Tuesday, January 8, 2008

Babyectomy

Surgical removal of tonsils: tonsillectomy
Surgical removal of appendix: appendectomy
Surgical removal of breasts: mastectomy
Surgical removal of uterus: hysterectomy
Surgical removal of baby: babyectomy


Yes, a cesarean is surgery!
Following is the actual surgical report from my cesarean. That's right, with a
cesarean "birth"... there are no "warm fuzzy" moments. It's all about "stab incisions" and organs being extracted from your body. I'm putting this here because had I known exactly what was involved in a standard surgical birth, I would have asked more questions
and made certain preferences clear. Emphasis added.

The patient (you're not a woman, a mother, or even a human being, you are simply a "patient") was taken to the operating room where spinal anesthesia (you know, that huge needle they stick in your spine after you sign a form saying that if you become paralyzed or die that you and your family won't sue) was introduced without complication. The patient was then prepped and draped in the usual sterile manner(because there are TONS of nasty germs in a hospital and they're getting ready to cut you open and you wouldn't want an infection. That's why hospitals are for SICK people. Not pregnant people).

The abdomen was entered via Pfannenstiel incision, which was extended to the fascia via sharp dissection (ooo... doesn't that make you feel nice??). Hemostasis was assured via cautery. The fascia was incised and this incision extended. The remainder of the fascia was taken down in the usual manner.
The midline was identified and entered without complication. The lower uterine
segment was identified and bladder flap was created inferiorly (Your
bladder is "in the way" so to speak, so they have to move it.
I'm sure it's impossible to get it back in the exact same position
it was in, so NEVER let a doctor tell you that a cesarean will ensure that you won't suffer from incontinence)
. The uterus was entered via stab incision (don't you just picture some mad scientist stabbing you in the gut when you hear that? I know I do...), which was extended sharply. The membranes ruptured and clear fluid was noted. The head of the infant was delivered;
the nares and mouth were suctioned well, and the remainder of the
infant was delivered without complication. The infant was carried
over to the neonatologist. The placenta was manually extracted,
the uterus was delivered into the abdominal incision, and the
endometrial cavity was cleansed. (This last sentence means
that they actually TOOK MY UTERUS OUT OF MY BODY
and plopped it up on my abdomen. That's the common thing to
do. They like to dig around inside your body and see what's
going on.)


The uterine incision was then closed in two layers, first being a running
interlocking layer of #1 chromic, second being a running, imbricating
layer of the same. Hemostasis was assured via cautery as well as
suture of 2-0 chromic. When hemostasis was assured, the uterus
was returned to the abdominal cavity
. The gutters were cleansed
of clot and debris. Hemostasis was assured and the bladder flap
was reapproximated using 2-0 chromic in a running fashion.
Hemostasis was assured and the gutters again were cleansed
of clot and debris. Copious irrigation was done. Hemostasis
was assured and the peritoneum was closed using #0 chromic
in a running fashion. The subfascial layer was made hemostatic
and the fascia was reapproximated using 0 Vicryl in a running
fashion. Hemostasis was assured of the subcutaneous layer
which was reapproximated using 3-0 plain in an interrupted
fashion. Hemostasis was further assured and the skin was
reapproximated using 3-0 Vicryl in a running, subcuticular
fashion. Estimated blood loss was 600 cc. Complications
were none.


**Note: They don't consider depression, a huge gash on
your abdomen, breastfeeding failure, not being able to
walk on your own or without pain, nightmares, etc to be
"complications".

10 comments:

frylime said...

definitely no c-section for me if i can help it.

it's funny how case reports are so sterile. you'd think they'd add a "you go girl" once the baby was out or something...

Student Nurse Nancy said...

Wow - This puts my C-section into a whole new light! YIKES!

J. E. said...

I agree that a lot of people don't see a c-section as major surgery! It definitely is! I'm a L&D nurse and a mother of 3... I'm all for the natural birth and if your midwife is well trained, that's one thing. But don't always assume the hospital is a bad place. Just last week I took care of a woman who came in from a birthing center. She came in after 3 hours of pushing @ 9cm... hello... if the cervix doesn't reduce don't force it! when she got to us she was only 7cm from a very swollen cervix. baby was having late decels and the midwife (lay midwife) said baby had been doing great hr in 130s. As we continued to assess this pt she started having a lot of bright red bleeding and ended up having the dreaded SPINAL and proceded to have her c-section. Well guess what? She was abrupting and we saved her baby and her life. If she wasn't at our horrible hospital I'm sure the outcome would have been much different.
I agree that vag birth is the natural/ best way to bring your baby into this world, but the hospital is a life saving place. so don't just knock it on a generalized basis.

L&D nurse!

geena said...

"The patient was then prepped and draped in the usual sterile manner(because there are TONS of nasty germs in a hospital and they're getting ready to cut you open and you wouldn't want an infection. That's why hospitals are for SICK people. Not pregnant people)"

It doesn't matter where in the world you are - they would "prep and drape you in the usual sterile fashion" whether you were in a hospital, birthing center, or even your own home.

I don't do L&D, but I know that there are a lot of c sections done unnecessarily. It is not a worthless procedure, however. It has also saved many lives.

I realize your disdain is towards the former.

Aidan's mom said...

I think your blog is necessary and is getting out the message that far too many c-sections are being done. I am sure I am stating the obvious here, but there are good medical reasons for them in some circumstances and I am one of them. I developed acute onset Class I HELLP syndrome the night of my premature son's birth. He was a small 28 weeker and my liver was in imminent danger of rupturing. My son needed to be delivered immediately to ensure we both did not die.

Just a friendly reminder there are decent medical reasons for a c-section and I was awfully glad to have a skilled doctor performing it. He saved my life and my son's life.

Lori

Jill said...

I remember asking my midwife what the heavy feeling on my chest had been during my C-section (this was before the doctor had pressed all his weight onto me to help expel the baby as most do), and she'd told me it was "just" my internal organs. Oh, JUST my organs, placed neatly out of the way.

Permission to Mother said...

Wow... this post is powerful, too. I do hope that the retelling of your story is healing and helps others, too.
Denise

Tiffany said...

I had a c section, it was not someething I wanted but I took my birthing classes and learned and watched what happend. I dont understand my doctor was not uncaring I was not "patient" he knew me and I was aware of everything. I was nervous but well taken care of. I dont like when people turn everything into such negative hatefull remarks. I dont know how you can be happy advocating with such negative things like this. My family has a mix of birth experiences and it it good. Does this help those who have to have surger, they go in with such horrible feelings and fears. What a negative vibe you are sending to them.

Anonymous said...

I am compelled to respond to some of the blogs here: Considering the World Health Organization states that a Csection rate should be between 10-15% MAXIMUM in a developed country...(I was a primary section victim in 2006...the year the sections hit an all time high in the U.S. (31.1%) I can't believe that EVERY woman who asserts she and her baby were "saved" by the doctor who butchered her open knows or wants to see the truth. I will say, a small percent of sections are necessary. But how many of the babies "saved" were actually thrown into harms way in the first place by the $*#@* medical staff that employed the cascade of interventions (including fetal monitors that require you be bound to a bed on your back and tethered)??? I know, because of what I do for a living in the mental health field, that the human mind and its defense mechanisms is the most powerful drug. If people didn't somehow JUSTIFY what they do to others, or worse, what they allowed done to themselves, they could never live with themselves, never mind sleep at night. I also know the utter devastation cesareans wreak on women, mothers, families. As a rule, there is no TRUE informed consent in OB/GYN in the United States. Signed, home VBAC

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