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Course: Health and medicine > Unit 12
Lesson 4: Pregnancy complicationsC-section
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- Honestly the chances of having a natural birth after c-section are quite high and i do believe it should be the one used if there is to be a second child. but it is all dependent on the doctor,mother,and babies safety.
so why do they now push more toward c-section for your second child after a c-section?(7 votes)- Repeat c sections aren't really pushed for a second child after a c-section. Not every woman wants a vaginal birth after a c-section (vbac) and opts for a repeat c-section. There are some situations where a woman wants a vbac, but isn't considered a good candidate for one. After a c-section or uterine surgery (anything that compromises the integrity of the uterine wall), a uterine rupture could occur which requires an emergency c-section. The risk for a rupture is relatively low (for the lowest risk woman), approximately 1 in 200. There are certain risk factors which may increase the risk of a uterine rupture. The reason for the previous c-section could determine whether or not she would be a good candidate (such as if the problem would likely occur again or not - which is discussed between the woman and her provider). Some women don't want to take the risk of having a uterine rupture (or aren't considered a good candidate) and opt for a repeat c section. Others are low risk and try for a vbac. There are many factors that could influence the decision, but c-sections aren't generally pushed for unless medically necessary (or is considered safer for mom and baby) or the mom chooses it. Some physicians refuse to allow vbacs as they'd prefer not to take the risk. Some hospitals don't allow vbacs because they are not equipped to handle a uterine rupture (which seems to be more common in rural hospitals, but not limited to).(3 votes)
- Is it possible for the mother to die from getting a C-section?(7 votes)
- also, the mothers uterus will also have a strain from all the pressure being applied to the spinal cord.(2 votes)
- Why baby 'Born prematurely' they have very little chance of survival why?
For example Isaac Newton he was born prematurely, and had very little chance of survival.(4 votes)- Children born prematurely do not develop the things they should have before leaving the womb which in some ways makes them underdevelop to begin their journey independently outside the womb. Btw, "very little chance of survival" is relative: the chance of survival at less than 23 weeks is close to zero, while at 23 weeks it is 15%, 24 weeks 55% and 25 weeks about 80% (Normal is 40 weeks). So a baby can still be born prematurely in week 35 and statistically have a 95+% (99+%?) chance of surival, which for many instances is high, but considering you are discussing human life, you ideally want 99.99+% or so. PIcking out Newton as a specific example in attempt to refute a sample probability is not good statistics :P(4 votes)
- Do intestines & organs get moved outside the abdominal cavity during a C-section?(3 votes)
- Actually, the uterus is quite large after 9 months gestation and it is 'front and center' having pushed other organs out of the way. So, there is no reason to move other organs around much. In fact, most women can see movement such as kicking when looking at their abdomin late in the pregnancy because the uterus is so anterior.(4 votes)
- How long is a typical C-Section?(2 votes)
- In a non-emergency C-Section can take 10 to 15 minutes, with an additional 45 minutes for the delivery of the placenta and suturing of the incisions.(4 votes)
- does it affect sexual life after c-section?(2 votes)
- Largely the answer is no. (assuming you are talking about after given time to completely heal, etc...)
What can happen (rarely) are some long term complications from the procedure that can cause scar tissue to form and adhere to other organs or structures in the lower abdomen. This can lead to any number of symptoms. In some of these cases sexual activity is impacted. Usually these types of issues occur in women having multiple C-sections, or other surgical procedures or trauma in the lower abdomen.
