Having a C-Section? What You Should Know
Are You Going to Have a C-Section?
Very few women, upon learning they are pregnant for the first time, expect to have a c-section, yet every year thousands of women give birth in that manner. Most women expect to deliver naturally or vaginally, but many end up needing a cesarean birth if labor isn't progressing, if the baby is in distress, if the baby is premature, or if labor would be dangerous for the mother. Others choose to have a c-section, simply because they don't want to experience the pain involved with a vaginal birth or for some other personal reason.
If you are pregnant, it's best to prepare for the possibility that you too will have a c-section, even if it isn't in your plans. Here you will find information regarding how you can prepare, the procedure, emergency c-sections, scheduled c-sections, and recovery from c-sections.
Also included are four of my personal stories.
C-Section Rate in the U.S.
Today, every 1 in 3 births will be via c-section. Many of these are emergency while some are elective or scheduled.
How to Prepare for a C-Section
Even if you're planning for everything to go well during labor and delivery, it's best to know what to expect should an emergency arise during labor. You can prepare yourself, your partner, and your family by doing a bit of homework:
- Speak with your doctor or midwife. The first person you should speak with about a cesarean delivery is your doctor or midwife. As a medical professional, he/she will be able to tell you what the probability of having a c-section will be for you, along with what will happen should your labor not progress. They will probably discuss what steps they would take before considering a c-section.
- Read a pregnancy book or magazine. There are many great books and magazines out there that have a plethora of information about c-sections. My favorite books to read were What to Expect When You're Expecting , Your Pregnancy Week by Week, and Your Pregnancy and Childbirth Month to Month . Each book explains everything thing there is to know about c-sections. Magazines also offer great information about c-sections and sometimes give different perspectives about the procedure. American Baby is a free publication from Parents magazine that has great pregnancy information.
- Take a childbirth class. Childbirth classes are designed to prepare you for all aspects of birth. During these classes, they will discuss c-sections and allow you to ask any questions you may have. Ask your health care provider about classes in your area or attend an online class, like the one offered from Baby Center.
- Speak with others who have had c-sections. I always found that the best way to find great and helpful information is to speak with those who have experience! Speak with friends or family members who had c-sections and ask them for their perspective. You can also chat with many women online in pregnancy forums. Keep in mind though, especially when hearing difficult stories: what happened to another woman may not happen to you.
Hospital Bag for C-Section
Boppy nursing pillow (for baby or belly)
nursing gowns or nightgowns
cell phone and charger
going home outfit
sleeping pillow and extra blanket
insurance information and ID
C-Section Surgery Video (Viewer Discretion is Strongly Advised)
Reasons for C-Section
There are several reasons why you may need a cesarean:
- Labor does not progress. This is the most common reason for the need of a c-section. If contractions are not strong enough to push the baby through the birth canal or if the baby will not fit through the birth canal, labor will be prolonged. This is dangerous especially when the bag of waters has ruptured, since it can lead to infection.
- Baby is in distress. Sometimes, if a labor does not progress normally, the baby may seem distressed. This is usually shown by a drop or even a sudden increase in the baby's heart rate, but the fetal monitor may find other signs as well.
- Mom is in distress. There are times when a mother's health declines during labor. Some women have difficulty enduring labor due to high blood pressure or other conditions. If at any time your health is at risk (which ultimately puts the baby's health at risk), your doctor may consider a c-section.
- You are having more than one baby. Twins and other multiples will most likely be delivered via c-section due to their positioning in the uterus. Of course, if both are facing the right direction, you may try to have birth vaginally.
- Baby is larger than expected or birth canal is too small. Babies come in all sizes, but some are just too big to fit through the mother's birth canal. One reason for this is gestational diabetes, which can cause babies to grow to a larger size than average. In some cases, it is not the baby's size that's the problem; the mother's birth canal may just be too small for delivery.
- You have issues with your placenta. There are times when a placenta has detached from the uterine wall or is blocking the opening of the cervix. Both cases would need a c-section to keep the baby healthy and to prevent you from losing too much blood.
- You have an active herpes infection. If you have a herpes infection that is active when you go into labor, the doctor will most likely choose to deliver the baby via c-section to prevent the infection from spreading to the baby. If a newborn gets the infection from the mother, consequences such as blindness can occur in the newborn.
- This is not your first c-section. Even though VBACs (vaginal birth after cesarean) are encouraged if you had a previous c-section with no complications and a horizontal incision, you still may want to consider a second c-section. You may be at risk for uterine rupture or excessive bleeding if you try to labor. On the other hand, if you had a vertical incision, you will need to have c-sections for any subsequent births. Discuss these things with your doctor and do what you believe is best for you and your baby.
There are also women who choose to have a c-section even though there may not be a need to have one; this is called an elective or scheduled c-section. Some are afraid of the pain of natural labor while others may like that they can choose the day their baby is born.
How Long Does a C-Section Take?
