C-sections and blood

by kristyann 16 Replies latest watchtower medical

• 

  lonelysheep

  Can I ask why it is a requirement that, once you have a c-section with your first child, why do you have to deliver the rest as c-sections as well?

  Most times, it is an option. There may be reasons why it is required for some on an individual basis.

  With my second child, I had the option on how to deliver. I chose c-section (no pain and very, very easy recovery this time).

  lso...I know that there is supposed to be a limit on how many c-sections you can have... but my bf's mom claims to have had all FOUR of her kids by c-section. I heard that this is VERY dangerous to have so many children delivered via c-section. Anyone know why?

  I've heard of 4 being the maximum. Unfortuantely, I don't know the reasonings behind it.

  The uterus is still being sliced open afterall.
• 

  Scully

  Does one "require" a blood transfusion to have a cesarean birth? No.

  Is it sometimes necessary to have a blood transfusion following a cesarean birth? Yes, sometimes; and it is sometimes also necessary to have a blood transfusion following a vaginal birth too.

  In fact, the greatest risk for haemorrhage is not actually during the birth, but in the first 24 hours following the birth. Postpartum haemorrhage (PPH) is defined as a blood loss of >500 mL immediately after the birth, or an excessive flow of lochia resulting in the saturation of a large pad in less than 1 hour. PPH is more common following a vaginal delivery, as there is a greater risk of having retained products with a vaginal birth. Typically during a cesarean, the surgeon cleans out the remnants of the placenta from the uterus before beginning to close the incisions.

  In the several years that I have worked in the field, I have seen many incidents of postpartum haemorrhage, and only one of them was with a post-op cesarean patient who had no other risk factors.

  Having said that, there are conditions that might predispose a person to an increased risk of bleeding prenatally, during delivery and in the postpartum period. For example, in the event that the placenta is implanted over the cervix (placenta previa) it is possible to have prenatal bleeding - this needs to be monitored closely, and the woman usually ends up in hospital on bed-rest. Also, in the event of the placenta separating from the uterus prematurely (abruptio placenta) extreme blood loss is a very real possibility, and usually an emergency cesarean is needed to (1) save the baby's life, and (2) save the mother's life. High blood pressure during pregnancy (pregnancy induced hypertension / PIH) can result in a condition called HELLP syndrome that is also life threatening and can cause massive bleeding and a condition called disseminated intravascular coagulation (DIC) which requires massive amounts of blood (I know of cases where women have had to receive over 30 units of blood and stayed in ICU for weeks) in order to save their lives.

  Blood loss can also be excessive when the baby is quite large. The uterus can become so stretched that it cannot contract effectively after the delivery (uterine atony) and thus cannot successfully control the bleeding. This usually is noticed shortly after the birth, and is managed with IV fluids and oxytocin, sometimes ergotamine, and sometimes Hemabate.

  I don't want to scare you with too much information, but in reality, if you are healthy there is a very low risk of needing a blood transfusion if you have a cesarean birth.
• 

  troubled mind

  The old rule was only three c-sections because the uterine wall is weakened and chance of rupture is hightened .I think with the new type of incision they no longer believe that way. I know of women that have had their first child c-section and then go on to have natural births later , not something my Doctor would let me attempt because of higher risk being a witness.
• 

  sf

  Yea, I knew I was working with 'old light'. Thanks for the updates ladies!

  All I know is that after the second one, I told the doc to "go ahead and tie me up while you are in there! I'm done!"

  sKally
• 

  Scully

  Can I ask why it is a requirement that, once you have a c-section with your first child, why do you have to deliver the rest as c-sections as well?
  

  Also...I know that there is supposed to be a limit on how many c-sections you can have... but my bf's mom claims to have had all FOUR of her kids by c-section. I heard that this is VERY dangerous to have so many children delivered via c-section. Anyone know why?

  
  

  
  It is not a requirement that "once you have a c-section, always a c-section". Many obstetricians will offer a patient the option to do a trial of labour with the next delivery, with the understanding that if labour doesn't progress, they will go to the OR. A successful vaginal birth after cesarean is referred to as a VBAC.

  Every time a cesarean is performed, the uterus is cut open, some scar tissue is removed (for the second and subsequent deliveries) and is re-sutured. Think of the uterus as a balloon. Any scar tissue would be like a weak spot on the balloon. During the pregnancy it stretches and stretches and stretches. The weak spot gets stressed. During labor the uterus gets squeezed by contractions and stresses the weak spots of the uterus even more. What would be expected in the case of a balloon during these circumstances? The weak spot is at increased risk of breaking; and likewise the uterus is at risk of rupturing. This can also result in massive haemorrhage and death of both the mother and baby.
• 

  sf

  Incidently, my firstborn was breach. It was why, I was told, they had to do a c-section.

  With my daughter, I was told it was best to have a second c-section because vaginal birth might rip my scar open from twelve years earlier and that, due to how I would have to be postioned, I might strangle the baby. {I'm not comfortable going into any more details than this}

  sKally
• 

  dinah

  Both of my children were c-sections. With my second child, my doctor told me I was welcomed to try a normal delivery but he wouldn't recommend it. Recovery time with the second was must faster because I never went into labor with him.

  Three of my cousins, and four friends all had c-sections also. None of them experienced any complications, or required blood. Surgery is always a risk. As far the the WT stand on c-sections, I've never heard them say anything negative--just that you would have to die if things got complicated and you needed blood.