This leaflet gives you information about having an unplanned or emergency caesarean birth, sometimes known as an EM LSCS or C-section. An unplanned or emergency caesarean birth is a surgical procedure performed to deliver a baby quickly when there are immediate concerns for the health of the mother or their baby.
飦� If you are reading this leaflet before the birth of your baby and have any questions please do contact your named midwife.
飦� If you are reading this following the birth of your baby and you have questions a bout the care events during your labour or the birth, please do ask the midwives caring for you on the ward for a debrief, or you can self-refer to the Birth Reflection service on the 麻豆国产 Maternity website (at a time that is convenient to you).
Why did I have an unplanned / Emergency caesarean听
An emergency caesarean birth is performed when a vaginal delivery poses a risk to the mother or baby, requiring rapid surgical intervention. The goal is to birth the baby as quickly as possible.
Categories of emergency caesarean birth听
The different reasons why you may need or be advised to have an emergency caesarean birth will determine the urgency by which the procedure needs to take place, this is given a category:
Reason for an unplanned caesarean birth听
Being booked for an elective caesarean birth and your waters breaking and/or going into early labour
What are the risks and benefits associated with an emergency caesarean birth?听
A caesarean birth is a safe procedure, but like any type of surgery it does carry a risk of complications.
Your doctor or midwife will discuss with the potential risks and benefits of the procedure.
Risks to you:
Some of the main risks to you of having a caesarean include:
Risks to your baby:
A caesarean can sometimes cause the following problems in babies:
What are my Choices?听
It is essential that you understand the procedure and why the doctor has recommended this as the safest way to birth your baby.
The potential risks will be discussed with you at the time, and you may be asked to sign a consent form, however, if an immediate (Category 1) LSCS is required then your verbal consent is all that is needed. As your birth partner or next of kin is unable to make that decision or give consent on your behalf, it is a good idea to consider your feelings around having an unplanned caesarean birth prior to going into labour.
The following questions may help you decide what is right for you and your baby; these can be discussed with your midwife or doctor during labour:
Going to theatre听
When it is time for your caesarean birth the midwife caring for you will accompany you to theatre and support you throughout. Your birth partner will be invited to attend theatre with you. However, your partner maybe asked to leave the theatre should you require a General Anaesthetic (GA), where you are put to sleep.
Depending on the urgency or Category of caesarean, the transfer to theatre could happen in a hurry, once the decision has been made.
You may find an increased number of staff in attendance. Please be assured that this is normal, as additional staff are required to ensure your safety during the transfer to theatre.
Anaesthesia for your unplanned emergency caesarean birth.
Most women undergo a spinal anaesthetic block or if they have a good working epidural a top up maybe all that is required. In some situation where the birth of your baby is required immediately, you may be offered a General Anaesthetic. This will be performed in theatre, and the Anaesthetist will discuss this with you.
You will have a cannula (a thin plastic tube) inserted, if this hasn鈥檛 already happened. usually into your hand or forearm, this allows the anaesthetist to give you fluids, antibiotics, drugs to help the uterus contract and possibly drugs to correct low blood pressure - if required.
Urinary catheter
Whilst your anaesthetic is working you will not be able to walk to the toilet or be aware of the sensation of needing to
pass urine. Due to this you will need to have a catheter inserted to empty your bladder. This will be inserted in theatre by the midwife once you are comfortable and usually stays in for 12 hours post-surgery or until you are mobile.
The birth of your baby
When the anaesthetic is working, your tummy will be cleaned with antiseptic and then a sterile drape placed over
it, this drape will be brought up to create a screen so that you cannot see the operation being performed. Your birthing partner will be seated with you for the surgery. If you require a GA, they will be asked to wait for you in the labour room or recovery area . In this event the staff will keep your partner informed of the events in theatre.
The obstetrician will then begin the surgery.
After the operation听
At the end of surgery your partner will be taken to the recovery room alongside the theatre whilst you are transferred onto a bed and made comfortable. Your baby can then be placed back in skin-to-skin contact.
If possible, we advise at least one hour of uninterrupted skin-to-skin contact with your baby. Once you and your baby are ready, we will ask to perform an initial newborn check and weigh your baby. You will be asked for your consent to give your baby vitamin K (Konakion) this can be given by an injection or oral drops. The Department of Health recommends that all babies should be given a vitamin K supplement (Konakion). This is because babies have very little stores of vitamin K at birth, and vitamin K deficiency can cause bleeding in babies in the first few months of life. After a period of monitoring in the recovery room, you will be transferred back to the Labour Ward.
You will be cared for and observed on the Labour Ward for 6 to 12 hours dependant on clinical need before being transferred to Beatrice Ward (Postnatal Ward). During this time your blood pressure, pulse, temperature, blood loss and wound will be monitored regularly. We will ask you about your pain levels and you will be offered regular analgesia. You will be supported with the care of your baby and to establish feeding your baby. Birthing partners are welcome to stay overnight on the Ward, in a reclining chair, to support you.
Eating and drinking
You can eat and drink when you feel hungry or thirsty.
We encourage you to try chewing gum 2-3 times a day as this has been shown to speed up the return of normal bowel function after an abdominal operation.
Pain control
The spinal anaesthetic will contain a long-acting painkiller which continues to work after the numbness of the spinal has worn off. This is usually 4 to 6 hours after the spinal anaesthetic. If appropriate you will also have been offered a pain-relieving suppository (Diclofenac) into your back passage (rectum) immediately after your caesarean in theatre. You will have regular pain relief prescribed, the midwives will ask you about your pain levels and can give additional pain relief if the regular medication is not enough. You may request pain relief at any time and a midwife will be happy to advise you. All the pain relief you are offered will be safe to take if you are breastfeeding.
