C-Section
What Is a C-Section?
A c-section, or cesarean birth, is a surgical procedure where a doctor makes an incision between the abdomen and uterus to ensure a safe delivery. Typically, a doctor will recommend a c-section when the health of the baby or mother is at risk. A c-section can be planned ahead of time, but often, the need for a c-section arises during the labor process. Because of this, it is important to learn about the procedure.
Types
There are two types of c-sections, one of which is planned ahead of time, the other of which is an emergency decision made in the moment.
Planned c-section. There are several reasons for scheduling a c-section. When a c-section is planned ahead of time it gives the mother time to learn about the surgery, potential complications, and the recovery process.
The surgery requires a regional anesthesia. Typically, a regional anesthesia (epidural or spinal block) is chosen, allowing the mother to be awake for the surgery. The mother will also be given an IV before surgery to administer fluids and medication, and will have a urinary catheter put in to make sure the bladder remains empty during surgery. Since many women choose to be awake for the surgery, there will be a screen placed between the mother’s head and belly, so the surgery is not directly visible.
Once the baby is delivered through c-section, depending on any complications, you may be able to hold your baby after your baby has been assessed, and even begin breast feeding. The surgery, including removal of the placenta and stitching up the wound, takes about 45 minutes to an hour.
Emergency c-section. An emergency c-section can happen extremely quickly and is usually unexpected. A doctor can perform an emergency c-section in about 2 minutes. The mother would be given a regional or general anesthesia for the surgery. If general anesthesia is necessary or chosen, the mother will have to wait a bit longer to be able to hold and breastfeed her baby.
Why It’s Done
There are several reasons a c-section may be recommended, but typically, it is required when the health or life of the baby and mother are at risk. Sometimes complications arise during pregnancy, making a vaginal birth difficult. Other times, the complications don’t arise until labor, and require an emergency c-section. Reasons for recommending a cesarean delivery include:
- Breech position
- Baby has developmental issues or conditions
- Mother has health issues (high blood pressure or heart disease)
- Previous c-section
- Mother has active genital herpes that can be transmitted to baby
- Problems with the placenta
- Stalled labor
What to Expect
What to expect for your c-section will be dependent upon whether it’s a planned or emergency c-section. Whether it is a planned or emergency c-section, there are some overlapping components regarding the surgery itself and recovery afterward.
Before
Depending on when and why the c-section is happening, it will determine the steps leading up to the surgery. There are three components of preop care that include:
- At home. Your healthcare provider may recommend that you shower with an antiseptic soap the night before and morning of your surgery. It is also important to not shave your pubic area 48-hours before surgery due to an increased risk of infection on the surgery site.
- At the hospital. The day of surgery at the hospital, a team of healthcare professionals will prep you for surgery. This will include cleansing the abdomen, running an IV to administer fluids and medication, and putting in a urinary catheter to make sure your bladder remains empty for the duration of surgery.
- Anesthesia. Typically, a regional anesthesia is administered (epidural or spinal block). This allows for the mother to stay awake during the surgery and potentially hold and breastfeed her baby after the birth. However, in some cases, general anesthesia may be needed, which may delay the time between the baby being born and the mother being able to hold and breastfeed her baby.
During
The surgery begins once the anesthetic has taken effect so that the area is completely numb and no pain is experienced. The doctor will make a horizontal incision between the abdomen and uterus, just above the pubic hairline. In emergency situations, the doctor may make a vertical incision. Once the abdomen is opened an incision is made into the uterus, and the baby will be lifted out from the uterus. A team of healthcare professionals will make sure the baby’s nose and mouth are clear of fluids and breathing properly, and the umbilical cord will be clamped. The baby can be placed in the mother’s arms once it’s determined that there are no complications and the baby is healthy. The doctor will close up the incisions with sutures.
After
Following the surgery, you will likely stay in the hospital for a few days and doctors will discuss a pain management plan, including medication and plenty of fluids. Once the anesthesia starts to wear off, you will be encouraged to get up and move around. Standing, moving around, and getting enough fluids will help to prevent constipation and deep vein thrombosis. The catheter will also be removed as soon as possible.
You will be able to start breastfeeding as you feel ready. Be sure to speak with your lactation consultant to help find the most comfortable positioning. A team of healthcare professionals will help navigate medication for pain management, taking breastfeeding into consideration. Be sure to speak with your healthcare provider about any proactive or preventative measures you can take before leaving the hospital.
Upon returning home, make sure to rest, take it easy, have a good pain management plan, and refrain from sex at least six weeks.
Complications
Although c-sections have become more commonplace, it is still considered a major surgery, and comes with risks that can create complications for mother or child. Some of the risks include:
- Bleeding (postpartum hemorrhaging)
- Blood clots
- Breathing issues for the baby, especially if performed before 39 weeks
- Infection (endometritis)
- Longer recovery time than with vaginal birth
- Surgical injury
- Wound infection
- Negative reaction to anesthesia