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Shanon Cook: Hi, I'm Shanon Cook, mom of one with another one on the way. Now, if you're having your baby here in the United States, there is a 1 in 3 chance you will be having the baby here in an operating room. Whether your cesarean section was planned or it was kind of a last-minute switch, the prospect of surgery can be really daunting. So here to put our minds at ease, or not, is Dr. Jacques Moritz. He's head of the ob-gyn unit here at St. Luke's. He's also my doctor, so I'm on my best behavior today. What are some of the reasons that someone might have a planned c-section?
Dr. Jacques Moritz: So, a planned c-section, the major reason would be sometimes twins, very common now in this country. Breech, so breech is where instead of the head being down, the butt is down. Placenta previa, where there's no way the baby can come out because it has to go through the placenta. Sometimes some medical issues that don't allow women to deliver vaginally, they would be in this room.
Shanon: So, what about an emergency c-section? Why might that happen?
Moritz: Right. Emergency c-sections happen when you're trying to have a vaginal delivery and things go wrong. The heart rate of the baby goes down. Why? Sometimes there's a cord around the neck. Sometimes the placenta is breaking loose. Anything that's in jeopardy of the baby. It's a very safe procedure. We do a lot of them, that could be criticized, but we definitely know how to do them.
Shanon: Let's talk about this. This is obviously the operating table. So Mom has her arms out like this in the Jesus position.
Moritz: Mom has her arms out like that. We're trying to modify that a little bit so that they're not restrained down. Even though they're loosely restrained. They need the arms to be down, because you need to get IV fluids and they're monitoring and mostly because the blood pressure cuff is on. You can't really do blood pressure with your arms like this. That's why it's in this position.
Shanon: And there's a curtain, they put a curtain up here. So they can't see what going on.
Moritz: The mom's here, I'm here, you would be my assistant. You would be over there. And there's a big drape. Those are the little clips for the drape. There's another one there. So there's a big drape here. Mom's head is here and this stool here is for the father. This is the monitor here that measures heart rate and oxygen saturation and blood pressure. These are all the gasses. This is just regular air, this is oxygen, these are other gasses to put people to sleep. This is just a computer that monitors beat by beat what's going on.
Let's talk about this side of the curtain for a second, because there's a lot of things that are not understood about a c-section to the mother that's over here, is a c-section does not cut muscle bellies. So they say, well how do you get the baby out? Well, we move the muscles off to the side, make a small incision in the uterus, take the baby out, and the muscles come right back together again. So that's a, people are always saying, oh you cut all my muscles, I can't do crunches anymore. You can do all the crunches you want afterwards, they haven't been damaged or touched at all. As we said before, it's relatively fast.
Shanon: How fast?
Moritz: How fast? Usually 15 to 20 minutes for a first time c-section.
Shanon: Well sometimes it needs to be fast, doesn't it?
Moritz: Sometimes it can be even faster than that. But you know, you want to take your time. I mean, urgent urgent c-sections, that may be eight minutes, maybe 10 minutes. It's very very quick.
Shanon: So, talk me through the team. Who's here?
Moritz: So, there's somebody like myself, the attending surgeon. An assistant, usually a resident. And over here would be a scrub nurse. She would be handing the instruments. Walking around the room is another nurse, that's the circulating nurse. That's the person getting us, if we need anything, turn on the gas, don't do this, turn on … put the lights up stronger. Whatever we need, that's called a circulating …
Shanon: Turn on the gas. Is that so Dad can get out of here?
Moritz: Not that kind of gas! And then, over in that corner over there would be the warmer, and there would be a pediatrician standing there waiting to receive the baby. Whenever we do a c-section, in this country, we always have a pediatrician around. And then the major thing we didn't talk about is epidurals are now the choice for doing a c-section. So the mother's completely awake. She hears everything, she smells everything, there are certain smells. And that's the Bovie machine, that's the electrosurgical machine that we use. And this attaches on to the mother and it controls the power that we use. And this is cutting and this is coagulation. This is a very very important part of the surgery. Down below, we didn't talk about that. That's a machine that pumps air into the legs, to squeeze the legs to prevent blood clots from happening.
Shanon: From the moment that Mom is wheeled through the door to when she's wheeled out, how long a period is that?
Moritz: The whole wheeling in and wheeling out should be 30 to 45 minutes until she's in the recovery room. And if everything goes fine, at least in this hospital, the baby is with the mother the minute she gets to the recovery room. They put some monitors on her that were put on here for the EKG, that's for this, and then the mother goes right into the arms. Because we want to get skin to skin as soon as possible.
Shanon: Right and she can't get much of it here because her arms are …
Moritz: Not really. Their arms are out that way, right. A lot of times, it's so quick that the pediatrician gives the baby back to the father and puts it right next to the mother's face and that's nice.
Shanon: Dr. Moritz, thank so much for explaining all of that to us, love that noise.
Moritz: Love that noise.
Shanon: I'll see you in a couple of weeks.
Moritz: I'll be there.
Shanon: And remember, if you have any concerns or fears about c-sections, make sure you speak to your doctor. For BabyCenter, I'm Shanon Cook.