The total time of a c-section is about 45 minutes to 1 hour, which varies due to unexpected circumstances.
Prep for the surgery takes about 15-20 minutes. That includes getting the spinal block, IVs, attaching various wires, and prepping the abdomen.
From the start time of the surgery until the baby is taken out of the uterus is approximately 3-5 minutes. The closing of the incisions takes up the rest of the time.
Risk of Cesarean Section
As with any major surgery, there are risks:
- Infections of the uterus, skin, or pelvic organs
- Loss of blood
- Blood clots
- Injured bladder or bowel
- Negative reaction to medications
Baby After C-Section
Here is the procedure that is followed for a c-section delivery:
- The mother is given medication to numb the lower half of her body (what kind depends on type of c-section). A catheter is inserted into the bladder to keep it out of the way during the surgery. She may be given oxygen, and will be monitored for blood pressure and pulse. Arms and legs will be strapped down to prevent any movement during the procedure.
- Her belly is swabbed with an antimicrobial solution (iodine) and curtains are hung so that neither she nor her partner can see the actual operation.
- The medical staff prepares the equipment, making sure all necessary instruments are in place and they are ready to take care of the baby once delivered.
- Once the doctor is ready to begin, the partner, who must wear sterile hospital clothing and a mask, may enter and sit by the head of the mother. A camera may be used once the baby is born.
- When the mother is numb, the doctor makes the first incision into the mother's belly, right above the public hairline. It is usually a horizontal cut, but in some cases it may need to be a vertical cut.
- The doctor and assistants spread the abdominal muscles to get to the uterus. Another incision is made in the uterus, again either horizontal or vertical. Most of the time, a horizontal incision will be made in the lowest part of the uterus since the incision will heal the best there and cause less bleeding. If the baby is not in the right position or there's a problem with the placenta, a vertical cut may need to be made, which will prohibit you from a VBAC in the future.
- The baby is removed from the uterus, his/her mouth being suctioned as the head is delivered. The cord is cut, and the nurses take the baby to clean him/her and take the vitals. Once that is done, you are shown the baby, all swaddled in a blanket.
- The placenta is removed from the uterus and all incisions are closed. The skin incision in your lower belly will either be closed with staples or stitches. Tape is sometimes placed over the closed incision.
Emergency cesarean deliveries are the most common. They usually occur after the mother has labored for a prolonged period, but they can occur if there is an urgent need to deliver the baby quickly either due to the mother's health or the baby's health.
If the surgery is to take place after a prolonged labor, usually a spinal block or epidural block is used to numb the mother. In extreme cases, the mother may need to undergo general anesthesia. If that is the case, then the partner is most likely not permitted to attend the delivery.
The procedure for the delivery remains the same.
Elective or Scheduled C-Section
Elective or scheduled c-sections occur for a few reasons: delivery of multiples, a previous c-section, or by choice of the mother. Basically, the doctor and parents decide on a date prior to the actual due date of when to deliver the baby.
The morning of the delivery, the mother and partner will be asked to arrive early to complete any necessary paperwork and to monitor the baby's heart rate and activity. When it comes time for the surgery, the mother will be given either a spinal or epidural block, and the standard procedure will be followed.
Note: Even though you arrive early in the hospital that day, all other natural deliveries or emergency deliveries will take precedence before your delivery. You may need to wait hours until the staff is ready to deliver your baby.
Usually, an elective c-section is planned approximately one week before the due date of the baby. Why is it so close to the due date? The doctors want to be sure that the baby is fully formed and not pre-term with breathing or other complications. It is possible, however, that your baby may have other plans and you may go into labor earlier than planned, as I did with my second baby.
There are risks even after the c-section surgery, which include:
- infection of the incision
- fever, which may indicate infection
- extreme pain
- blood clots
- scar tissue inside the pelvis that adheres to other organs
- additional surgeries to correct any issues
- reactions to medications
- infertility from injured reproductive organs or malformed scars
- extended hospital stay
- extended recovery, even beyond the normal six weeks
You will have a scar in your pelvic region from the surgery. Most scars are a horizontal line right above the pubic bone that will fade over time and be a slight line. Others may be a vertical line that too will fade over time.
If you are worried about the look of the scar, there are creams to use to reduce the look of the scar. Consult your doctor before you use such a cream.
Recovery for C-Section
Since a c-section is considered major surgery, it will be a long while before your body is recovered. Six weeks is usually the time frame for recovery from this operation.
After the surgery, you will be placed in a recovery room where nurses will monitor your progress, checking your pulse, blood pressure, and incision site. Depending on the condition of your baby, you may or may not see him/her. If you are able, you will be encouraged to breastfeed should you choose to do so. If the baby is being cared for elsewhere, try to get some rest before you are moved to your hospital room.
