Caesarean Section

A cesarean, also known as a c-section, is when a baby is delivered through an incision in the mom’s abdominal wall and uterus, rather than delivered vaginally. Currently, a little more than 30 percent of deliveries in the United States are by c-section.

For some moms, a cesarean birth is recommended by their doctor as a medical precaution even before they go into labor.

A planned cesarean might be recommended for a multiple pregnancy, or if the mom has had a Cesarean before. Other reasons for a scheduled c-section include if the baby is breech (feet or bottom first instead of head down), if the baby is very large, or if the mom has a chronic condition such as heart disease, diabetes, high blood pressure, or kidney disease, any of which would make a vaginal delivery more dangerous.

Some moms-to-be elect to have a c-section; however, doctors generally recommend a vaginal birth if it’s a low-risk pregnancy.

Although you might have hoped for a vaginal delivery, there are times when an emergency cesarean is required. Doctors might advise a cesarean delivery late in pregnancy or even during labor. For example, a c-section may be necessary in these situations: if the mom has preeclampsia or placenta previa (where the placenta detaches and comes out first before the baby), if the cervix stops dilating mid-labor, if there is a uterine rupture, or if the mom has an active herpes infection at the time of labor. An emergency c-section may also be recommended if the baby has a poor heart rate, if the baby is in distress, if there is a problem with the umbilical cord, or if the baby doesn’t move down the birth canal.

Preparation is much the same as for a vaginal birth — for example, you’ll need to pack a hospital bag and perhaps create a birth plan. Your physicians will also discuss pain management options with you ahead of time, and if it’s a scheduled c-section, you will need to fast the night before. Doctors will usually ask you to sign a consent form.

As with any surgery, you will be medically prepped, hydrated with IV fluids, and washed with an antiseptic solution. An epidural or spinal anesthetic will be administered in some cases, but for others, such as for some emergency c-sections, you might be put under a general anesthetic.

During the procedure, the surgeon makes a horizontal incision about four to six inches long along the pubic bone (where your bikini line is). He or she cuts through tissue and separates the abdominal muscles, and then cuts open the uterus. You might feel a slight tugging sensation, as the doctor guides your baby out. Then, the umbilical cord is cut, and the baby is lifted away.

Your partner will usually be able to join you in the operating room wearing the sanitary scrubs provided by the hospital. If you or your partner is squeamish, looking away as the baby arrives may be a good idea, although it is normal for a screening curtain to be placed between your upper and lower body.

After the birth, you will usually be able to see your baby; however, at this point, it may be brief, because staff will need to check your baby’s heart rate, color, and temperature. While your baby’s health is being checked, the placenta is removed, and the uterus and abdominal incision are stitched up. You will also be given antibiotics to help prevent infection.

Afterward, you will be closely monitored for several hours in a recovery room, but while you’re in the recovery room, you can hold your baby, try to breastfeed, and enjoy skin-to-skin contact.

If it’s a planned cesarean, you will most likely be able to have an epidural or spinal block and remain awake during the baby’s delivery. Sometimes during an emergency cesarean, the mom will be put to sleep under a general anesthetic to ensure a safe and fast cesarean delivery of the baby.

Though every woman’s situation is unique, the delivery of a baby via cesarean may take as little as 15 to 20 minutes, with a further 45 minutes needed to stitch up the uterus and abdominal incision.

There isn’t any difference between a vaginal birth and c-section regarding starting to breastfeed, and milk may or may not have come in at this point. Provided both you and your baby are doing well, your baby can try to latch on for some very nutritious colostrum shortly after delivery.

Recovery differs from person to person, but it generally takes longer to recover from a cesarean birth than from a vaginal birth. Usually you will stay in the hospital for a few extra days after a cesarean birth, so your doctors can make sure you are healthy and healing well.

Although it can be challenging with a newborn, try to rest as much as you can. Avoid lifting anything heavier than your baby, follow up with your doctor to have the stitches on your tummy removed (the uterine stitches will dissolve), and regularly clean the scar to avoid infection. Wear loose clothes that don’t rub or irritate the scar. Driving and exercise will also be off limits until your doctor gives you the all clear, usually around two to four weeks post-birth. Recovery from an uncomplicated cesarean can take four to six weeks.

Having a cesarean delivery is major surgery, and as with any birth, complications are rare but do exist. Your healthcare provider is the best person to advise on the best delivery option for your medical needs. Doctors always weigh any risks of a c-section against the risks of a vaginal delivery, so for peace of mind, always ask why a c-section is being recommended, and ask if any alternatives are available at all.

If yours is a scheduled c-section and your cesarean takes place before you go into labor, then you will not notice any signs of labor. However, sometimes it becomes clear that an emergency c-section is required once labor has already started. So whether you’re preparing for a c-section or not, it’s good to know the signs of labor that you can expect during your third trimester, usually between week 38 and week 42.

Try to remember that whether it’s a c-section or a vaginal birth, your medical team will be taking great care of you. In no time at all, it’s you that will be taking great care of your little one, as the birth fades into memory and you focus on the day-to-day tasks of parenting such as bathing and feeding your baby.