C-Section operations are not all the same

A while ago on BB i posted a thread asking if a particular method of c-section was used in australia and was told that it most likely was. I also called a hospital and the midwife confirmed the method, but wasnt sure if any of the obs at her hospital performed it.

Well I spoke to my Ob about this particular method this week and he didnt really know what i was talking about. After i explained it he said he would be happy to do it for me. But if i didnt ask him, i would not get the operation I want. So I just thought i'd post some info about different methods used in c-sections because i believe that we should have the choice of what sort of operation we would prefer...especially for elective c-sect.

The most common incision made is the LOW TRANSVERSE INCISION otherwise known as the Bikini Cut. This is a low risk incision and allows most women to attempt a VBAC with little risk of ruptures.

Most obs use this in normal circumstances but what they dont use is one particular method of making the cut. The muscles in your stomach do not have to be cut; they can be pulled apart....its important to know that this is possible because if the muscles are pulled apart rather then cut, the recovery is easier, there is less blood loss and less pain. The pull apart method is called the 'MISGAV LADACH' method but not all australian obs use this method. Its used overseas a lot with really good results and has become the prefered method of cut.

Study into the benefits of the Misgav Ladach technique 2004

The CLASSICAL INCISION made vertically, its what was performed decades ago as the norm. Today its only used in complicated situations such as placenta previa, emergencies, or babies with abnormalities.

The most rare of the cuts is the LOWER SEGMENT VERTICAL INCISION. This is only used if there are problems with the uterus that would not allow another type of incision to be made.

Knowledge is power! ;)

Fantastic information!

wow very interesteing

interesting. out of curiosity - who is your Ob? Just so I can say "so and so does it" when I go back for another bubba!

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interesting. out of curiosity - who is your Ob? Just so I can say "so and so does it" when I go back for another bubba!

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i've just begun to see Jan Naidoo from the sunshine hospital.

He came very highly recommended and has a lot of experience and a lovely man. I was surprised though when he said he doesnt do the misgav method...he said he cuts the muscle to get to the uterus

thankfully he said he'll do it the way i've requested though...thats the benefits of going private. I just wish i had of known about it years ago. The method came about only about 10 years ago, so its still fairly new and australia usually is behind the rest of the world in many areas.

Great info Peg. FWIW my OB didn't cut my stomach muscles, he pulled them apart as per the method you described. I guess is just the way he does it because I'd never heard of the method and didn't ask before hand. If anyone would like his details PM me because I found him fantastic!

Fantastic information, especially for those who are faced with c/section.

Miss E - I'd love your Obs details!

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Miss E - I'd love your Obs details!

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Dr. Haider Najjar

I asked my OB today and he confirmed that he pulls the muscles apart verus cutting them as well, he did my last CS and i had a good recovery, although i had no idea what method he used. Thanks for bringing it to our attention!!!

its great to hear that there are some obs who use the pull apart method

hopefully it becomes more widespread in the years to come.

Wow, thats very interesting. I am now intrigued as to what method was used on me??? Might have to give the hospital a call. Thanks for sharing the info Peg :)

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Wow, thats very interesting. I am now intrigued as to what method was used on me??? Might have to give the hospital a call. Thanks for sharing the info Peg :)

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your welcome

;)

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Dr. Haider Najjar

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Mother Goose, just wanted to add that I can't recommend him highly enough. I found him incredibly supportive throughout my pregnancy and he was also really supportive of my birth wishes. When things didn't go to plan I was so glad that I had an OB who I trusted completely. The other thing I love about him is that he is truly passionate about what he does, on a number of occassions we talked about the magic and miracle of pregnancy and birth, I could be wrong, but I think it is pretty rare to find an OB who is so passionate about what he does.

Great post Peg, I don't 'plan' to have a C-Section but I will be asking my OB at my next appointment if he does this method so that I can request it now 'in case' one is really needed. Thanks so much for posting :)

I too had the pull apart thing done. My ob explained it beforehand. Recovery was excellent. I'm also hoping for less internal scarring and a better chance at VBAC as a result.

For the record, I had placenta praevia and a classical incision was certainly not necessary.

My first OB (with DS) used that method too - he's the president of RANZCOG.

I can only assume that my second OB used the same method too - unfortunately I don't have it on video to check - you can definitely see in my first birth video that the muscles were pulled apart rather than cut.

Interesting! The actual method used wasn't something I had looked into much. I had an elective c/s at a public hospital and had my muscles pulled apart rather than cut. From what the midwives and ob said I assume most c/s at this hospital are done this way. My recovery has been really good so far - I imagine it would be a lot more painful to have tummy muscles cut.

I also had my CS at a public hossy and the muscles were pulled apart rather than cut - i wasn't aware of the method at the time and never asked for a particular proceedure either, I recovered fairly quickly and now 2 and half years later feel great - The stitching was also fantastic and now my scar is near invisble. I had mine done on the sunshine coast, QLD if any one needs details.

That's really interesting, thanks for sharing :D I'll have to ask my OB what he did, but I did have a fantastic recovery so maybe he did. I've asked him before why my recovery was so good compared to friends of mine and his explanation was that he sews all the layers (I think he said there's 7 layers that need to be sewn) separately and he knows some other OBs sew them all together :o

SO it may be worth asking to have each layer sewn separately too?