Cesarean section (operative delivery) is abdominal surgery. With this, the fetus is pulled out through a cut of the abdominal and the uterine walls.

What examinations are needed during the preparation for birth by Cesarean section?

- Gynecological examination – with this the attending gynecologist observes the degree of cervical enlargement;
- Ultrasound Diagnosis (UDD) - this examination defines the parameters of the fetus and its predilection, i.e., his position in the mother's womb;
- Measuring the baby's heart tones;
- A series of laboratory tests that include complete blood count, biochemistry (glucose, urea, creatinine, total protein, bilirubin, aspirin, ALAT), hemostasis (bleeding time, prothrombin time, aPTT, fibrinogen), chronic infections (AIDS, Hepatitis B, and C), vaginal secretion microbiology;
- Consultation with an anesthesiologist and an internist/cardiologist.

The hospital’s team prepares all necessary documents of Dr. Shterev Hospital patients. If the future mother has been monitored in another hospital but wishes to deliver in Dr. Shterev Hospital, it is advisable to choose a gynecologist at least a month before the predicted date of birth. Thus the chosen Ob/Gyn will read all the medical documentation for her previous pregnancy monitoring results and will receive data on the health of the patient. The doctor will do an ultrasound examination and will learn what the baby condition is. Thus the gynecologist and his team will be fully prepared for a smooth delivery.

If the pregnant woman does not monitor her pregnancy at the Dr. Shterev Hospital, in addition to the described Ultrasound examination, in the last month of her pregnancy she has to make four visits to record the baby's heart tones, as well as additional examination assigned to her individually by her Ob/Gyn.

Future mothers who want to deliver at Dr. Shterev Hospital later during their pregnancy has to provide the following documentation:

- Exchange card from the female counseling, which contains all the medical records from the beginning of her pregnancy until her first visit to the Dr. Shterev Hospital;
- Hospitalization Direction (Forms of the Ministry of Health and NHIF No. 7) - when the woman has a continuous contribution to the public health insurance and the birth will be on a clinical path;
- An outpatient card for issuing hospital papers required for the period before and immediately after birth.

These documents are provided at the first visit by the future mother. Pregnant women who follow their pregnancy at the Dr. Shterev Hospital from the outset do not need to give any additional papers as the hospital's administrative team prepares them.

Due to the nature of the surgical birth, it is necessary that all patients sign the "Informed Consent Protocol for Caesarean section" and "Protocol on the anesthesiology consultation.

Planning of the Cesarean section at Dr. Shterev Hospital

The pregnancy monitoring OBI/GYN offers the period for doing the planned Cesarean Section. The dates are close to the term of natural birth (they differ not more than 10-12 days when the pregnancy goes normally).

The patient should come to the hospital 2 hours before the planned Cesarean Section, and the last food and liquid intake should be not later than 22 o’clock on the previous evening.

If the patient has received contracts before being registered, she should contact her gynecologist. If the birth starts at night or on weekends, then she should call her gynecologist or come directly to the hospital for examination and hospitalizing.

What should you bring with you to the hospital for a Cesarean birth?
Besides her ID-card, the pregnant women should have with herself the document for hospitalization, if she had not provided such during the last month of her pregnancy.

All the supplies needed by the woman for her stay at the hospital are provided by the Dr. Shterev Hospital so that in this crucial moment the patients may focus on the most important - the emergence of the new life. They receive personal cries, nightgown, bed linen and towels, disposable slippers, ladies' dressings for nursing mothers and breastfeeding pads. All mentioned is included in the price, which is paid for a natural birth at Dr. Shterev Hospital. Meet our official price list here!

Every woman can bring what she thinks she needs and does not fit into the list of supplies provided by the hospital.

How does birth with cesarean section go?

Preparation for Cesarean section birth since the entering the hospital until the patient enters an operating room takes about 45 minutes, during which a gynecological examination, recordings of baby tones, cleaning and enema are done. The patient is dressed in a nightgown and lays on a bed where with an abbot she gets some special fluids, and then the anesthesia starts. This procedure takes 5 to 10 minutes. The future mother lays on one side with bended knees for better access to her spine. An experienced anesthesiologist, who is part of the birth team, determines the place of anesthesia and applies it. The anesthesia starts to work right after. The patient is fully conscious but immobilized from the waist down. This spinal anesthesia is harmless to both the mother and the baby. Immediately before the start of surgery, but after anesthesia, a urethral catheter is placed. The team assembles a barrier, and the future mother can not directly monitor the operation.

