I hope I explain this question clearly, and that I’ve put it in the right place. I’m definitely not looking for medical advice, just information about how things work.
My daughter delivered her son by emergency caesarian last week. The baby was full term; the doctors were planning to induce in two days because of her high blood pressure, but then she started labor naturally. By the time they were settled into the birthing room, she was having virtually continual contractions, but the cervix wasn’t dilated enough to deliver. Then the baby’s vital signs dropped. And then my daughter’s vital signs began dropping too, and the doctors rushed her into the operating room. Both came through fine and are now back home.
Now, this is my question: since the uterus was doing contractions, wouldn’t it continue doing that during the operation? How do the doctors deal with that? Do the contractions just stop as soon as the cutting starts? Or when the baby’s out? Or when the stitching-up starts?
Thanks; interesting. I was hoping someone would know what happens if no drugs are administered. Presumably once the baby and placenta are delivered the uterus “knows” it no longer needs to contract, but this is just my uneducated guess. Is the surgeon cutting (and stitching) a moving, contracting muscle?
Keep in mind that historically Cesareans were typically done after the mother died, as a desperate last resort, and I figure that by the time this became a potential issue (doctors able to reliably operate on a living woman and expect her survival) we had drugs to take care of problem contractions.
Yeah, I know that. So is it usual that some “stop contractions” drug is administered? My daughter doesn’t remember anything like that, but then she probably already had IV lines in and was also distracted about the whole not dying thing.
I know one of the drugs they use is Terbutaline for shot term stopping of labor. I remember my ex-wife Labor&Delivery nurse talking about it on several occasions.
I was with my wife during and after her C-section, and she said immediately after leaving the OR she started having really bad contractions and it felt painful and weird. It is possible she didn’t feel it during the surgery due to the epidural, but she definitely had contractions after.
They give you something in the I.V. to make the contractions restart to expel the placenta during the surgery. I guess they just work around them when sewing you back up.
You would not give a tocolytic during a c/s- that would cause the uterus to relax. The uterus needs to continue to contract to close off all those blood vessels where the placenta was or else the woman could bleed out easily.
Pitocin, often given before vaginal delivery to increase contractions, is also given post c/s to encourage contractions for that reason.
MLS, you ask an interesting question. I’ll ask one of the OB-GYNs I work with for their experience and post it here for you in a day or two (unless someone more knowledgeable comes and answers your question first). My best guess would be that the uterus does indeed continue to contract during the surgery, but that the contractions are ineffective because of the incision or else irregular and disorganized because of the temporary ‘insult’ of the surgery.
I think it depends on what stage of the C-section we’re talking about. As the (rather meagre) meta-analysis I linked to above shows, tocolytics are employed for C-sections - I agree they would seem to be counterproductive if not contraindicated *after *the baby is out. Earlier, they may promote an easier ‘delivery’ through the section and that could translate to better baby outcomes. The verdict is not clear.