A cesarean delivery is more commonly referred to as a C-section. It’s a procedure to deliver babies through surgical means, through an incision in the abdomen. For many women, this is the safest way to deliver a baby and can also be considered safer for some babies.
Just because you have a C-section for your first baby doesn’t mean you will have to have one for a later baby. It is possible to have a vaginal birth later, but many women will choose or need the same surgery afterward. Your doctor will discuss your best options for your exact needs.
Not sure if a C-section is for you or whether you really need one? Want to know more about the procedure and things you can do to prepare? How about the steps to take afterward? There’s a lot to take in and you won’t always remember everything your doctor mentions. Here’s all you need to know about C-section deliveries.
Two Types of C-Sections
Your doctor will refer to your C-section as either Elective or Emergency. Elective C-sections are when the operation is fully planned from the beginning. You can book in for the procedure, everything is prepared in advance and you will have a care team already waiting for you. These are usually done when the doctor believes a C-section is best for your health and never during labor and delivery.
An emergency C-section covers all other types of C-sections. Even if a C-section was suggested but you opted to try a natural labor and ended up needing a C-section, it would be classed as an emergency one. They can take longer to recover from, especially if the procedure is performed during labor. Your body is already weakened, which can make the muscles extremely tired. You may need an extra care team and extra visits afterward to ensure you’re healing well.
There is a higher risk of infection and complications with an emergency C-section. This is why doctors prefer you to have an elective one if there is a high risk to your or your baby’s life.
Why Is a C-Section Performed?
While pregnancy and birthing are natural, there are some women who need medical help. This isn’t a new thing! People throughout history have performed C-sections. However, medical knowledge and tools now make it a safer option than in the past. When women would instantly die from the blood loss or subsequent infections, mothers have a higher chance of survival.
Your doctor will usually prefer you to give birth naturally. After all, it’s what the body is preparing to do and can be better for both you and the baby. Your body gets the memo right away to prepare milk for your little one and your baby is exposed to bacteria and yeasts within the vagina to help build up the immune system quicker.
However, there are times the C-section is considered the best option. Your doctor can decide during labor or beforehand, depending on your age, your pregnancy, and your laboring.
The most common reasons for a C-section mid-delivery include:
- The labor not progressing quickly enough, which can be due to the cervix not opening fully or your baby’s head not being able to pass through the birth canal. This can put extra pressure on the baby and cause distress for both of you.
- Your baby not getting enough oxygen, which can decrease the heart rate and put your baby’s life at risk.
- Your placenta is a risk factor, which can mean hemorrhaging or some of the placenta being left behind causing a bacterial infection. A C-section allows doctors to get into the womb and make sure the placenta is fully removed and more effectively stop the bleeding.
- There’s an issue with the umbilical cord, which may only be noted mid-delivery. In some cases, the cord is delivered first, which stops oxygen and nutrients getting to your baby during the delivery, putting their life at risk.
- Something obstructs the birth canal, such as a displaced pelvic fracture or other obstruction. Your baby gets to come out, so the doctor needs to go in a different way.
- The baby is turned the wrong way, so finds it hard to get out of the birth canal. This sometimes is only spotted mid-delivery due to movement and the length of laboring.
There are times that your doctor will discuss C-sections earlier. You can also talk to your doctor about this method of delivery.
The most common reasons include:
- A breech baby, which is when the baby isn’t facing head down. The positioning makes it extremely difficult and dangerous to give birth to the baby. While possible, doctors want the safest option for all.
- You’re having multiple babies, which can cause problems for your energy levels and put you at a higher risk of problems during labor. The doctor will just want to make sure all babies are delivered safely.
- There are known problems with the placenta or umbilical cord, so your doctor knows there could be a risk later in labor. Your doctor will see on scans if there is a higher risk to your pregnancy and will take steps to ensure delivery is as safe as possible for all.
- There’s a health concern, such as high blood pressure problems, preeclampsia or a complex heart problem. These issues can be within you or your baby. The delivery could be too arduous or cause severe problems.
- You’ve had C-sections in the past, especially if you’ve had multiple C-sections in the past. There’s a risk of the scar tissue tearing, which could cause hemorrhaging. Your doctor just wants the safest option for all.
While your first child may be born via C-section, doctors will try their best to encourage natural labor. There are risks to having C-sections, especially multiple ones. The only time they’re encouraged is if there is a serious medical risk of not having one or when problems occur during a natural delivery.
What Are the Risks Involved in Having C-Sections?
As mentioned, there are risks involved with C-sections. This is major abdominal surgery, which means a longer recovery time and all the other risks that come with having a surgery. You are at a higher risk of developing infections and severe bleeding.
There are other risks involved for both you and your baby. The risks to your baby include a surgical injury (due to accidental nicks) and breathing problems. Surgical injuries are extremely rare. Breathing problems can occur within the first few days of life and are more likely a problem in babies born before 39 weeks or where the lungs haven’t matured enough. Most elective C-sections are performed from 39 weeks onwards.
If the C-section is elective due to multiple twins or a high-risk pregnancy, your doctor will be ready for the breathing problem risks. Your baby is usually given steroids to develop the lungs more quickly. The medications can be given during pregnancy to help prepare the baby for early delivery.
When it comes to you, there are greater risks. Those who have a C-section are more likely to need another one for subsequent pregnancies. While a vaginal birth after cesarean is possible, there are risks of the scar tissue tearing and more women are encouraged to have a C-section instead. At one point, it was common practice to put women to sleep through general anesthetic to delivery through a C-section, which could put women at more risk.
You will usually have a spinal delivery by C-section. This form of anesthetic means you are awake, but some women do have reactions to it. Some reactions are minor, such as headaches in the days after delivery. However, you can also experience a drop in your blood pressure, which can lead to complications. You will be monitored throughout.