The first cut during cesarean section birth is just of the first layer of the skin. All other layers of the abdominal cavity are removed without tools. There is no muscle cutting, so the surgery traumas are less and this helps the fastest recovery of the patient.

The second incision is on the uterus, the amniotic blister opens, and the baby is pulled out. The placenta and membranes are taken off and then comes the sewing of the surgical incision. The pull off of the baby takes 3-4 minutes to 10 minutes, and the surgery ends within 1 hour.

Right after the baby is pulled off, the umbilical cord is clamped, and it is taken by a midwife and a pediatrician/neonatologist. They do the baby's first cleaning. The baby is given to his mother for a while, and then the midwife and the neonatologist take care of it in its early few hours and monitor its life functions.

Prepare for the upcoming birth with a visit to the School for Future Parents "We create joy"! Learn more about the initiative here and book your participation on 02/9200901!

Hospital stay

The minimum stay in the hospital after a Cesarean birth is four days. After the surgery, the patient stays 24 hours in Reanimation sector under active monitoring by OBI/Gyn and anesthesiologist. After this period the women are moved to the Maternity ward. During her stay there the mother is actively monitored 24 hours a day. The purpose is to prevent infections, to monitor her recovery and to ensure proper breastfeeding and first care for the newborn.

Every day she is examined by her gynecologist, who checks the condition of the uterus, the incision, the loci, the temperature, and the pulse are measured. To prevent infection due to the abundant licking secretion, the woman goes through a compulsory toilet twice a day, which is facilitated by the comfortable bathrooms available in each of the rooms in the maternity ward at the Dr. Shterev Hospital. Follow-up is also the beginning of lactation (breast milk) to ensure effective breastfeeding.

First care for the newborn

The first care for the newborn begins from the moment of its appearance when a midwife and a neonatologist take it, the umbilical cord is clamped, and the baby makes its first cleaning as a newborn. In the next days of its stay in the "Dr. Shterev" Hospital, the general condition, the growth and the weight of the newborn are monitored every day. It goes through compulsory vaccinations on an immunization calendar:
- After 24 hours – against Hepatitis B;
- After 48 hours - against tuberculosis;
- After 72 hours blood is screened for of congenital diseases (phenylketonuria, hypothyroidism).

If desired, the mother may refuse to vaccinate her baby by signing a declaration.

During her hospital stay, the women get 24 hours of support and help by the midwives with the first care for the newborn. Our team teaches the new mother how to treat the bellbottom of the baby, how to breastfeed it and how to do its everyday cleaning. Dr. Shterev Hospital provides everything necessary for the baby during the first days after birth.

The hospital discharge of the women and the baby is after the end of the 5-days after the postpartum recovery in the Discharge Room of the hospital.

Pregnancy and birth are the most important part of a woman's life. Meet your adherents in this exciting adventure in the face of obstetricians, midwives, anesthesiologists and the whole team of Dr. Shterev Hospital!

Book an appointment with your doctor on 02/920 0901! Follow our public channel at Viber to make your access to professionals comfortable and convenient! Write a personal message to our official Facebook page to learn your gynecologist schedule or sign for your baby's tune-up!

The pregnancy lasts around 280 days, but the real change in future mother’s life starts at the moment when her child is born. At Dr. Shterev Hospital we know how crucial this step in the new life is and have dedicated our modernly equipped and cozy maternity ward. After accurate pregnancy monitoring, each woman does final examinations, and on the day of birth, she is surrounded by a team of medical specialists like OBI/Gyns, midwives, anesthesiologists and neonatologists. The Cesarean section gives a lot of answers for different medical issues and hours after it the mother can hug her newborn baby. The recovering lasts five days as the first 24 hours are in the reanimation sector to guarantee the health and complete care for the mother and the youngest patients.