This should not be confused with endometriosis, which is something else entirely.(1 vote)
- Is a C-section carried out on any other animals apart from human beings?(1 vote)
- Yes, veterinarian s perform c-section s on other animals experiencing dystocia or difficulty in birth. Most commonly in the US, that would include dogs, cats, and cows.(3 votes)
- My mom had me through c-section, but that was because I had Tetrology of Fallot, a cardiac condition. Could this also be a reason for having a c-section?(1 vote)
- Would you do a C - Section if you notice the fetus dont move as much as it should ? Because you would feel fetal movement ? Would you do a ultrasound and if the pratictioner notice the fetus movement is limit you would do a C - Section ?(1 vote)
- Potentially. It depends. Reduced movement should always be checked out as it could indicate something is wrong. Usually when a woman experiences decreased movement a non-stress test is done either in the doctor's office or in labor and delivery. The non-stress test monitors the baby's heart rate. If everything looks good, the woman is typically sent home (and instructed to return if still experiencing reduced movement). If there is concern during the non-stress test, there could be an immediate need for delivery (depending on the severity of the situation) or additional tests may be done to determine if it's safe to keep the baby in or if there's a need to make a plan for delivery. However, I don't believe that it would mean an automatic c-section. It would really depend on what's going on with the baby. If there are signs of distress, a c-section would likely be done.(2 votes)
- could having a rod in your lower back be a big problem in giving birth?(1 vote)
- This can absolutely complicate natural childbirth. During pregnancy and childbirth, the bones and joints in the pelvis and lower back actually shift and move around to create more room for the baby. If the rod is preventing any of this it can cause quite a lot of pain, not to mention damage to yourself or the baby.(1 vote)
Video transcript
- [Voiceover] A c-section,
or a cesarian section, is a type of surgery that's
used to deliver a baby. Basically, the surgery begins with the mom receiving anesthesia, whether that's local anesthesia so she remains awake, or general anesthesia
that puts her to sleep. Then the surgeon makes an
incision on the abdomen. So usually the incision is
horizontal or transverse, so it goes across the abdomen about one to two inches above the pubic hair. And the reason why we tend to prefer that horizontal incision is because it tends to cause less post-operative pain. And the wound from it tends to heal better and it tends to be stronger. And also because it results in
a better cosmetic appearance, since the scar from
the horizontal incision kinda blends in with
the crease at the bottom of the abdomen, so it's not as noticeable. Sometimes though, if the surgeon needs to get in more quickly,
either because the mom is bleeding a lot or because
the baby's in danger, the incision that's made will be vertical, so up and down the
abdomen, kinda like this. Since that's a quicker way of getting in and generally vertical
incisions cause less bleeding. Now, after the incision
is made, the surgeon then makes his way through all
of the layers of the abdomen to access the uterus. He then makes an incision in the uterus to remove the baby. Then the umbilical cord
is clamped and cut, the placenta is removed, and then finally, when everything's done, the uterus and the abdomen are
stitched and stapled closed. And generally speaking, most women, provided that everything goes well, are able to go home in about three days. So, how common is this
and why would a woman need to have a c-section,
rather than a vaginal delivery? Well, one in every three
babies born in the U.S is born through a c-section. And that's not even the
highest rate in the world. The highest rate in the world
is actually seen in China at 46% of all births. So that's quite a bit. Now in terms of who gets a c-section, I guess you can split
things off into two groups. So, there are the women,
the group of women, who have planned c-sections. So, they know from before
they're gonna get a c-section. So there's planned c-section. Versus the group of
women who have unplanned or emergency c-section. So there's planned
c-section versus unplanned or emergency c-section. So sometimes c-sections
are planned in advanced, several weeks before
the mom goes into labor. And the most common reasons
for planning a c-section include, for example, if the mom has had a c-section in the past,
that's a pretty common reason to have a c-section, if she has a history of a c-section in the past. If the baby is very large. So that's called fetal macrosomia. Fetal marcosomia. Macro for large and soma for body, so the baby has a really large body, which tends to make vaginal
delivery pretty difficult. So in that case, we opt for a c-section. Another indication is if
the mom has an infection such as herpes or HIV. So infections that can
spread to the baby as the baby's passing
through the vaginal canal. So we attempt to avoid that transmission of infection by delivering
the baby through a c-section. If the woman is carrying
more than two babies, two babies or more, or if the mom has a condition
called placenta previa. So a condition called placenta, placenta previa, in
which case the placenta blocks the way to the vagina. So the baby can't exit through the vagina, its path is blocked. And speaking of that, any type of mechanical obstruction to delivery such as a uterine fibroid or a displaced pelvic fracture. Anything that would
block the way of the baby through the vagina would be an indication for a c-section. In other cases, the mom plans
on having a vaginal delivery and she goes through with
the vaginal delivery, but plans change during labor and she needs to have
an emergency c-section. So some of the reasons
for an unplanned and an emergency c-section include contractions that are not strong
