Homoeopathy and Caesarian delivery……..What homeopathy can do in a Caesarean section , also known as C-section or Caesar, is a surgical procedure in which incisions are made through a mother’s abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. It is usually performed when a vaginal delivery would put the baby’s or mother’s life or health at risk, although in recent times it has been also performed upon request for childbirths that could otherwise have been natural.

Types

o   There are several types of Caesarean section (CS). An important distinction lies in the type of incision (longitudinal or latitudinal) made on the uterus, apart from the incision on the skin.

o   The classical Caesarean section involves a midline longitudinal incision which allows a larger space to deliver the baby. However, it is rarely performed today as it is more prone to complications

o   The lower uterine segment section is the procedure most commonly used today; it involves a transverse cut just above the edge of the bladder and results in less blood loss and is easier to repair.

o   An emergency Caesarean section is a Caesarean performed once labour has commenced.

o   A crash Caesarean section is a Caesarean performed in an obstetric emergency, where complications of pregnancy onset suddenly during the process of labour, and swift action is required to prevent the deaths of mother, child(ren) or both.

o   A Caesarean hysterectomy consists of a Caesarean section followed by the removal of the uterus. This may be done in cases of intractable bleeding or when the placenta cannot be separated from the uterus.

o    Traditionally other forms of Caesarean section have been used, such as extraperitoneal Caesarean section or Porro Caesarean section.
A  repeat Caesarean section is done when a patient had a previous Caesarean section. Typically it is performed through the old scar.

Complications
Caesarean section is recommended when vaginal delivery might pose a risk to the mother or baby. Not all of the listed conditions represent a mandatory indication, and in many cases the obstetrician must use discretion to decide whether a caesarean is necessary. Some indications for caesarean delivery are:
Complications of labor and factors impeding vaginal delivery such as
prolonged labor or a failure to progress (dystocia)

o   fetal distress

o    cord prolapse

o   uterine rupture

o   placental problems (placenta praevia, placental abruption or placenta accreta)

o   abnormal presentation (breech or transverse positions)

o   failed induction of labour

o    failed instrumental delivery (by forceps or ventouse. Sometimes a ‘trial of forceps/ventouse’ is tried out – This means a forceps/ventouse delivery is attempted, and if the forceps/ventouse delivery is unsuccessful, it will be switched to a caesarean section.

o   overly large baby (macrosomia)

o    umbilical cord abnormalities (vasa previa, multi-lobate including bi-lobate and succenturiate-lobed placentas, velamentous insertion)

o   contracted pelvis

o   Other complications of preganancy, preexisting conditions and concomitant disease such as

o   Pre-eclampsia

o   Hypertension

o   Multiple births

o   Precious (High Risk) Fetus

o   HIV infection of the mother

o   Sexually transmitted infections such as genital herpes (which can be passed on to the baby if the baby is born vaginally, but can usually be treated in with medication and do not require a Caesarean section)

o   Previous Caesarean section (though this is controversial – see discussion below)

o   Prior problems with the healing of the perineum (from previous childbirth or Crohn’s Disease)

o   Other

o   Lack of Obstetric Skill (Obstetricians not being skilled in performing breech births, multiple births, etc. [In most situations women can birth under these circumstances naturally. However, obstetricians are not always trained in proper procedures])

o   Improper Use of Technology (Electric Fetal Monitoring [EFM]

Risks
Risks for the mother 

As with all types of abdominal surgery, a Caesarean section is associated with risks of post-operative adhesions, incisional hernias (which may require surgical correction) and wound infections. If a Caesarean is performed under emergency situations, the risk of the surgery may be increased due to a number of factors. The patient’s stomach may not be empty, increasing the anaesthesia risk. Other risks include severe blood loss (which may require a blood transfusion) and post spinal headaches.
Women who delivered their first child by Caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second delivery.
Risks for the child 
For the baby, complications can also include neonatal depression due to anesthesia and fetal injury due to the uterine incision and extraction.
One study found an increased risk of complications if a repeat elective Caesarean section is performed even a few days before the recommended 39 weeks.
Risks for both mother and child
Due to extended hospital stays, both the mother and child are at risk for developing a hospital-borne infection.
Studies have shown that mothers who have their babies by caesarean take longer to first interact with their child when compared with mothers who had their babies vaginally.
Anaesthesia 
Both general and regional anaesthesia (spinal, epidural or combined spinal and epidural anaesthesia) are acceptable for use during caesarean section. Regional anaesthesia is preferred as it allows the mother to be awake and interact immediately with her baby. Other advantages of regional anesthesia include the absence of typical risks of general anesthesia: pulmonary aspiration (which has a relatively high incidence in patients undergoing anesthesia in late pregnancy) of gastric contents and Oesophageal intubation.
Regional anaesthesia is used in 95% of deliveries, with spinal and combined spinal and epidural anaesthesia being the most commonly used regional techniques in scheduled caesarean section. Regional anaesthesia during caesarean section is different to the analgesia (pain relief) used in labor and vaginal delivery. The pain that is experienced because of surgery is greater than that of labor and therefore requires a more intense nerve block. The dermatomal level of anesthesia required for cesarean delivery is also higher than that required for labor analgesia.
General anesthesia may be necessary because of specific risks to mother or child. Patients with heavy, uncontrolled bleeding may not tolerate the hemodynamic effects of regional anesthesia. General anesthesia is also preferred in very urgent cases, such as severe fetal distress, when there is no time to perform a regional anesthesia.

