C-Section

What is a C-section?

A C-section (also called a cesarean or cesarean delivery) is surgery to deliver your baby through your abdomen and uterus. C-sections happen when a vaginal delivery isn’t possible or safe.

What are the reasons for needing a C-section?

A planned C-section happens when any of the following conditions exist:

• Cephalopelvic disproportion (CPD): You may need a C-section if your baby’s head is too large to fit through your pelvis.
• Previous C-section: You may need one if you already had one due to risks of having a vaginal birth after C-section (VBAC).
• Expecting multiples: Although twins can often be delivered vaginally, two or more babies might require a C-section.
• Breech position: Your provider may recommend a C-section if your baby isn’t in a head-down position.
• Health conditions: A C-section may be needed if labor or delivery could be unsafe for you or your baby due to having a heart condition, placenta previa or an active genital herpes infection.

An unplanned or emergency C-section delivery might be necessary if these things happen during labor:

• Labor isn’t progressing: Your cervix dilates and stops, doesn’t efface (thin) or your baby stops moving down the birth canal.
• Umbilical cord compression: The umbilical cord is looped around your baby’s neck or body or caught between your baby’s head and your pelvis.
• Umbilical cord prolapse: The umbilical cord comes out of your cervix before your baby does.
• Placental abruption: The placenta separates from the wall of your uterus before your baby is born.
• Fetal distress: Any signs that show your baby is in trouble may lead to needing a C-section.

C-sections happen in about 3 in 10 deliveries in the U.S.

How do you prepare for a C-section?

If you have a planned C-section, the following will happen:

• You’ll sign consent forms for the procedure.
• The anesthesiologist will discuss options for anesthesia. Most often, it’s a spinal block that numbs you from your breasts down to your feet.
• A catheter will be inserted to keep your bladder empty.
• You’ll have heart and blood pressure monitors applied.
• You’ll get an IV in your hand or arm to give you medicine and fluid.
• You’ll discuss the procedure and what to expect with your obstetrician (if you haven’t already).

If you need an unplanned C-section, your obstetrician delivers your baby during labor because a vaginal birth is no longer the safest option. Most unplanned C-sections aren’t emergencies. An emergency C-section is when delivery needs to happen quickly due to very high risk of complications.

What happens during a C-section?

Here are the steps of a C-section:

1. Most planned C-sections use an epidural, so you’re awake for the delivery. In rare cases, general anesthesia is used, and you’re asleep. They may give you an oxygen mask.
2. Next, they’ll clean your abdomen with antiseptic, then place a sterile drape over your legs and chest. There will be a hole in the drape where the incision will be made. Finally, your providers will raise a sterile curtain or drape between your head and your lower body.
3. Your partner or support person will be allowed to come back at this time if you’re awake and not under general anesthesia.
4. The obstetrician will make an incision through your skin and into the wall of your abdomen. Then, they’ll cut a 3- to 4-inch incision into your uterus.
5. Your obstetrician will remove your baby through the incision. The umbilical cord is then cut, the placenta is removed, and the incisions are closed with stitches and staples.

If you're awake for surgery, you’ll be able to see and hold your baby shortly after they’re born.

How long does a C-section take?

A typical C-section takes about 45 minutes to an hour and a half from start to finish, including delivering the baby and closing the incision. In emergencies, it may happen much faster, sometimes within 10 to 15 minutes.

How painful is it?

You’ll be under anesthesia to prevent you from feeling any pain. You may feel a tug or pull when your baby is removed and as they repair your incision.

What are the different types of caesarean sections?

C-sections can be planned or unplanned. They can also be different based on the type of cut your obstetrician makes. The different types are:

• Low transverse or bikini incision: A cut is made horizontally across your lower uterus (most common).
• Low vertical incision: A cut is made vertically across your lower uterus.
• Classic incision: A cut is made vertically in the upper part of your uterus.

What happens after a C-section?

Your obstetrician will deliver the placenta after your baby is born. Next, they’ll stitch your uterus and stitch or staple your abdominal muscles. A typical C-section surgery requires at least three to four days in the hospital.

Your abdomen will be sore for several days or weeks. In some cases, your provider may prescribe pain medication. You can expect to limit your activities, take it easy, and rely on family and friends once you go home.

What are the benefits of a C-section?

In most cases, the biggest benefit of a C-section is that it’s safer for both you and your baby. It’s a way to eliminate risks of a vaginal delivery.

What are the risks involved?

The risks of complications are slightly higher with C-sections than with vaginal delivery. These include:

• Infection
• Blood loss
• A blood clot that may break off and enter your bloodstream
• Injury to your bowel or bladder
• A cut that might weaken the uterine wall
• Risks from general anesthesia
• Injuries to the baby

Other disadvantages of having a C-section are:

• Recovering from a C-section may be more difficult than a vaginal delivery.
• C-sections are more likely to cause chronic pelvic pain.
• You’re more likely to have a C-section in future pregnancies.
• Your baby may be at greater risk for breathing problems or trouble breastfeeding.

Is a C-section safer than normal delivery?

Vaginal births are usually safer. But a C-section may be the only safe option depending on your situation.

What is the recovery process for a caesarean section?

Once the anesthesia wears off, you’ll begin to feel the pain from the incisions. You might also experience gas pains and have trouble taking deep breaths. Make sure an adult is there to help you get up from bed the first several days.

A full recovery can take between four and six weeks. Ask your healthcare provider what you can expect during recovery. Most providers recommend limiting walking and lifting, and avoiding exercise and other strenuous activities for several weeks. Ask your friends or partner for help with errands, cooking and cleaning so you can rest and recover. Avoid driving for about two weeks. Before driving again, make sure you can comfortably turn your body and press the brake and gas pedals.

You can expect cramping and bleeding for up to six weeks, as well as some discomfort around the incision. Taking over-the-counter pain relievers like acetaminophen or ibuprofen for pain may help. Avoid sex for at least six weeks or until your healthcare provider gives you the OK.

You will also have a vaginal discharge after the surgery. It will be red at first and then gradually change to yellow. Be sure to call your healthcare provider if you experience heavy bleeding or a foul odor from the vaginal discharge. Use sanitary pads, not tampons, until you’re completely done bleeding.

Can I have a baby vaginally after a C-section?

You may be able to have a vaginal delivery after a C-section if:

• Your surgeon used a low transverse incision.
• You’re not having twins or triplets.
• Your first C-section was only performed because your baby was breech or wasn’t tolerating labor.

You should discuss this with your healthcare team. They can help you weigh the pros and cons.

When should I call my healthcare provider?

Call your provider if you have these symptoms after a C-section:

• Red or swollen incision
• Pus or leaking discharge from the incision
• Fever, chills or flu-like symptoms
• Severe pelvic pain and cramping
• Heavy bleeding

How many C-sections can you have?

There isn’t an exact number. Factors like your health history and reasons for previous C-sections all play a role. Your healthcare provider will talk to you about the risks of having several C-sections if they apply to you.