Deborah Howell (Host): So you have your first C-section coming up. It's both a happy and a nervous time for you. Knowing what to expect can help ease your mind and get you mentally prepared for the procedure. I'm Deborah Howell and our guest today is Dr. Constantine Scordalakes, a Board Certified Doctor of Obstetrics and Gynecology, or OBGYN, at Women's Healthcare PC at the Women's Hospital.

And today we'll be letting you in on what to expect with your upcoming C-section. Welcome Dr. Scordalakes.

Constantine Scordalakes, MD: Good morning. Thank you for having me.

Host: First off, what is a Cesarean section?

Constantine Scordalakes, MD: A Cesarean section, in contrast to a traditional vaginal delivery is delivery of the baby through an incision in the abdomen.

Host: And how common are C-sections?

Constantine Scordalakes, MD: The vast majority of deliveries occur traditionally or through vaginally. However, about approximately, depending on where you live and your facility and your provider; approximately 20 percent, at least at our facility, happen by Cesarean section.

Host: Okay. Good to know. And who's a good candidate for this procedure?

Constantine Scordalakes, MD: Really, anyone who cannot deliver vaginally or if we feel it might be safer to deliver through a C-section is a good candidate. The reason Cesarean sections tend to be less difficult if you will, or traumatic on the baby, versus a vaginal birth. And so it's, it's unfortunately a little bit more difficult or for the mom as far as the recovery, but easier on the baby.

Host: Right. And what are the different kinds of anesthesia for this kind of surgery?

Constantine Scordalakes, MD: Excellent question. The vast majority are done by something called either an epidural or a spinal. And then very, very infrequently we may have to do general anesthesia. But the benefits of a spinal or epidural is that the mom can be awake during the procedure.

Host: And why is that an advantage?

Constantine Scordalakes, MD: That's very important because we want every mom to have an excellent birth experience. We want her to start bonding immediately after delivery with the baby. And so when the mom is awake, she can partake in this miracle of birth and start the bonding process as soon as it's safe.

Host: Got it. Now, you know, there are so many misconceptions and preconceptions about C-sections. How do you talk to a patient about what to really expect?

Constantine Scordalakes, MD: Well, we kind of just go over what happens during the process. And that usually alleviates a lot of the misconceptions and anxiety surrounding C-section. So, essentially, we kind of say that you can either have a C-section that's going to be planned, or it's going to be one that happens when we make the decision while the patient is laboring.

 But either way, if it's scheduled, they'll come in an hour or two before their C-section, we'll get them ready, and then kind of walk back to the OR. If they're in labor and we decide to do a C-section, then we'll just kind of usually take them in a wheelchair or on the bed. If it's scheduled, they'll sit down, anesthesia will start by accomplishing anesthesia, and then they lay down, they're awake, we test to make sure that they have adequate anesthesia, we drape to make things sterile, and then we start the procedure.

If the patient requests, there's even a clear drape so she can see the entire procedure happening.

As soon as the baby's out, then we will, the NICU team will quickly assess the health of the baby. And once they've established the baby is doing well and safe, they wrap the baby and take it right over to mom.

Host: Beautiful, beautiful. Probably the biggest question I have for you today is what are the risks of having a C-section?

Constantine Scordalakes, MD: The risks of a C-section are the same as that of any surgery. So in general, we tell patients there's always a risk of bleeding. Sometimes, enough that it may require a blood transfusion. And risk of bowel, bladder, or other nearby organs. Luckily, those kinds of, complications or side effects are extremely rare.

Host: That's good. And another biggie for the women of course is what's recovery like after a Cesarean?

Constantine Scordalakes, MD: So the recovery is going to be a little bit harder than after a vaginal birth, but the good news is that the next day, women are usually up and walking and moving around. And after about six weeks, I think they'll feel pretty close, if not back to 100%.

Host: And do women stay in the hospital following Cesarean or do they go straight home?

Constantine Scordalakes, MD: They will stay in the hospital anywhere from two to four days, sometimes even longer if it's required. But the vast majority go home by the second or third day.

Host: Got it. Now, are there pain medicines that can be taken post surgery that won't harm the baby?

Constantine Scordalakes, MD: Absolutely. The vast majority of pain we can probably handle with just Tylenol and ibuprofen, which are over the counter. And we also have narcotics, which are safe to take even with breastfeeding.

Host: And the mother is able to breastfeed directly after birth?

Constantine Scordalakes, MD: Absolutely. As soon as she's able, it's okay to start the process of attempting breastfeeding. And again, it is safe to breastfeed while you're taking pain medication.

Host: Got it. Well, I think that's all I have. Is there anything else you'd like to add to our conversation?

Constantine Scordalakes, MD: I just want to thank you for having me, and again, we value our patient's feedback, and we seek to continually improve. And, we want every mother to have an excellent birthing experience, whether it's vaginal or by C-section. We just look forward to hearing, uh, everyone's feedback and comments.

Host: That's wonderful to hear. And it's been a real pleasure, Dr. Scordalakes. Thank you so much for being with us today to talk about Cesarean sections and what to expect. We really appreciate you being here.

Constantine Scordalakes, MD: It's been my pleasure. Thank you.

Deborah Howell (Host): And for more information, you can go to whcpc.com. And that wraps up this episode of the podcast series from Deaconess, the Women's Hospital, a place for all your life.

Please remember to subscribe, rate, and review this podcast and all the other Deaconess Women's Hospital podcasts. For more health tips and updates, follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.