Vaginal birth after caesarean 
In the past, caesarean sections used a vertical incision which cut the uterine muscle fibres in an up and down direction (a classical caesarean). Modern caesareans typically involve a horizontal incision along the muscle fibres in the lower portion of the uterus (hence the term lower uterine segment caesarean section, LUSCS/LSCS). The uterus then better maintains its integrity and can tolerate the strong contractions of future childbirth. Cosmetically the scar for modern caesareans is below the “bikini line.”
Because uterine rupture may be catastrophic, VBAC should be attempted in institutions equipped to respond to emergencies with physicians immediately available to provide emergency care.

Recovery Period 
Typically the recovery time depends on the patient and their pain/ inflammation levels. Doctors do recommend no strenuous work i.e. lifting objects over 10 lbs., running, walking up stairs, or athletics for up to two weeks..

ROLE OF HOMOEOPATHY IN CAESARIAN DELIVERY. 
In caesarian delivery,homoeopathy helps in a way that helps patient to recover fast and healthy,and offers wonderful aid in complications. Before and during C-section,taking these remedies gently but effectively aid preparation and recovery in several ways, like warding off infections, easing anxiety, and minimizing blood loss.
Infections  which can strike an immune system compromised by surgery(c-section), may cause complications like bleeding and prolong recuperation. Protect against infections with Ferrum phosphoricum.
Recommended Dosage: Two days prior to surgery, 6X or 6C of Ferrum four times a day, every six hours. Stop the day of your surgery.

Ease Anxiety 
Nervousness before an operation may weaken immune system. If patient feels anxious, apprehensive, or physically weak, she can be soothed with nervous system by taking the remedy Gelsemium sempervirens. If anxiety is severe and patient feels like she is facing death,give Aconitum napellus instead.

Prevent Dangerous Bleeding
If the procedure poses the potential for a large loss of blood and due to intravenous (IV) therapy, give Arnica montana. It reduces bleeding during surgery, prevents blood from pooling under skin, and minimizes the surgical shock that can cause cardiovascular problems.
Recommended Dosage: 30X or 30C of Arnica the night before the surgery, the morning of the surgery, and just prior to the surgery.

Stop Postoperative Bleeding 
Bleeding occurs frequently after surgery, and mostly reduces with Arnica montana. other medicines are-.
Arsenicum album helps when excessive bleeding leads to great weakness, burning pains, restlessness, and anxiety, as well as thirst.
Cinchona officinalis works best if bleeding and a loss of fluids like sweat or urine cause to feel faint or have ringing in the ears.
Ipecacuanha is used for fast bleeding of bright red blood that is often accompanied by nausea or a shortness of breath.
Secale cornutum helps when there is uterine bleeding and the blood is thin and fetid. It’s also suitable when entire body feels hot and patient is aggravated by the heat.
Recommended Dosage: 30X or 30C of one of the above remedies every hour for up to four hours until the bleeding stops. If the bleeding does not slow significantly, try another remedy in the same dose.

RELIEVE CONSTIPATION 
CAESARIAN DELIVERY typically slow or stop normal bowel function. The following remedies, taken alone or in combination, may provide relief from constipation.
Arnica montana helps if patient is in a shock, characterized by a pale skin tone, that stops normal intestinal functions, including bowel movements.
China is useful if you there is large accumulation of fecal matter that is difficult to expel, and there is watery but painless diarrhea.
Raphanus sativus is indicated if patient is constipated without any bowel movements or has gas pains in the upper left part of the abdomen.
Recommended Dosage: 6X or 6C or 30X or 30C potency three times a day for up to four days

FLATULENCE

 
caesarian delivery can disrupt your digestive system, resulting in flatulence. Gas may collect and cause jabbing pains and severe bloating.Carbo vegetabilis assists people who suffer from great distension and offensive gas. This remedy is best if patient gets relief from release and if carbonated drinks ease the gas pains.
Cinchona officinalis is useful when there is more pain than distension, frequent rumbling in the abdomen, and no relief from releasing gas.
Colocynthis works when there is more pain than distension and cramps are relieved by bending over.
Raphanus sativus helps people who have a distended abdomen but are unable to expel gas.
Recommended Dosage: 6X or 6C or 30X or 30C potency every two hours during intense pain and every four hours during mild discomfort.

NAUSEA AND VOMITING 
Nausea can prevent from getting out of bed–and patient needs to move around to regain normal bodily functions. And vomiting can irritate the muscles and stitching around a wound.
Arsenicum alb treats violent vomiting made worse by drinking cold water or eating. It is also suitable if there is burning pain in stomach.
Ipecac helps people who experience persistent nausea with vomiting, and for whom vomiting does not provide relief.
Nux vomica is good if there is ineffectual retching without actual vomiting.
Phosphorus treats nausea with or without vomiting. It’s most helpful when there is headache and a strong thirst for iced drinks.
Recommended Dosage: 6X or 6C or 30X or 30C of a remedy every two hours during intense symptoms and every four hours during mild discomfort.

CARE FOR TENDER TISSUE 
Caesarian delivery causes trauma to your skin and muscles. Calendula officinalis, helps heal most wound.
Arnica montana soothes bruised or swollen muscles and bruises caused by intravenous injections.
Hamamelis internally and externally reduces hemorrhoid bleeding and varicose veins that may occur after delivery It’s helpful when capillaries are enlarged.
Bellis perennis is very useful as c-section causes deep tissue injury.