Caesarean Section: When Is It Needed?

What Is a Caesarean Section?

A Caesarean section, or C-section in short, is a type of surgery where a baby is delivered through incisions (cuts) made in the mother’s abdomen and uterus.

Typically, the incision is made horizontally on the lower part of the abdomen. A Caesarean section is a significant surgical procedure with associated risks. Therefore, it is typically performed only when deemed the safest choice for you and your baby.

According to the data from the Malaysian National Obstetrics Registry, about 1 in 5 deliveries in Malaysia are caesarean deliveries.

When Is a Caesarean Section Needed?

A Caesarean section might be advised either as a scheduled (elective) procedure or performed urgently if a vaginal delivery is too risky. Scheduled Caesareans are typically scheduled starting from the 39th week of pregnancy.

This procedure might be necessary for several reasons:

• Your baby is in a breech (feet first) position, and the doctor has been unable to turn him into a head-down position.
• Your pelvis is too tiny to deliver a normal-sized baby, or your baby’s head or body is too big to pass safely through your pelvis.
• Your placenta is attached too low in the uterus (placenta praevia).
• You are expecting multiples (two or more babies).
• You have pregnancy-related high blood pressure (pre-eclampsia) or a heart disease.
• You have an infection (e.g. a first genital herpes infection or untreated human immunodeficiency virus [HIV] infection).
• Your baby is not getting enough oxygen and nutrients.
• Your labour is not progressing.
• There is excessive vaginal bleeding.

What Is the Difference Between a Normal Birth vs a Caesarean Section?

The differences between a normal birth and a C-section include:

• Procedure: In a C-section, the baby will be delivered through incisions in the mother’s abdomen and uterus, while in a normal birth, the baby will be born vaginally (through the birth canal). 
• Risks: Risks in normal birth include tearing, episiotomy, and prolonged labour, whereas risks in a C-section include infection, bleeding, blood clots, pelvic organ injuries and longer recovery time for the mother.
• Recovery: Recovering from a C-section takes more time than a normal birth.

How Is a Caesarean Section Performed?

Most C-sections are performed under spinal or epidural anaesthesia, which means that you will be awake during the procedure but will not feel the pain as the lower part of your body is numbed. Occasionally, a C-section is carried out under general anaesthetic (where you will be asleep).

During a C-section:

• A screen is placed across the body during the surgery so that you cannot see what is being done. The doctors and nurses would keep you informed.
• An incision of about 10 to 20 cm long will be made transversely across the lower abdomen and uterus to deliver the baby through the incision. Yet, a vertical cut may be necessary for situations where the baby is in a breech or sideways position if the placenta is positioned low at the front of the uterus, or if there are other abnormalities present in the uterus.
• The womb and the various layers of the abdomen are carefully stitched up once the baby is delivered.
• Once the mother and baby are in stable condition, she and her partner may have the opportunity to hold the baby.

How Long Does a C-Section Surgery Take?

The whole surgery takes around 40-50 minutes if there are no complications.

What Should I Expect Before a C-section?

Upon admission to the hospital for a scheduled Caesarean birth, a woman may receive an oral antacid to decrease stomach acidity and another medication to minimise secretions in the mouth and nose.

An intravenous (IV) line will be inserted into the hand or arm, through which an electrolyte solution will be administered.

Additionally, an antibiotic will be administered via the IV to reduce the risk of postoperative infection.

Monitors will be utilised to monitor blood pressure, foetal heart rate, and maternal blood oxygen levels throughout the procedure.

Can I Have a Natural Birth After a C-Section?

Yes, you can. If you match the following characteristics, your chances of having a natural birth after a C-section are greatly increased:

• Your doctor made a low transverse cut.
• Your pelvis is not too narrow to deliver a normal-sized baby.
• You are not expecting multiples.

Although a normal delivery is usually preferred, under certain circumstances, a C-section can be life-saving for you or your baby. Talk to your doctor if you have any concerns about the procedure.

Make an Appointment at Pantai Hospitals

A dedicated and expert team of obstetricians and gynaecologists at Pantai Hospital is available for consultation to provide the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions regarding your reproductive health.

Please contact the Health Screening Centre at your nearest Pantai Hospital for health screening appointments.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.