Delivery by Caesarean Section

A cesarean section is surgery to deliver a baby through an incision in the mother's abdomen and uterus.

There are several reasons a woman might have a cesarean. She may have elected to have one due to her own worries about giving birth; or her OB-GYN may have advised one due to concerns that a vaginal birth might not be the safest way to deliver her baby. Also, if problems arise during labor that make it necessary to get the baby out straightaway, an emergency cesarean will be required.

Elective cesarean

A cesarean is elective when it’s planned before labor starts. You might choose this option yourself if you’re particularly nervous about vaginal birth, or it might be recommended for medical reasons – for example, if your baby is breech, his head is too big to pass through your pelvis or you’re pregnant with twins or multiples.

You’ll also need an elective c-section if you have placenta previa (where the placenta implants low down in the uterus, blocking your baby’s route through the cervix). Your OB-GYN may also recommend you have one if you’ve had a cesarean with a previous baby, as there’s a small risk of uterine rupture when you go into labor. An elective cesarean is carried out under epidural anesthesia or a spinal block, so you can remain awake for your baby’s birth.

Emergency cesarean

This will be unplanned and usually takes place if a baby is showing signs of distress, if labor is progressing very slowly or induction has failed.

An epidural can be used in an emergency if you already have one in place or if your OB-GYN is willing to hold off until one takes effect. However, in a ‘crash’ situation you may be given a general anesthetic. This may happen if a baby needs to be delivered immediately because:

• There are signs of placental abruption (when the placenta detaches from the uterus before the baby is born).

• The baby does not move into the pelvis, indicating that the pelvis may be too small for the baby to pass through.

• The baby is in distress or the cord has prolapsed (the umbilical cord has slipped into the birth canal, cutting off oxygen flow to the baby).

• The cervix stops dilating or dilates very slowly so that both mother and baby become exhausted.

What happens during a cesarean?

It may help to prepare yourself for a cesarean, so that if you do have one you know what to expect.

If your cesarean is elective you’ll be given an epidural or spinal block. You’ll feel a tingling sensation followed by heaviness in your legs as the anesthesia takes hold – your OB-GYN will check it’s working by spraying your legs with iced water. You’ll then have a catheter fitted – this is a thin tube that drains urine from your bladder. You won’t feel this procedure because of the numbing effects of the anesthesia and the catheter may be left in afterwards until you’re recovered enough to walk to the bathroom. Your abdomen will be swabbed with antiseptic before your OB-GYN makes the incisions and removes your baby. You’ll feel a tugging sensation but shouldn’t feel any pain (tell the doctors if you do feel pain). As in a vaginal delivery, your baby’s cord will be clamped and cut and he’ll be given a few routine checks.

In an elective cesarean you’ll be conscious throughout and will be able to hold your baby as soon as he’s born. Your birth partner can be present if they wish, but will have to wear hospital scrubs or a gown. A screen will prevent you from seeing the operation but a doctor or nurse may lower it slightly as your baby is pulled out, so you can see the moment he enters the world. Read preparing for a cesareanfor more details.

Your physical recovery

Most women will be able to walk again (slowly and painfully) the day after a cesarean. Try to walk as soon as you can, as getting mobile helps prevent blood clots after your surgery (you may be given compression hose as a safeguard). You’ll be given pain relief to help you cope and each time you walk it’ll be less painful than before.

The scar you receive is likely to be very small and just below your bikini line, so you can still wear a tiny bikini if you’re brave enough! Lots of women like their cesarean scar as it’s a constant reminder when they look in the mirror of the birth of their child.

How you’ll feel emotionally

Many moms feel disappointed after having a cesarean, especially if they didn't even go into labor (if they had an elective caesarean for a medical reason such as a breech baby, for example). Often moms feel as if they missed out on the birth experience and experiencing their babies come into the world via the traditional route. If you’re feeling down about not having vaginal birth, remember that your cesarean happened for a reason. That was the way your baby was meant to come into the world and you’ll still have your own special memories of this time.

Studies show there’s no difference in the bonding process between moms and babies who had vaginal births and moms and babies who had caesarean births. That said, it’s tougher taking care of a helpless newborn while recovering from major surgery and many moms feel overwhelmed. Remember to make sure your guests know that you need time to recover from the operation too and keep visits to a minimum unless friends and family have arrived to take your baby off your hands for a couple of hours so you can rest.

Will you need another cesarean?

As to the future, bear in mind that just because you had a cesarean for this birth doesn’t necessarily mean you’ll need one with any other babies you may have.

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