Risks During Cesarean Section Surgery
- Injury to the Uterus: The uterus can be damaged during surgery, whether it is due to the surgical procedure or a complication that occurs during the delivery. This type of injury is not common, and many types of uterine injuries can be repaired during the cesarean procedure.
- Injury to the Baby: The most common type of injury to a fetus is a small nick caused by the scalpel used to make the cesarean incision. In the vast majority of cases, the cut is small enough to heal on its own and does no lasting damage.
- Injury to the Urinary Tract: Accidental surgical damage to the urinary tract, which consists of the kidneys, bladder, ureters and urethra, is rare. Typically, this occurs when an accidental nick happens during a surgical delivery.
- Hysterectomy: If bleeding cannot be controlled, or another life-threatening problem occurs, a hysterectomy may be the treatment of choice to save the life of the mother after delivery. The need for a hysterectomy after a surgical delivery is rare.
Risks After Cesarean Section Surgery
- Infection: The risk of infection is present after all surgeries, including a cesarean delivery. Good hand washing practices and proper incision care can help prevent an infection after surgery.
- Blood Clot: A blood clot is a risk of most surgeries, due to the lack of mobility during anesthesia and after surgery. This risk is increased by pregnancy, as the body makes blood clot more easily during pregnancy to prevent hemorrhage during labor. Walking as soon as it is safe can reduce the risk of blood clots.
- Bleeding: Some bleeding is expected during and after the delivery; however, the risk of bleeding is increased by a cesarean delivery when compared to a vaginal delivery.
- Longer Recovery: The recovery time from a cesarean delivery is increased when compared to a vaginal delivery. A typical recovery lasts 4-6 weeks and typically includes instructions not to lift anything heavier than a newborn during those weeks, which can be challenging.
- Pain: It is normal to have pain at the site of the cesarean incision during the recovery period. The pain is most severe in the first few days following surgery and gradually decreases over the following weeks. Adhering to lifting restrictions can help prevent pain, as can bracing the incision during activity that uses abdominal muscles.
Risks During Future PregnanciesVaginal Birth After Cesarean (VBAC) is possible and often successful; however, each pregnancy is unique, just as each mother is unique. The discussion of how a future birth should be handled is one that only your physician can answer, as your health and medical history will play a role in the type of delivery that is selected.
The reasons that made a c-section necessary the first time may or may not be present with a future birth. For example, if the baby was delivered through the abdomen because it was tolerating labor poorly, your next child may tolerate labor without difficulty. If a cesarean was necessary due to the large size of the fetus, your next child may be smaller in size. In contrast, if a cesarean was necessary because of a previous uterine surgery that made a vaginal delivery too risky, a c-section would likely be performed again. The main concerns with VBAC include:
- Placental Previa:The risk of placental previa, a condition where the placenta covers all or a portion of the birth canal, is increased after a cesarean section. placenta accreta--This condition, where the placenta grows into the muscle of the uterus, makes it difficult for the placenta to separate from the uterine wall. This can lead to increased bleeding and, in rare cases, hemorrhage.
- Uterine Rupture: While the risk of uterine rupture is small, the consequences are very serious and can be life threatening for the mother and fetus. The uterus, the organ that contains the fetus during pregnancy, develops a tear causing severe bleeding. Most commonly, the tear develops on the incision line of a previous c-section, making a previous cesarean the greatest risk factor for uterine rupture.
- Hemorrhage: Severe or uncontrolled bleeding can be caused during the delivery by a number of causes. Severe bleeding, while not common, is more likely to happen in women who have had a previous cesarean section.
C-section. Medline Plus. Accessed June, 2013. http://www.nlm.nih.gov/medlineplus/ency/article/002911.htm