Cesarean Sections
Dystocia occurs when a pregnant animal is unable to deliver babies naturally through the birth canal. This may happen either due to poor muscle contraction or due to an obstruction within the birth canal (breech/abnormal positioning, head too large to pass through canal, etc.). Non-surgical treatments, such as calcium and oxytocin therapy, are also available for patients that do not have a blockage of the birth canal and when babies are not in distress.
How does the surgeon perform a C-Section?
In a C-section surgery, an incision is made along the mother’s abdominal midline (belly). The uterus is then examined and the location of the puppies/kittens is determined. One or more incisions are made in the uterus (hysterotomy procedure) to remove the babies. Each baby is passed off to a second care team, to care for the delivered babies while the surgeon completes the procedure with the mother. The placental tissue associated with each baby is removed. The incisions in the uterus can either be closed so that the uterus may remain in the body for future pregnancies OR the uterus and ovaries can be removed (ovariohysterectomy) so that no future pregnancies can occur - this is a spay procedure. The body wall and skin are then closed and the mother is recovered. As soon as the mother is out of anesthesia, she is placed with her babies so that they can nurse. Regardless of whether the uterus is removed or remains in place, the mother should be able to nurse the babies normally and have good milk production.
Care is taken to remove the babies as quickly as possible so that they are minimally impacted by the anesthesia given to the mother. Medications used as part of surgery and given to the mother to go home are carefully chosen to reduce impact on the growing babies. Most pets can be discharged within a few hours of recovery from anesthesia after a C-section and they do not need to spend extensive time in the hospital once they are awake.
What are some of the indications that an emergency C-Section is needed?
C-sections can be performed on an emergency basis when an animal is experiencing difficult labor, or they may be scheduled on an elective basis once a pregnancy is full-term for animals that are not expected to pass babies normally on their own (certain breeds such as mastiff and bulldog-type breeds have a high chance of requiring veterinary assistance with labor). In some cases, if a fetus dies in uterus, a C-section may be needed to remove the fetus so that the mother does not become sick due to an infection.
The American Kennel Club website provides great information on pregnancy, labor and when to seek veterinary care for dystocia.
In general, these are signs of concern that may indicate your pet needs emergency care:
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Stage 1 of labor (panting, shaking, anxiety-type behaviors) lasts for more than 12 hours
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Stage 2 of labor (pushing) lasts more than 4 hours with no babies delivered
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More than 2 hours has passed since the delivery of a baby and pushing is still occurring (or there are known to be more babies that still need to be delivered)
TREATMENTS & DIAGNOSTICS FOR CESAREAN SECTIONS:
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X-rays can be taken to determine if any babies are present within the uterus, determine their approximate age and count the number of babies present
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Ultrasound can be used to evaluate babies in the uterus and count their heart rates. Fetal heart rate is an important indicator of whether the babies are in distress
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Calcium and oxytocin (delivery hormone) can be administered to pets that are having poor contractions that are preventing them from delivering full-term babies. This is not recommended for pets with a blockage in the birth canal due to a malpositioned baby or when the fetal head is too large to pass.
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Occasionally, a veterinarian can use digital pressure and manipulation to attempt to reposition a malpositioned baby to allow it to pass through the birth canal.
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C-section surgery can be performed when there is a difficult birth and babies cannot pass through the birth canal on their own or when babies are in distress and need to be delivered quickly.