C-Section - what to expect in Germany.

Dr. Christine gives you an overview about what, when and how.

What is a c- section?

A caesarean section is an operation to deliver a baby.
It is also called sectio, abdominal delivery or c- section. The rate is steadily increasing worldwide. In Germany, it was about 30 % in 2020, according to the Federal Statistical Office.

C-sections in Germany

In Germany, c-sections are divided into two types: primary and secondary.

A primary c-section is when the birth has not yet begun (rupture of the membranes or labour in the cervix), whereas in a secondary c- section the birth has already begun.  There is also an emergency caesarean section. This takes place in an emergency (e.g. detachment of the placenta or lack of oxygen to the baby) and can be performed at any time during the birth.

Duration & Anaesthesia

The caesarean section takes about 30 minutes and is a routine procedure for the gynaecologist. The anaesthetic can be either local as a spinal anaesthetic or epidural, or general anaesthetic.
In Germany, local anaesthesia, where the parents can usually both be present in the operations room and the mother is awake, is the standard method. General anaesthesia may be preferred only for special medical reasons. An emergency caesarean section is always performed with a general anaesthetic because of the urgency.

Preparation of the Mother

During a caesarean section, the pregnant woman is dressed in a surgical gown and wears anti-thrombosis stockings. Usually, the incision site is also shaved and a bladder catheter is inserted. This is to ensure that the bladder is completely empty. This reduces the risk of hurting the bladder during the operation. The pregnant woman lies on her back during the operation and a large sheet covers the view of the operation area. One arm is usually used for an infusion, the other is usually free to move after the baby is born. 

The Operation

Today, almost all clinics in Germany operate according to the so-called Misgav Ladach method (the gentle caesarean section).

The incision is between 10 and 15 cm long and just above the symphysis. It runs along the skin line given there. After this incision, the abdominal wall is opened layer by layer: the subcutaneous tissue and the firm and coarse connective tissue (muscle fascia). The underlying abdominal muscles are pushed aside and the whole is stretched rather than cut. The peritoneum is also opened and the uterus is opened over about 10 cm at its front above the urinary bladder. The doctor lifts the baby out of the abdominal opening with his hand. The umbilical cord is cut and then it comes to the midwife standing by, wrapped in warm blankets. The birth of the baby takes only a few minutes. If it is not an emergency caesarean section and the mother has a local anaesthetic, she can now hold her baby in her arms after a brief inspection of the baby.

Meanwhile, the surgeon removes the placenta with his hands and closes the uterus again with stitches.  Then the other layers follow. Finally, the skin is sutured and the wound is covered with a special plaster.

After the operation, the mother comes back to the delivery room with the baby and her partner and spends another 2 hours there. Then the baby and the mother are transferred to the mother and child unit. The usual hospital stay in Germany is between 3 and 5 days. The mother can usually get up again a few hours after the operation and is slowly mobilised. The bladder catheter is removed when the mother can walk safely again and go to the toilet. Otherwise, the hospital stay is similar to that after a vaginal delivery.

Please join our weekly Mama Talks, visit one of our birth preparation courses or book a private session should you need more information.

June 2021 - Gravidamiga - Dr. Christine Krämer
This blog post has been prepared with the greatest possible care and does not claim to be correct, complete or up-to-date.“ This is not a sponsored post and it does NOT substitute a visit to a doctor.

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