Some women develop endometritis, which is an infection and inflammation of the uterus’ lining. You will often experience fever and uterine pain, as well as some foul discharge. The condition often needs to be treated with antibiotics.
Many women will lose more blood through a C-section than they would with a vaginal birth. In some cases, this can mean transfusions are necessary. Emergency C-section patients are more likely to suffer severe blood loss than those who opted for the elective C-section. There is also a higher risk of blood clots developing, especially within the pelvis or legs. The clots can travel to your lungs, causing severe health problems. The risks are part of the reason you will be kept in the hospital for a few days after the procedure.
There are also risks in future pregnancies, which is why doctors will not encourage unnecessary elective C-sections in a first pregnancy. Not only can the scar tissue rupture, but the placenta can also detach and cause major problems. Other placental problems can also occur in subsequent pregnancies, leading to stillbirths, risks to the mother’s life, and more.
Like with your baby, there’s also the risk of a surgical injury to you. This is rare but happens when organs are nicked accidentally. The bladder, colon, intestines and other important organs are close to the uterus. In some cases, the scar tissue from the C-section connects to organs, causing them to combine. This problem may not be noticed until a subsequent C-section and can lead to health problems if they rupture.
Preparing for your C-Section
If you have an elective C-section, you will have the time to prepare. When there’s a risk of an emergency C-section, your doctor may offer tips to prepare just in case. However, it’s much harder to plan ahead for the emergency.
Most of the time, you’ll meet your anesthesiologist. This is the person who will look only after you during the procedure, while everyone else in the room is more concerned about the delivery. It’s important to feel comfortable to talk to your anesthesiologist, so you can share if you’re feeling dizzy or in case you go into shock.
You may have blood tests just before the C-section. The tests will check for infections you may have that you can pass onto your baby and will make sure your blood types match. If you’re rhesus negative and your baby is rhesus positive, your doctor will need to make sure there are medications available to protect any future pregnancies you may have. The blood tests will also help your team have the right blood on hand should it be necessary.
When the C-section is earlier than 39 weeks, your doctor may prescribe medications to support the baby. These are usually done in the weeks before and you may need some tests to see how much your baby has already matured. Taking some of the amniotic fluid to carry out an amniocentesis is the best option.
You will need to plan for the unexpected. Make a list of all your questions to ask your healthcare team and make arrangements with your family. What’s going to happen with older children you may have and who will be with you during the procedure? Depending on the age of older children, you may also want to discuss the procedure to make sure they’re ready.
In some cases, you may be asked to use antiseptic soap before the surgery to help minimize the risk of infection. This isn’t a common request. You will usually find doctors request that you don’t shave your pubic hair, as this can increase the risk of infection.
You may be given medication to take the night before and the morning of the procedure. Your doctor will also likely tell you not to eat within a certain number of hours before the procedure.
What Will Happen During the Procedure?
During most C-sections, you will be awake. It’s only in the most dangerous and risky situations that your anesthesiologist will put you to sleep for it.
Once the anesthetic has been administered, you will start to feel a numbing sensation from your waist down. This feeling will return when the anesthetic wears off. Your doctor will place a catheter into the bladed and IV lines will be put up to ensure fluid and some medications are placed into your body as and when necessary.
Now your doctor can make an incision through your abdomen, usually at the level of your bikini line. The line is horizontal and easy to hide with a bikini and underwear. In more serious situations, a vertical incision is placed from navel to pubic bone. The exact type depends on the emergency situation. The incisions are made one step at a time, through the wall, the muscles, the fatty tissue and to the uterus.
The uterus is then cut into, allowing the delivery of the baby and the placenta. A low transverse incision is the most common type of uterine incision, but this will depend on the medical issues and how the baby is lying.
After delivery, the doctors will clear your baby’s nose and mouth of fluid and cut the cord. The placenta is then fully removed and your incisions are closed up. During this time, you will likely be able to see your baby before doctors carry out blood and weighing tests, while you’re closed up.
When Can You Go Home?
You and your baby will usually stay in the hospital for 72 hours after the delivery of your baby. Your doctor will want to make sure you and the newborn are healthy and make sure you’re both ready for life outside. In some more serious cases, you both may need to stay in the hospital for longer.
In the majority of cases, hospitals will try to keep mother and baby in the hospital for the same length of time. There are times that either one will need to remain in the hospital for longer. The baby may remain in the nursery for as long as necessary if there are no other family members and the mother needs to remain in the hospital for longer.
Your health vitals will be monitored continually, as will the incision site. Your doctors want to make sure urine output is normal, there’s no infection and no signs of dehydration. The baby’s vitals will also be checked regularly to ensure no infection and no dehydration.
There may be some lactation consultants in the hospital to help with breastfeeding. Discuss this option with your healthcare team. If you’re choosing bottle feeding, your healthcare team will usually arrange for supplies from the hospital to monitor the amount drank throughout the stay.
Once you do get home, take it easy and rest if necessary. This is major surgery and you will be slower than normal. Don’t lift anything heavier than your baby and don’t allow older children to jump on you. They will be excited, but they need to remember that mommy has had surgery.
Support your abdomen and take pain medication when needed. Most of the time, you’ll have Tylenol or something a little stronger, depending on the severity of the pain. You should also drink plenty of fluids throughout the day to prevent constipation and support breastfeeding.
Sex is likely not on the cards right now and you should avoid it until you’ve got the all clear from your doctor. This is usually around the six-week mark. You will also find you’re not able to drive until your six-week check.
If there is any sign of infection, pain within the breasts, foul discharge or urination problems, talk to your doctor. These are signs of a complication after the delivery.