Caesarean Section

Caesarean section, or C-section, is the delivery of baby through a cut in the mother's tummy (abdomen) and womb. The incision may be made horizontally across the lower part of the abdomen above the pubic area (transverse or bikini cut) or, in certain situations, vertically from the navel to the pubic area (vertical cut).

In Singapore C-section is usually done under general anesthesia. Sometimes at the request of patients, it can be done under epidural anesthesia when the woman remains awake during the childbirth. Very rarely, it is done under local anesthesia.

Caesarean sections are usually performed when a quick delivery is needed to ensure the mother's and infant's well-being. Common reasons for performing emergency C-section are:

• Baby is showing signs of distress (fetal distress), such as passing motion (meconium) in the womb or baby's heart rates are irregular or falling on monitoring by electronic device (cardiotocograph)
• Slow and difficult labor (dystocia)
• Mother has hypertension
• Placenta suddenly detached with heavy bleeding

When a known pregnancy problem or risk factor makes vaginal birth unsafe, a caesarean section is planned ahead of time (elective caesarean section). Examples include:

• Baby in an abnormal position (lying horizontally instead of head-down position)
• Placenta that is blocking the cervix (placenta previa)
• Mother has severe high blood pressure (preeclampsia)
• Narrow pelvis and a large fetus (cephalopelvic disproportion)

Risks of Caesarean Section

Caesarean section is considered relatively safe. However, mother who delivers by cesarean has a higher risk of complications and a longer recovery period than with a routine vaginal birth. Such risks in Singapore are minimal and not common. Possible complications include:

• Wound infection
• Womb infection
• Heavy blood loss
• Heart or lung (cardiopulmonary) complications from anesthesia
• Blood clot in the veins of the legs and lungs (thromboembolism)
• Injury to the baby as well as mother such as bowel and bladder injuries
• If the woman becomes pregnant again, she has some risk of the scar tearing open during labor (uterine rupture)