Yes, the baby is closely monitored during a C-section delivery. There are several ways that doctors and medical staff keep track of the baby’s wellbeing throughout the procedure. Monitoring the baby is a top priority, as it allows the surgical team to immediately intervene if there are any signs of fetal distress.
Fetal Heart Rate Monitoring
One of the main forms of monitoring done during a C-section is tracking the baby’s heart rate. There are two methods used:
External Fetal Monitoring
This involves strapping two sensor belts around the mother’s abdomen. One belt uses ultrasound to detect the baby’s heart rate. The other belt monitors contractions. The belts are connected to a machine that prints out a paper tracing of the baby’s heart rate and the mother’s contractions. This allows doctors to evaluate the baby’s heart rate patterns and make sure there are no concerning changes.
Internal Fetal Monitoring
This method involves attaching an electrode directly to the baby’s scalp during the C-section. The electrode records the baby’s heart rate and sends the information to a monitor. Internal monitoring provides the most accurate and immediate picture of how the baby is tolerating labor and delivery. It allows doctors to detect any drops in heart rate right away so they can intervene if needed.
Doctors will often use internal and external monitoring together to get the best assessment during a surgical delivery. The combination provides both an ongoing, comprehensive view and the capability to detect more subtle changes.
Tests During Delivery
In addition to fetal heart rate monitoring, doctors can run tests during the C-section to check on the baby’s health status:
Fetal Scalp Blood Sampling
If there are any concerns from heart rate monitoring, the doctor may take a small blood sample from the baby’s scalp. This blood is tested for pH levels, which indicate if the baby is receiving adequate oxygen. It allows immediate detection of fetal distress.
Pulse Oximetry
A pulse oximeter can be placed on the baby’s hand, foot or head as soon as the head is delivered. This non-invasive device measures the baby’s oxygen saturation levels. It ensures the baby is getting enough oxygen throughout the rest of the delivery.
Visual Assessment
The surgical team also observes the baby visually to make sure it is OK. Here are some of the things they look for:
– Muscle tone – They check if the baby is moving actively, which indicates it is getting oxygen. Limpness could be a bad sign.
– Breathing efforts – They watch to see if the baby starts breathing as expected after birth. Delayed breathing could require stimulation and suctioning.
– Color – A healthy pinkness indicates good oxygenation and circulation. Paleness or blueness could indicate problems.
– Activity level – They observe if the baby is alert and responsive when delivered. Poor activity can signal fetal distress.
Umbilical Cord Monitoring
Doctors carefully monitor the umbilical cord during a C-section. They want to ensure there is adequate blood flow through the cord to the baby. Stress on the cord, crimping, or pressure could impair oxygen delivery.
Some ways they monitor cord health:
– Ultrasound – Using a sterile ultrasound probe to visually assess blood flow through the cord prior to delivery
– Observation – Looking for a pale, tightly coiled or compressed cord when the uterus is opened, which may indicate compromised flow
– Doppler device – Using a hand-held Doppler scanner to listen for the cord’s heartbeat
– Restricting cord traction during delivery – This prevents impedance of blood flow
Presence of Neonatal Team
For every C-section, there are specialized providers present focused just on the baby. This neonatal or pediatric team may include:
– Neonatologist – A doctor specializing in the care of newborns
– Pediatrician – A doctor specializing in child health
– Neonatal nurses – Nurses with expertise in caring for babies immediately after birth
– Respiratory therapist – To help with breathing issues if needed
Having this team present ensures any problems can be addressed immediately. They thoroughly assess the newborn after delivery and can perform resuscitative measures if required.
Putting it Together: A Typical C-Section Delivery
To see all these monitoring methods together, here is an overview of what typically happens during the delivery portion of a C-section:
1. External fetal monitors are placed to observe heartbeat and contractions
2. The mother’s abdomen is prepped surgically
3. The mother is given anesthesia
4. A catheter may be placed in the baby’s scalp for internal monitoring
5. The abdomen is surgically opened and the uterus is exposed
6. A sterile ultrasound is used to visualize the baby and umbilical cord
7. No concerning changes in heart rate or oxygen levels are seen prior to delivery
8. The amniotic sac is opened and the fluid is suctioned out
9. The neonatal team is present and prepared to receive the baby
10. The baby’s head and body are gently lifted out
11. The umbilical cord is assessed – good color, pulsations felt
12. The baby starts crying and has good muscle tone
13. The cord is clamped and cut
14. Baby is immediately brought to warm station for assessment
15. Apgar scores at 1 and 5 minutes are 9
16. Oxygen saturation levels are normal
17. Baby is placed skin-to-skin with mother and appears healthy
Conclusion
Monitoring the baby during a C-section delivery is a highly coordinated effort between the obstetrics, surgery, pediatrics, and nursing teams. Fetal heart rate, oxygenation, umbilical cord flow, and newborn transition are all closely watched. This vigilant monitoring allows the doctors to ensure the baby remains safe throughout the procedure and after birth. While a C-section requires major abdominal surgery for the mother, it can be an extremely controlled delivery resulting in excellent outcomes for the newborn.