You will probably be in the hospital for about 2-3 days after the birth. For approximately 24 hours after the surgery, you may need to stay in bed until feeling returns to the lower half of your body. During that time, your catheter from the surgery will be removed and you will be encouraged to void and move your bowels on your own. Your incision will be checked periodically, and if you have stitches, they may be removed before you leave. If you experience pain, you will be given pain management in the form of medication. You will be able to drink water, and your first meal may be liquid to help your digestive system get back on track and keep it easy on your bowels.
For six weeks you will be told to take it easy, which means you need to be careful when lifting anything (including the baby), and you may not be permitted to drive until you are healed. You should also take it easy going up and down stairs, mostly to prevent injuries sustained from falling.
The best exercise you can do is walking. Walking will help you to stay active while being easy on your body. Just a little bit of time each day will do wonders for you, helping you to get back on your feet and keep your bowels moving. As each day progresses and you feel better and better, you can increase your walking time.
Once you have your six week appointment, you may be allowed to have intercourse again, but it is strongly recommended not to get pregnant again for at least another year. Getting pregnant too soon after a c-section may not be wise since your incision in your uterus needs proper time to heal.
Emergency C-SectionClick thumbnail to view full-size
Giving Birth by C Section
When I was pregnant with my son, I was expecting to deliver naturally. Two weeks before he was due, I went into labor at 2 a.m. We went to the hospital, went through all the preliminary prep, and settled in for a long labor.
Boy, I had no idea what I was in for.
After a few hours in the hospital and a lot of walking around, I had only progressed to about 4cm and the baby had not come down. To stimulate contractions, I was given pitocin and my water was broken. Contractions were very intense after that, so intense that they had to remind me to breathe-actually breathe-until the contractions passed. To ease my pain, I asked for an epidural, which helped me to relax.
Eight hours later, after all that plus trying to push, the doctor determined that even though my cervix had dilated, the baby was not coming down through the birth canal and would have to be delivered by c-section. Although I had planned to give birth naturally, I was relieved that my baby would be delivered in a safe manner.
Since I already had an epidural in place, all the medical staff needed to do was wheel me into the operating room and top off the epidural. Once they were ready, my husband was brought in and the baby was delivered. My incision was closed with staples and I was sent to recovery where I slept until they took me to my room.
Upon delivery, the medical staff discovered that the baby wasn't in the best position for a natural delivery. Besides being larger than expected for his gestational age, he was facing the front of my belly instead of my spine, making it difficult for his head to fit through the birth canal.
Pain the first night was a bit difficult, but the second day I was feeling great. I was able to get some sleep at night since the baby was kept in the nursery and only brought to me for feedings at night. After six weeks of recovery, I felt wonderful.
Second C-Section Story
When I was pregnant with my daughter, my doctor and I decided it would be best if I had a second c-section since the risks of a VBAC were too great. We scheduled a date just a few days before my actual due date, but my daughter had other plans. Three weeks before she was due, I went into labor. Since my doctor was away, I had an on-call doctor take over my case.
What was supposed to be an 'easy' scheduled c-section for me became painful as I was once again in real labor. This time, I walked into the operating room led by the nursing staff. I was given an epidural block on the table, which was a difficult task due to the incredible pain I had from contractions.
The procedure once again went smoothly. The baby was delivered and my incision was this time closed with sutures. Both the baby and I went to the recovery room where we stayed for a while.
The recovery for this birth was more difficult for me. The baby had to room in with me due to new hospital policies, which made it incredibly hard for me. Any time she cried, I either had to wait for the staff to lift her for me or get her myself (which I ended up doing most of the time). Also, once at home, I not only had a baby to take care of, but I also had a toddler to care for. Thankfully I had plenty of help so I was able to be back on my feet within the six weeks of recovery.
Third C Section
Third C-Section Story
As with my first two babies, my doctor and I decided on another c-section, and scheduled it for the week before my third baby was born. Like my daughter, my son had other plans and I started to labor five weeks too soon. Labor was stopped, but he decided to try to come again two weeks later. I was in labor for nearly 12 hours before it was decided to do a c-section.
The baby roomed with me again, but this time I had no issues. I found it easier to get him myself than to wait for the nursing staff.
My recovery time felt shorter, and I think it was due to successful breastfeeding and all of the help I received. Plus, I was kept very busy with a preschooler and a toddler running around!
Fourth C-Section Story
My fourth baby was also a planned c-section due to having three prior sections. She was scheduled right before her due date, but just like the others decided to arrive 2 weeks early. My water broke this time though, something I had never experienced before. After about 7 hours of labor, I had the c-section and she was born healthy.
Not all cesarean births are the same, but if you know the reasons and process behind c-sections ahead of time, you can have the peace of mind being prepared for what may happen to you should you need a c-section.
Are you considering a c-section?
- Your Pregnancy Week by Week by Glade Curtis
- What to Expect When You're Expecting by Heidi Murkoff
- Your Pregnancy and Childbirth Month to Month by the American College of Gynecologists