Dr. Slayton-Milam is a obstetrician/gynecologist for Cascadia Women's Clinic in Vancouver, Washington. Her undergraduate training was a Louisiana Tech University. From there she preceded to Louisiana State University for her medical degree, and conducted her residency at St. Louis University Hospitals. Dr. Slayton-Milam has been practicing for over fifteen years in the pacific northwest.
DR. SUZANNE SLAYTON-MILAM: Hi, my name is Dr. Suzanne Slayton-Milam, I'm with Cascadia Women's Clinic in Vancouver, Washington. Today we're going to discuss cesarean section. Cesarean section is a surgical procedure for delivery of the baby through an abdominal incision when vaginal delivery is not considered optimal or indicated. Some of these indications may include placenta previa, breech presentation or abnormal baby presentation, chord prolapse, fetal distress, abruption of placenta that is detrimental to the fetus, or mother necessitating delivery. Also previous cesarean or classical cesarean sections, severe preeclampsia and trauma may also be indications. These and all indications should be discussed with your physician. Every patient's condition and medical situation needs to be individualized. Depending on the situation the abdomen may be opened with a transverse or vertical incision in the lower aspect of the abdomen. The incision on the abdomen does not necessarily match the incision that is made on the patient's uterus. After the skin incision is made, the incision is carried through other tissue surgically until the uterus is reached. A transverse incision or vertical incision is made on the uterus depending on the medical situation. With a transverse incision, a patient may be allowed to labor in the future if that is in the mother's and baby's best interest. Vertical incisions, also known as classical cesarean sections are not allowed to labor because of the risk of uterine rupture. This can be catastrophic to mother and/or baby. The baby is then delivered and then handed to the supportive staff for evaluation and care. Cord blood is obtained from the placenta, and the placenta is then allowed to deliver. The uterus and the other layers are then repaired in reverse order. The skin is closed either with staples, or sutured depending on the patient habitus, amount of bleeding, and/or surgery preference. A supportive bandage is then applied. A catheter is placed prior to the operative procedure. This is usually placed after spinal or epidural anesthesia for patient comfort. The catheter is usually removed the following day, again depending on the patient's situation. Your physician may also choose to use TED hose or what we call pneumatic stockings which are placed in the legs to help prevent formation of blood clots. These blood clots are called deep venous thrombosis or also known as DVT. If part of the clot becomes dislodged and travels to the lung, this is called the pulmonary embolism and may be life threatening; diagnosis and treatment are essential. If you have an acute or sudden onset of chest pain or shortness of breath, you should call your physician immediately, go to the emergency room, or call 911. To help to also prevent against clots, it is recommended you start walking the day after surgery if approved by your doctor. Being up at least four times out of bed will decrease your risk of clots. It would be up to your physician to decide how many days you will be required to stay in the hospital. Once you are home, it is important to watch for signs and symptoms of infection. You should call your physician for the following: A temperature above 101 degrees Fahrenheit, temperature above 100 on two separate occasions that are 6 hours apart. Also you need to observe your wound closely; redness, warmth, drainage or swelling from the incision site should be reported. Burning in urination, persistent nausea and vomiting should also be told to your physician. It is also recommended not to drive for 10 to 14 days after your c-section. Do not drive if you are still on narcotics because it may alter your judgement. We recommend that you can shower once you are home but do not want you on a hot tub, pool, or bath tub for at least two weeks. Please do not lift greater than 15 pounds before six weeks; this is approximately the weight of the baby in the carrier. If you have stairs in your house, this is fine, just proceed slowly and cautiously and use the handrail. I hope this information has been useful and informative to you. May your cesarean delivery be a joyous occasion and a good experience.
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