Time flies so fast

Saturday, May 12, 2007

The C-section

Before i went to my scheduled appointment to my OB Gyne yesterday, i prepared a list of questions to ask.

One of the questions i asked is the possibility of having a normal delivery for pregnant women like me who's carrying twins. She said, of course, normal delivery is possible and it actually depends on the position of the baby (there were medical terms i did not actually understood). But of all the twin births she delivered, all of them were cesarean, unfortunately, because of the baby's position at the time they were due. Ouch!

My sister-in-law, who referred me to my OB Gyne, told me about the two types of cesarean cut - bikini (horizontal) and the mid cut (vertical). Not sure if the mid cut is the right term here but that was as far as i could remember my doctor told me. My OB advised that she normally does mid cut because it is safer and easier. Exactly as what she said, the mid cut is done for her convenience and the patient's convenience. She will do a bikini cut as per request of the patient but charges more because it is more delicate. She also said that it is risky on the second pregnancy. Some doctors and patients prefer the bikini cut for aesthetic purposes. And i am one of those who would like to have a bikini cut in case i will have cesarean delivery.
I texted a friend/officemate who delivered her 2 kids via c-section to ask her of the differences on these 2 cuts. She had a mid-cut because she left it up to the OB to do what's better. She said that she had 2 OB-Gyne and both of them gave her a choice on what type of cut she wants and that it's actually no big deal about it. Her second OB even questioned her why she chose a mid-cut over the bikini.
This makes me really puzzled and admittedly scared. I do have a bigger chance of delivering my babies via c-section due to twin pregnancy (although normal delivery runs in our family). And with this, i would like to know more about the 2 types of cut and their risks.

I checked the internet and here is what i saw regarding the differences of the horizontal vs vertical cut:
After the anesthesia takes effect, the doctor makes an incision through your abdomen. In most cases, a "bikini cut" is used. This is a horizontal incision just above the pubic area. In an emergency, she may make a vertical cut, which extends from the pubic area to the navel and allows quicker access to the baby.

http://www.epigee.org/health/cesarean.html
A small horizontal cut is made just above your pubic bone. This is called a bikini cut and is less risky then the vertical classical cut. It is less likely to rupture if you decide to have another baby.

The most common reason that a cesarean section is performed (in 35% of all cases, according to the United States Public Health Service) is the woman has had a previous c-section. The "once a cesarean, always a cesarean" rule originated when the uterine incision was made vertically (termed a "classical incision"); the resulting scar was weak and had a risk of rupturing in subsequent deliveries. Today, the incision is almost always made horizontally across the lower end of the uterus (called a low transverse incision), resulting in reduced blood loss and a decreased chance of rupture. This kind of incision allows many women to have a vaginal birth after a cesarean (VBAC).

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