enough to get the baby out. So the labor ins't progressing as quickly and as effectively as it
should, which if labor lasts too long, that can
be detrimental to the baby, it could lead to the baby
not getting enough oxygen. So we decide to go in through an emergency c-section to get the baby out as quickly as we possibly can. Another indication is if the
mom's pelvis is too small and that's discovered
during labor, again because the labor isn't progressing as it should. If the baby is in an odd position such as sideways or chin first or feet first, whatever it might be. If the baby's in an odd
position, that's a good reason to do an emergency c-section. And also, if the baby's life is in danger. So for example, if its
heart is beating too slow. Or if the mom's life is in danger. So for example, if
she's bleeding too much. Those are both very good reasons to have an emergency c-section. And these are just the most common reasons for having a c-section, by no means are they the only situations in which a c-section is necessary. Okay, so c-sections, just
like all surgical procedures, are not without complications. So for example, with each c-section one of the biggest complications
that you'll hear about, the risk of placental
attachment disorders increases. So the risk of placental, placental attachment disorders increases. So there's some disorder,
something's going wrong with the way that the placenta attaches and this is in subsequent pregnancies. So pregnancies following that c-section. So a lot of that has to
do with the fact that each c-section causes scar
tissue to form in the uterus and that scar tissue
can cause the placenta to attach to the uterus incorrectly. So the placenta can attach
in the wrong location such as with placenta previa. Or the placenta can adhere to or stick to the uterus too strongly, too firmly, which is called placenta accreta. So the risk of placenta previa and placenta accreta, which are two types of placental attachment disorders, increases with future pregnancy
following a c-section. And there's some other
complications including complications relating to anesthesia, which of course occurs
with any major surgery. There can also be damage to the bladder, the blood vessels, or the
intestines during surgery. And generally, c-sections do
involve longer healing time than vaginal deliveries do. And of course there's
also the risk of infection as a result of all that instrumentation inside the body that's occurring
throughout the c-section. So pretty standard
surgery-related complications. But let's talk about a couple of issues unique to c-sections. So firstly, there's a lot of thought and some pretty decent evidence to suggest that c-sections are
associated with an increased risk of respiratory problems in the baby. And perhaps with an
increased risk of death of the baby as well. And also, keep in mind
that with a c-section, we're making an incision into the uterus, a pretty large incision,
and then we're sewing that incision up after
delivering the baby. And sure, these incisions
tend to heal pretty well, but imagine that with future pregnancies the uterus stretches and during delivery it contracts with great pressure. And because a scarred area
of the uterus isn't as strong as the rest of the uterus, that portion, that scarred portion, is
really prone to rupture. So uterine rupture is a
grave, potentially fatal complication of c-section. And it's this fear of uterine rupture that's led to a greater
than 100-year-long debate over how to deliver a woman who's had a c-section in the past. This is a really controversial
issue in medicine. So if you think about it,
there are three possibilities for a pregnant, laboring woman who's had a c-section in the past. She can choose from
the very get-go to have a planned, elective c-section. That's kind of the first
possibility, right? She can plan from the
very beginning to have an elective c-section. So that's a first possibility. She could also attempt to labor. Right? Which is called a TOLAC. T-O-L-A-C, which stands for trial of labor after cesarean. So she could try to labor and that TOLAC could be successful, so it could end with a vaginal delivery. Everything could go well after she labors and the baby could be delivered vaginally. Or, the TOLAC could fail and
would have to be followed by an emergency c-section. So those are kinda the
three possibilities. Either she could choose
from the very get-go to have a planned, elective c-section. Or she could try to labor, which could end with a vaginal delivery. It could all go great and be successful and end with a vaginal delivery. Or the TOLAC could fail
and it would have to be followed by an emergency c-section. And I'll tell you, up until
about 30-ish years ago, every woman who'd ever had
a c-section in the past was told that every delivery
of hers in the future would have to be a c-section. But considering all the
complications that we just talked about
associated with c-section, in the 80s we really sat down and really thought about whether that's necessary. And we realized that in some women who've had a c-section in the past,
it's worth it to attempt a TOLAC to avoid the
complications of a c-section, because a TOLAC could
proceed successfully, right? And we would, in that case,
avoid the complications of a c-section. Whereas in other women, mainly those women who have a really high risk of uterine rupture with a TOLAC, it's necessary to stick to c-sections for every delivery after
the woman's first c-section. And deciding which of
those categories a woman falls into is really no easy feat. So there's no real
standardized way of deciding which women are good candidates for TOLAC and which aren't. We really, currently, we really do things on a case by case basis, which hopefully will change in the future as we gather more data on the topic. But currently, as it stands,
it's a very controversial issue and we tend to manage things on a very case by case basis. So, in a nutshell, those are some details about c-section.