hours resting after delivery. You will also need to stay at least 48 hours in hospital before being discharged. This time may be longer if there were any complications during or after delivery.
Upon discharge, the pregnant woman is already informed about the care and when she should return to remove the stitches.
Does Caesarean section hurt?
If the anesthesia is applied correctly, the caesarean section does not hurt. During birth, a woman may experience pressure and movement.
But, as this procedure is considered invasive and requires healing, the woman may need painkillers during the postoperative period.
How long does it take for a cesarean to heal?
The healing time of cesarean section can be variable depending on some factors such as the woman’s age and whether there were complications during childbirth. In general, the stitches are removed between 8 and 15 days after surgery. In more severe cases, healing can take up to 12 weeks.
The woman tends to gradually return to the normal routine.
However, if there is severe pain, pus or bleeding in the area of the surgery, she must reduce the activities preventing the stitches from bursting and the formation of hernias.
Some care can facilitate the healing process and ensure more quality of life during this phase:
Rest is essential for recovery. Until the stitches are removed, the woman is advised to avoid making physical efforts such as cleaning the house, driving or going up and down stairs frequently.
Thus, the help of other people (such as family members or caregivers) is welcome, especially in the early days.
Very carefully, during the bath, the points should be cleaned with running water and soap. While having the stitches, avoid rubbing or using creams and ointments in the cut area.
Keeping the place dry after cleaning can help prevent the proliferation of fungi and bacteria.
Eating healthily is important at all stages of life. But, in the post-operative period of childbirth, the woman must have some special care with the diet:
- First, it is important to follow medical recommendations;
- The diet should contain foods that help with healing and stimulate the regeneration of cells and tissues (for example, egg, boiled fish, red and purple fruits, leafy fruits);
- Avoiding caffeine, sugars and fats is also essential. Remember that the woman is breastfeeding and these foods should be eaten sparingly;
- If you do not have medical recommendations, do not diet to lose weight while the baby is breastfeeding. This can decrease breast milk production.
Some types of fabric (viscose, rayon, polyamide, for example) when placed in direct contact with the skin can generate friction.
This can cause discomfort and even inflammation in the most severe cases.
Therefore, the most recommended is to wear comfortable clothes (cotton or linen) and that do not pinch or hurt the stitches.
Ideally, the woman should have a period of childbirth protection. That is, one must wait at least 1 month after birth to have sex.
This necessary time may be even longer if there were any complications during birth or if the delivery was normal, since the vaginal canal will still be recovering from dilations.
What are the risks of a cesarean delivery?
In more severe cases, cesarean sections can cause infections, bleeding, gluing of the placenta in the uterus and difficulties in getting pregnant again. Although it is in rare situations, there is also a risk that anesthesia will not be well received by the mother’s body and cause failure of one or more organs or systems.
This type of delivery can also hinder the bond between the mother, the baby and breastfeeding. This is because the mother’s body interprets this operation as abnormal, that is, a “withdrawal” of the baby that he had kept until then.
There is also the possibility that women may develop complications and diseases that they did not have before, such as endometriosis or infertility.
Complications for the baby
Another complication that cesarean section can cause is that the baby is removed before its complete development. Calm down, let’s explain:
Counting months and weeks of gestation is only an estimate. It is also worth mentioning that, the baby is, on average, two weeks younger than estimated. For example, a 40-week-old baby actually has 38 weeks of development.
This is because the pregnancy starts counting from the last menstruation. But fertilization usually only happens after 15 days (during the fertile period ).
Thus, if the estimate is wrong and surgery is performed, a 38-week-old baby (36 years old) may end up being removed.
In this case, the small child, as he is still developing for 36 weeks, is considered premature and may have future complications (hypo or hyperglycemia , eating disorders or temperature instabilities, for example).
To avoid this situation, the Federal Council of Medicine (CFM) forbade voluntary cesarean sections before the 39th week of pregnancy (37th fetal development).
When is cesarean section indicated?
As stated earlier, this procedure can be recommended in some situations:
- When pregnancy poses a risk of death for the mother or the baby;
- When there is fetal distress, that is, when the baby is not receiving enough oxygen (diagnosed by ultrasound);
- If there is a rupture of the placenta;
- If the baby is very large (over 4.5 kg);
- If there is anything that prevents birth through the vaginal canal;
- Presence of diseases and infections that can pass to the baby (such as AIDS);
- If the mother loses consciousness or has another complication during normal labor.
Cesarean section is a procedure that can save the life of the mother and the baby. But it should only be done in cases of emergency or when normal delivery is not possible.
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