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“Cesarean Section” is a surgical procedure used for delivery by opening an incision on the abdomen and uterus. In some cases, a cesarean section needs to be planned in advance, but there are many cases where it is necessary to perform a cesarean to prevent unexpected complications.
<h2 style="color: #008080;">When is a cesarean section necessary? 
</h2>
A cesarean section is used in cases where natural delivery may not be safe for both mother and baby, such as
<ul>
<li>Previous cesarean section In most cases, if the mother has had a cesarean before, the next pregnancy may also require a cesarean because after the first abdominal surgery, the uterus will have a scar. In the next pregnancy, the original uterus must expand for delivery and contract during labor. Therefore, the scarred area may become tight and could rupture, causing danger to both mother and baby.</li>
<li>Diagnosed health problems that may be dangerous to the mother if natural delivery is attempted, such as heart disease, diabetes, preeclampsia, etc.</li>
<li>Placenta previa occurs when the placenta attaches to the lower part of the uterus or covers the cervix. If placenta previa is present, bed rest may be necessary to monitor symptoms, and when it is time for delivery, a cesarean section may be required depending on the doctor&#8217;s judgment.</li>
<li>Premature placental abruption is a condition where the placenta separates from the uterine lining before term. This usually occurs during the third trimester of pregnancy. This condition can cause bleeding and pain in the uterus and also deprive the baby of oxygen, requiring an emergency cesarean to save the baby&#8217;s life.</li>
<li>Breech or transverse fetal position is an abnormal position for delivery that may cause harm to the baby during labor. Therefore, cesarean section is the most appropriate method.</li>
<li>Disproportion between the baby&#8217;s head and the mother&#8217;s pelvis is usually found when the baby&#8217;s head and body are larger than the mother&#8217;s pelvis, necessitating a cesarean section.</li>
<li>Twin pregnancy In some cases of twin pregnancy, if the babies are not positioned properly for natural delivery or the mother&#8217;s body is not ready for natural birth, cesarean section may be required instead.</li>
</ul>
<h2 style="color: #008080;">Cesarean section procedure: Know this to ease your worries</h2>
<ul>
<li>When the mother is admitted to the hospital, the first step is to stop eating and drinking.</li>
<li>Staff will perform a bowel cleansing and clean the abdominal area, including shaving the pubic hair.</li>
<li>Blood will be drawn to check the mother&#8217;s initial health before delivery.</li>
<li>Intravenous fluids will be given since the mother must fast, which also facilitates medication administration.</li>
<li>Before surgery, doctors usually use spinal anesthesia, which is safe for the baby. The mother will be awake but will not feel pain.</li>
</ul>
<h2 style="color: #008080;">Can general anesthesia be used for cesarean section?</h2>
General anesthesia should only be used in emergencies when there is no time for spinal anesthesia, such as if the mother has an accident or the baby is severely oxygen-deprived and needs immediate delivery. However, this method is not safe for the baby because the baby will receive anesthesia from the mother.
<h2 style="color: #008080;">Post-cesarean care for the mother</h2>
<ul>
<li>After a cesarean section, most mothers and babies need to stay in the hospital for at least 2-3 days to monitor symptoms and control pain from surgery, which may require pain medication through an IV.</li>
<li>After surgery, the mother should try to get up and walk because movement helps reduce constipation, abdominal adhesions from surgery, and dangerous blood clots. While in the hospital, the medical team will monitor the surgical wound for infection, movement, fluid intake, and bladder and bowel function.</li>
<li>The mother can breastfeed as soon as she feels better. It is advisable to consult nurses about comfortable breastfeeding positions for both mother and baby. Doctors will consider medications used in treatment to ensure they do not affect breastfeeding.</li>
<li>Before discharge, the mother should consult the doctor about preventive care needed for both mother and baby, such as vaccines to prevent diseases that may occur in mother and child.</li>
</ul>
&nbsp;
Dr. Tharinee Lamluk 
Specialist in Maternal and Fetal Medicine 
Women’s Health Center, Phyathai 2 Hospital

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Pregnant mothers should know! To prepare yourself before a cesarean section

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