Contents
In which cases is a cesarean performed?
Today uone in five women gives birth by cesarean section. This intervention, whether performed urgently or scheduled (in 12% of cases), avoids, at the time of birth, endangering the mother or her baby.
Cesarean section can be performed either emergency, when the health of the mother or the baby is in danger, either because it has been scheduled.
Emergency Cesarean
In some situations, the obstetrician decides to perform an emergency cesarean section.
This is the case when:
• The cervix does not expand enough,
• The baby’s head goes down badly in the basin,
• The monitoring reveals fetal distress and that it is necessary to act quickly,
• The birth is premature. The medical team may decide not to tire the baby, especially if he needs prompt medical assistance,
Depending on the situation, the dad may be asked to leave the delivery room… or not!
The scheduled cesarean
Cesarean section is often scheduled in the following cases:
• In case of’history of cesarean section (in 1% of cases, the scar is resistant to contractions),
• when mom’s pelvis is too narrow for the baby’s volume,
• a presentation of the baby unfavorable: head tilted back or slightly raised, shoulder, buttocks,
• placenta previa, which increases the mother’s risk of bleeding,
• high blood pressure,
• the mother suffers from an attack of genital herpes which could infect the baby during a vaginal birth,
• stunted growth of the baby,
• a multiple pregnancy (especially for triplets),
• a first pregnancy over 40 years old,
• a cesarean for personal convenience.
In all cases, the decision is taken in consultation with the mother.
How does a cesarean delivery go?
Technically, how does a cesarean go? To get to the baby, the obstetrician will first perform a phorizontal incision of the skin in the pubic area. Then it’s the turn of theenvelope (aponeurosis) surrounding the muscles of the abdomen.
As to muscles themselves, we preserve them. They are simply spread with the fingers to visualize the peritoneum, a thin membrane around the uterus that the obstetrician then cuts. Then it’s the turn of the womb and pocket of waters. Go ! It only took a few minutes from the start of the procedure to the release of the baby.
Cesarean sections on the decline
In recent years, we have performed almost twice as many Caesarean sections than thirty years ago. An excessive figure for the Haute Autorité de Santé, which has decided to carry out an experiment in nearly a third of French maternity hospitals. And it worked ! The upward trend has reversed. Recently published results show that the annual rate of caesarean sections fell 0,3 percentage points to 18,9%. It’s a first !
Can the father be present during the cesarean?
Good news, more and more maternity hospitals are accepting the presence of the dad in the caesarean section when it is programmed. It is also the choice of many future mothers: 77% of them, according to the results of a survey carried out by the Interassociative Collective around Birth (CIANE) in 2014. It is even one of the criteria entering taken into account when choosing maternity, according to the National Institute for Prevention and Health Education (INPES). We are far from the time when the future fathers paced the waiting room, the future mother being alone in the labor room.
From now on, the obstetrical teams are more oriented towards a nursing-patient partnership. and try to put benevolence in the foreground, underlines Dr Beaufils, obstetrician at the Hôpital Femme Mère-Enfant in Lyon. However, no question of improvising! To ensure the safety of care, the obstetric teams set up specific charters, specifying in which cases the father is authorized to be present in the operating room in the event of a cesarean section.
Sébastien’s testimony: “For my second child, I attended the birth by Caesarean section, and I have fond memories of it. “
“In 2008, for the birth of my daughter, I did not attend the cesarean. Initially, it was to be a scheduled cesarean. But when my wife had the last follow-up ultrasound, the doctor noticed that the baby’s heart was not beating normally. So, it was decided to release it earlier than planned. I didn’t want to be in the OR. But the wait without news was very long! Five years later, for the second cesarean, I stayed with the mother and saw my son being born looking over the operating field. There was a relaxed atmosphere in the OR, no stress, a reassuring atmosphere, and I and my mother have fond memories of it. ” Sebastian, dad of Soline and Gaspard