A cesarean section—more commonly known as C-section—is the surgical delivery of a baby. It involves one incision in the mother’s abdomen and another in the uterus.
It is a common procedure that is used to deliver about one in three babies in the U.S., according to the Centers for Disease Control and Prevention (Hamilton and Menacker, 2010).
C-sections are generally avoided before 39 weeks of pregnancy so the child has proper time to develop in the womb. Sometimes, however, complications arise and a C-section must be performed prior to 39 weeks.
A C-section is typically performed when complications with pregnancy make traditional vaginal birth difficult, or puts the mother or child at risk. It can be planned ahead, but most often it is performed when complications arise during labor.
Reasons for a C-section delivery include:
- baby has developmental conditions
- baby’s head is too big for the birth canal
- breech birth, or if the baby is coming out feet first
- early pregnancy complications
- mother’s health problems, such as high blood pressure or unstable heart disease
- mother has active genital herpes that could be transmitted to the baby
- previous C-section delivery
- problems with the placenta, such as placental abruption or placenta previa
- problems with the umbilical cord
- reduced oxygen supply to the baby
- stalled labor
- transverse labor, or the baby is coming out shoulder first
Some mothers prefer to have a C-section with their first child to avoid labor and the pain that goes with it, or to avoid possible complications.
While a common type of delivery now, a C-section is still considered major surgery, which carries risks for both mother and child. The risks of a C-section include:
- blood clots
- breathing problems for the child, especially if done before 39 weeks of pregnancy
- increased risks for future pregnancies
- injury to the child during surgery
- longer recovery time compared with vaginal birth
- surgical injury to other organs
Prior to your due date, discuss your birthing options with your doctor to determine if you or your baby exhibit any signs that a C-section may be needed.
If you and your doctor decide a C-section is the best option for delivery, your doctor will give you complete instructions about what you can do to lower your risk of complications and have a successful C-section.
As with any pregnancy, prenatal appointments will involve many check-ups, which will include blood tests and other examinations to determine your health for the possibility of a C-section. These blood tests will reveal your blood type in case you need a blood transfusion during the procedure. While rare, your doctor will be prepared for a blood transfusion to ensure everyone’s safety is considered.
Even if you aren’t planning to have a C-section, you should always prepare for the unexpected. At prenatal appointments with your doctor, discuss your risk factors for a C-section and what you can do to lower them. Make sure all of your questions are answered, especially what could happen if you need to have an emergency C-section before your due date.
Because a C-section takes additional time to recover from than normal birth, arranging to have an extra set of hands around the house will be helpful. Not only will you be recovering from surgery, but your new baby will need some attention as well.
Before surgery, your abdomen will be cleaned and you’ll be prepared for receiving intravenous (IV) fluids into your arm. This allows doctors to administer fluids and any type of medications you may need.
There are three types of anesthesia offered to delivering mothers:
- spinal block: anesthesia is injected directly into the sac that surrounds your spinal cord, thus numbing the lower part of your body
- epidural: a common anesthesia for both vaginal and C-section deliveries, anesthesia is injected into your lower back outside the sac of the spinal cord
- general anesthesia: the anesthesia that puts you into a painless sleep, and is usually reserved for emergency situations
When you have been properly medicated and numbed, your doctor will make an incision just above the pubic hairline. This is typically horizontal across the pelvis. Later, the scar is usually easily coverable, even, for example, in a bikini.
In emergency situations, the incision may be vertical.
Once the incision into your abdomen has been made and the uterus is exposed, your doctor will make an incision into the uterus. Don’t worry; this area will be covered during the procedure so you won’t have to see or feel it. The type of incision depends on the position of the fetus so no harm is done to your almost-born child.
When the correct incision is made, your child will be removed from your uterus. Just like that, you’ll go from an expectant mother to a mother. Congratulations!
Your doctor will first tend to the baby by clearing the nose and mouth of fluids and clamping and cutting the umbilical cord. Hospital staff will then care for the child until he or she is ready to be put in your arms.
Meanwhile, your doctor will repair your uterus with dissolving stitches and close your abdominal incision with sutures.
The whole process generally takes about an hour.
After your C-section, you and your newborn will stay in the hospital for about three days. Immediately after surgery, you will remain on an IV. This allows for adjusted levels of painkillers to be delivered into your bloodstream while the anesthesia wears off.
Your doctor will encourage you to get up and walk around. This can help prevent blood clots and constipation. A nurse or doctor can teach you how to position your child for breastfeeding so there’s no additional pain from the C-section incision area.
When you go home, the Mayo Clinic has these recommendations:
- Take it easy and rest, especially for the first few weeks.
- Use correct posture to support your abdomen.
- Drink plenty of fluids to replace those lost during your C-section.
- Avoid sex for four to six weeks.
- Take pain medications as needed.
- Seek help if you experience symptoms of postpartum depression, such as severe mood swings or overwhelming fatigue.
Call your doctor if you experience the following symptoms:
- breast pain with fever
- foul-smelling vaginal discharge or bleeding with large clots
- pain when urinating
- signs of infection—for example, fever over 100 F, redness, swelling, or discharge from the incision