LISA: Hi I'm Lisa Birnbach for howdini.com. Every prenatal class for expectant moms and dads will give you advice on how to avoid getting a cesarean section. But when push comes to shove--get it?--the choice between a vaginal delivery and C section may not be up to you. In fact I don't think it's ever up to you. Dr. Keith Eddleman is the Director of Obstetrics at Mount Sinai Hospital in New York City and author of two books on pregnancy including Pregnancy for Dummies. Dr. Eddleman thank you for joining us.
DR. EDDLEMAN: Thanks for having me.
LISA: Dr. Eddleman, why is it that people think they can actually control whether or not they have C section given the fact that you don't know what's going on in your birth canal?
DR. EDDLEMAN: Well in reality there are very little things that you can do to control that decision. Things that, you know, pregnancy's a natural process and you don't know what's going to happen.
DR. EDDLEMAN: There are some things that are urgent that need to be dealt with immediately like if you have abnormalities in the fetal heart rate. And then there's some things that you can't change like if the baby's in a breach position. You can't change that right away. So, you don't really have a choice about those things.
LISA: Why would a woman have a cesarean as opposed to a vaginal delivery?
DR. EDDLEMAN: There are more and more women who are deciding to avoid the whole labor and delivery process and schedule a primary cesarean section which is a new thing probably in the last five or so years. But, more and more women are asking for it and more and more obstetricians are agreeing to do it.
LISA: Now why would you want to do that? That's much more surgery.
DR. EDDLEMAN: It is an abdominal surgical procedure just like having your appendix out or gallbladder out. So it is major surgery, but it does avoid the whole labor process and the potential for complications of labor like fetal heartrate abnormalities or fetal, what we call fetal hypoxia during labor--not getting enough oxygen during labor. If you do schedule a cesarean section early before 39 weeks, then you need to have an amniocentesis beforehand to check the lung maturity and chemicals in the amniotic fluid that tell you that the baby's lungs are ready to function. But, you really shouldn't do it electively before 39 weeks unless you do that first.
LISA: Let's say I'm having a C section, can you walk me through the recovery process?
DR. EDDLEMAN: Generally most cesareans are done with regional anesthesia, you have it with a spinal or epidural.
LISA: So is that what we used to call local?
DR. EDDLEMAN: It is a kind of local, but it's not like having local when you go to the dentist's office. This is a local that goes into your spinal cord and it numbs the body so that you don't feel pain at all. You have the epidural catheter, spinal catheter in place.
LISA: And you're awake.
DR. EDDLEMAN: You're awake, you're awake and you can hear the baby cry and you can actually feel--you'll feel movement, you won't feel pain though. You'll feel your doctors moving around and taking the baby out.
DR. EDDLEMAN: And then you'll hear the baby cry, you see the baby immediately. The recovery, you know, is a little different. You have a foley catheter in your bladder to drain your bladder for about 24 hours. You go to the recovery room, but because it is a surgical procedure you stay there for several hours. And instead of having pain around the vagina and the perineum, in the anal area, you have pain in your abdominal section. But they usually give you medication to control the pain. They usually advance your diet a little more slowly because it was an abdominal procedure. You also come in contact with the intestines.
LISA: Can you still nurse your baby right away even if your on those medications?
DR. EDDLEMAN: Absolutely, absolutely. We encourage that too. As soon as you get to that recovery room, we encourage you start breastfeeding if that's what you plan to do.
DR. EDDLEMAN: Generally you're in the hospital about three to five days afterwards, whereas it's usually 24 hours to 48 hours with a vaginal delivery. So, hospitalization is a little bit longer too. Other than that the recovery is pretty similar.
LISA: How long does a cesarean procedure take generally speaking?
DR. EDDLEMAN: Generally it's usually less than an hour start to finish. About an hour start to finish.
LISA: Thanks Dr. Eddleman. For howdini.com I'm Lisa Birnbach.