Blood clots (deep vein thrombosis and pulmonary embolism
Depending on your medical history and risk assessment you may be prescribed a regular blood thinning injection (daltaparin) to prevent blood clots in the legs and lungs. If this is required, it will continue for a minimum of 10 days, and you will be taught how to give yourself the medication by the midwives. The most common cause of a deep vein thrombosis is immobility, for example not moving around enough after surgery. It is therefore important that when you can move around, you do so. It is also a good idea to keep well hydrated. During your postnatal checks the midwives will ask you about any symptoms of blood clots.
Scars and Stitches
In most cases the caesarean birth scar will run horizontally across your lower abdomen just along the line of your pubic hair.
Usually, a single stitch is used which will dissolve, or a thin non dissolvable stitch which would need to be removed on the 5th day post-surgery. The surgeon will discuss this with you. The wound dressing is usually removed 24 hours after surgery. It is a good idea to wear loose comfortable clothing and keep the wound clean and dry to help prevent infection.
Getting out of bed and mobilising
You will be encouraged and helped to get up out of bed as soon as you are able to. You will need to wait until the spinal anaesthetic has worn off and the sensation to your legs and bottom feels back to normal, this will take a few hours to wear off completely. You should only get out of bed for the first time when a midwife or care assistant is with you, to support you in case your legs are still weak. Early mobilisation is important in aiding a swift recovery and also helps to reduce postoperative complications such as blood clots in the legs and pressure injuries. You are therefore encouraged to walk around the ward and sit in the chair 鈥� you can do this with your catheter still in.
Your Catheter
Your urinary catheter usually stays in for 12 hours, so that you can get up and go to the toilet when it is removed. Once your catheter is removed, you will be encouraged to drink plenty of fluids. When you pass urine you will be asked if you had normal sensation (feeling) at the time. You will also be asked to measure the amount of urine you pass. This will allow your midwife to assess your bladder function.
Blood loss after birth
As with a vaginal birth you can expect to have some vaginal bleeding following the operation. This bleeding can continue for 2 to 6 weeks and should get lighter each day. The midwife will monitor this. Please ask your midwife if you have any questions or concerns. Caring for your baby While you are in hospital, staff will be on hand to provide any advice and support you may need with infant feeding and caring for your baby. You are encouraged to ask for help lifting your baby in and out of the cot initially. The hospital operates a rooming in policy, which means your baby always remains with you, unless concerns about their wellbeing require their admission to the neonatal unit. If this is the case you and your partner will be able spend time with your baby there. Partners are also able to stay overnight on the ward in a reclining chair to help support you.
After your hospital stay听
Going home and length of stay. The length of your hospital stay depends on how quickly you recover from your operation. With good pain control and mobilisation (getting up out of bed and
moving) you may only need one night in hospital. You may require a review by an obstetrician before your discharge home. The midwife caring for you will also assess your readiness for discharge with a postnatal check for yourself and your baby. The midwife caring for you will complete your personalised postnatal care plan and prepare you for discharge. Your baby will require a paediatric check which should take place within 72 hours of birth.
Postnatal exercises
Your abdominal and pelvic floor muscles will take time to recover after pregnancy and a caesarean birth. Postnatal exercises should be started gradually and when you feel able to. These exercises can help to aid your recovery and help to avoid future health problems. Your midwife will discuss postnatal exercises with you and can answer any questions. You will be provided with a leaflet on how to do the exercises prior to discharge.
Your recovery continues at home
Gentle exercise can be resumed when your wound is healed, and you feel ready. Avoid strenuous activities, high impact exercise such as aerobics until after your 6 weeks postnatal check with your GP. Ask for help with strenuous housework such as hoovering. You should avoid driving for 6 weeks. It may be useful to check with your insurance company before driving again if you are taking strong painkillers.
Sexual intercourse can be resumed when you feel ready.
Postnatal checks
When you are discharged home from hospital your community midwife will take over your care and visit you at home or arrange for you to be seen in clinic.
Maternity telephone triage can be contacted if you have any questions or concerns.
Please book a postnatal appointment with your GP at 6 weeks.
Future pregnancies
Your doctor will advise you about future pregnancies and delivery mode. It is advisable to leave a 12-month gap between pregnancies. This enables your body to recover from your caesarean birth and reduces your risks of complications. Although having one caesarean birth increases the likelihood of you having subsequent caesarean births, most women who have had a previous caesarean birth are able to give birth vaginally in subsequent pregnancies, referred to as VBAC (vaginal birth after caesarean).
Further Information听
Visiting times
One birthing partner is welcome to always stay with you on the ward. All other visitors 8am to 8pm Maximum of 3 visitors at a time including a partner.
Birth reflection Service
Every birth is a unique experience, and very personal to each person. What feels normal to one woman may not feel normal or indeed right to another. Talking things through after the birth may help you to understand the events that took place during your care more clearly and provide you with an opportunity to ask questions about your birth experience.
The Birth Reflections Service is a confidential Midwifery lead service, where the focus is on listening to you, understanding what is important to you and what you would like more information about.
To self-refer to the Birth reflection service, please visit our website: Birth Reflections Service.
听
Our staff at 麻豆国产 District Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of NHS Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
