In the event of any deviation in the normal course of birth, all of the possibilities of modern medicine are readily available to us in order to ensure a safe delivery for your child and you.
A Caesarean section can be performed either before the start of actual delivery or during childbirth, where required by the medical condition of the child or mother, or where the birth must be completed as rapidly as possible.
Caesarean sections are performed in our clinic’s operating room.
A primary Caesarean section is planned in advance as part of the delivery procedure, where childbirth has not yet begun; this means that the foetal membrane has not yet ruptured, and contractions have not yet begun. Absolute indications for a primary Caesarean section can include: the abnormal position of the child (e.g. where the child is in the lateral position), a danger to the life of the mother and/or child (e.g., a womb rupture) or specific pre-existing conditions in the mother or child. A relative indication for a Caesarean section could be a suspected mismatch between the mother’s pelvis and the size of the child. During a planned Caesarean section, the pregnant mother can usually decide for herself whether the Caesarean incision should be performed under full or a local (epidural) anaesthesia.
A more modern operating method has for a number of years now been available for Caesarean sections: the "Misgav-Ladach” method.
A secondary Caesarean section can be performed once childbirth has already begun, meaning that the foetal membrane has ruptured or uterine contractions have started. In most cases, obstructed labour or a change in the child's heartbeat are the triggers for Caesarean section, to protect the health of the mother and child.
Bonding after a Caesarean section in the operating room
"Bonding" describes the inner emotional connection which parents develop with their child. This falling in love forms the basis for a durable, unique relationship.
Bonding should begin immediately after childbirth, where the condition of the mother and child allow it. The literature describes an extremely sensitive phase in the first hours after childbirth. The declared interdisciplinary objective at Dr. Geisenhofer Women's Clinic is therefore not to separate mother and child after childbirth. Both mother and child are focused on this contact with all of their senses and hormonal systems. This declared objective, which is part of the everyday routine for a spontaneous childbirth, is now also implemented and supported following a Caesarean section, directly in the operating room. So, even after a Caesarean section, it is possible not to miss out on this form of emotional connection. After a year-long positive pilot phase, all procedures have now been established as well as possible and the bonding process, even after a Caesarean section, has become a matter of course for us in our Clinic.
What is meant by the "Misgav-Ladach" method?
The "Misgav-Ladach” method is a gentle surgical procedure to perform a Caesarean section, in which the tissue layers are not separated using surgical instruments, but only slightly incised and then pulled apart and distended.
Specifically, the surgical technique involves the following: After incising the skin layer with a scalpel, the subcutaneous fatty tissue is distended with the fingers. After sharply incising the muscle fascia with scissors, the muscle curvatures of the straight abdominal muscles are then forced apart.
After creating a sharp opening in the peritoneum with a pair of scissors or scalpel, a small area of this is also distended with the fingers. A small section of the uterus above the bladder is now opened with a scalpel, the opening is then further expanded with the fingers, and the baby is extracted.
Once the umbilical chord is cut, the placenta is also removed. The opening in the uterus is now closed with a continuous suture. The peritoneum as well as the straight abdominal muscles are not sutured (unlike in a "traditional” Caesarean section). Once the muscle fascia is continuously closed, the skin is then sutured.
In this way, nerves and blood vessels which would otherwise need to be cut remain undisturbed.
This accelerates the healing process, and the patient can then be discharged as early as five days after the operation. Further advantages of the "Misgav-Ladach” method include the short length of the operation compared to a "conventional" Caesarean section, the protection of the blood vessels and the relatively low need for painkillers.
What advantages does a Misgav-Ladach section offer the child compared to conventional technology?
- Shorter operation times under general anaesthesia and hence, less exposure to anaesthetics
- A fitter mother thanks to faster post-operation recovery