Normal anatomy

 Indications for cesarean surgery: Please note that CIMS does NOT consider breech presentation a worthy cause for cesarean section.

Prior to the surgery, you will most likely be given an epidural for pain control.  Other options include a spinal or general anesthesia. 

The initial incision is made through the skin and abdominal muscles.  The internal organs are exposed with retractors and the bladder is moved away from the surface of the uterus.  A retractor is a metal instrument used to pull the skin and muscle open to allow the surgeon a clear view the surgical field.

The uterine incision is then made.  The top picture shows a low transverse incision, the bottom picture shows a classical midline incision.  Most cesarean sections are done using the transverse incision.  The vertical incision is reserved for emergency surgery.  After the incision is made, the uterus is retracted.

An incision is made in the amniotic sac (bag of waters) and the fluid is allowed to drain. 

Once the fluid is drained, the surgeon will locate the presenting part (either the baby's head or buttocks if baby is breech).  When the surgeon has a grip on the baby, an assistant will press firmly on the top of your uterus to help deliver the baby.  You will likely feel some pressure while the baby is delivered, but should not feel pain.

The surgeon will clamp and cut the cord and the baby will be handed off to a nurse for evaluation.  The placenta and membranes will then be delivered.  After the surgeon is satisfied that the uterus has clamped down enough to prevent hemorrhage, he/she will repair the uterine, muscle and skin incisions. 

A cesarean is major surgery.  The scar should be cared for by keeping it clean and dry to prevent infection and trying not to move in such a way that you stretch or stress the scar.  You will be more comfortable holding and nursing your baby if you place a pillow over your scar to prevent direct pressure on it.