Whether you’re the type to have a very specific birth plan that you don’t want to stray from or one who expects to go with the flow of pregnancy, you can never truly know what to expect when you give birth. Even if you planned to have an all-natural, at-home, drug-free delivery with minimal medical intervention, you may still wind up having to have a C-section. After all, in the UK, about 28% of babies are delivered that way.
So whether you already know that you’ll have to have a planned C-section or you just want to be prepared for the possibility of an emergency one, this article will tell you everything you need to know about C-sections.
What Is a C-Section?
A cesarean section, commonly called a C-section, is when a baby is delivered surgically through incisions in the abdomen and uterus - as opposed to vaginally. Like we mentioned above, C-sections are relatively common, but they are still a major, invasive surgery and therefore are only recommended in situations in which they are medically necessary.
Planned vs Emergency vs Elective C-Sections
In certain cases, doctors will know ahead of time that a woman will have to give birth via C-section, and they will plan for it early on. Possible reasons for planned C-sections include:
- If the mother has certain medical conditions, like heart disease, diabetes, high blood pressure, or kidney disease, which make vaginal delivery dangerously stressful to the body
- If the mother has certain infections, like HIV or active genital herpes, which can be transferred to the baby during vaginal birth
- If the baby has certain health factors, like some congenital conditions or macrosomia, which is when the baby is too big to safely fit through the birth canal
- If the mother is significantly overweight, obese, or having a geriatric pregnancy
- If the baby is in breach, which is when it is in feet- or butt-first position, and can’t be turned around
- If there are placenta problems like placenta previa, which is when the placenta partially or completely blocks the cervix, or placental abruption, when the placenta separates from the uterine wall
- If the mother is giving birth to multiples
- If the mother has previously had a C-section
Not all of these reasons will definitely require a mother to have a C-section, but they are often part of the decision.
However, much of the time, C-sections happen without being planned for ahead of time, due to all sorts of reasons that come up during labour and delivery. For example, a woman might be required to have an unplanned C-section if:
- She is having contractions but her cervix isn’t dilating even after 24 hours
- Her cervix dilates but not all the way
- The baby is determined to be too big to fit through her pelvis
- The baby is in distress
- She is too exhausted to keep pushing
- The uterus ruptures
- The umbilical cord emerges before the baby does, which can cut off the baby’s oxygen supply
Some women may also personally make the choice to ask for an elective C-section, though the current medical consensus is that C-sections should be avoided unless they are medically necessary. So if your fear of labour pain or desire to give birth on a certain day is tempting you to ask your doctor for a C-section, you may want to think again.
How to Prepare for a C-Section
If you are having a planned C-section, there are definitely some things that can help you with preparing for C-section. As we mentioned above, C-sections are a major surgery and a pretty big deal so, even though they are somewhat common, you should still take it seriously and do your best to be as prepared as possible for the procedure.
Like with all surgery, there will be some things that your doctor will ask you to do before your C-section to reduce the risk of complications. This includes not eating for eight hours before the procedure.
In terms of putting together a C-section birth plan, there are a few things you might want to consider planning for. These include:
- Deciding who you would like to be with you during the birth
- Deciding if you want to photograph or film the birth and asking the doctor for permission to do so
- Deciding if you want to have the screen lowered so you can see your baby being born and telling the doctor if you do
- Discussing with your doctor how your incisions will be closed
- Packing a bag with entertainment, high-waisted cotton or disposal pants, a dressing gown, a nightdress, slippers, cranberry juice (which may help reduce risk of post-catheter urinary tract infections) and loose clothing that won’t put pressure on your wound.
Know that, while you may feel tempted to shave before your surgery, doctors recommend not to do so, as this will create small nicks in the skin that can promote infection.
What the C-Section Procedure Involves
Another important element of preparing for your C-section is educating yourself on what the procedure entails. So here is an overview of the C-section process from beginning to end.
Planned or emergency, C-sections tend to look the same every time and are generally quite safe. You may be surprised to learn that the mother is not put under general anaesthesia for this procedure, so she is awake and aware of what is going on. This is so that you can be present and alert at your birth and meet your new baby as soon as possible.
But, don’t worry, you’ll get local anaesthesia through the form of an epidural or a spinal block so that you won’t feel anything in your lower body. You’ll have your abdomen prepped, which includes washing and potentially shaving. You’ll have a catheter inserted into your bladder and an IV into your arm.
Then you’ll be taken to the operating room. Whoever is with you will have to suit up in scrubs and a mask. Unless you requested otherwise, you’ll have a curtain pulled across your midsection so you won’t be able to see the procedure itself. Your companion will be able to stand near you and hold your hand. There’ll be a few different medical staff members in the room including an anesthesiologist and a few nurses.
Then it’s time for the actual procedure. The doctor will most likely make a four- to six-inch incision just above where your pubic hair ends and another in the lower part of your uterus. There are two different C-section incision types:
- Low-transverse incision. Used in 95% of C-sections, this incision type is done across the lower part of the uterus, where the muscle is thinner. This causes less bleeding and is less likely to tear if you give birth vaginally in the future.
- Vertical incision. This one goes down the middle of your uterus and is only used if the baby is in an unusual position, like low down in the uterus.
From there, it’s time for the miracle of birth! After suctioning out some amniotic fluid, the doctor will essentially reach inside of you, cradle your baby’s head, push down on the top of your uterus, and guide the baby into the world. Then they’ll cut the umbilical cord and remove the placenta, though you’ll probably be too wrapped up meeting your new bundle of joy to notice.
All in all, this whole procedure will take about 30-45 minutes. After the big show, your baby will be whisked away for cleaning. In the meantime, after a check to make sure all your organs are looking okay, your doctor will stitch up your uterus with absorbable stitches and your abdomen with stitches or surgical staples.
You’ll spend about an hour in the recovery room while the anaesthesia wears off. You’ll get oxygen and potentially antibiotics and oxytocin, which is a hormone that helps control bleeding and encourages the uterus to contract back to its normal size. You may feel itchy, nauseous, or shaky. If you do, talk to your nurse; they’ll probably be able to offer you something to make you feel more comfortable.
If you ask, you’ll probably be able to have your baby with you during this time for skin-to-skin and breastfeeding. We’re sure you’ll want to get to know your new son or daughter as soon as possible, so don’t hesitate to speak up and ask to be given your precious early bonding time. If neither you nor your baby need immediate medical treatment, it will most likely be allowed.
Learn more: Baby bonding and skin-to-skin contact
Recovering From a C-Section
As it is a major surgery, recovery after C-section can be difficult, especially if you didn’t expect to have one and hadn’t had the opportunity to properly prepare for it. On average, most mothers spend three to four days in the hospital for Cesarean recovery.
The day of the C-section, you’ll have to rest, wear pads for the bleeding, and receive a more or less constant stream of painkillers. Most likely, your doctor will make you wait until you’ve passed gas - a sign your organs are all in order - before you can eat.
On the second day, you’ll switch to oral painkillers and have your catheter removed. The nurses will have you get up and walk around to get your muscles working. It’ll feel weird and hard. Don’t worry, that’s normal. You’ll be released from the hospital on day three or four, have your incision checked after one or two weeks, and one final postpartum appointment at six weeks.
Of course, the Cesarean section recovery does not end when you come home. It’ll probably take between a month and six weeks for you to start feeling normal again. Don’t hesitate to take pain medication as you need it throughout this time.
Learn more: A Survival Guide to the Fourth Trimester
C-Section Recovery Tips
As far as C-section recovery pain goes, you can expect your incision to feel sore and especially painful when you cough, laugh, or sneeze. You’ll have to be careful not to put any extra strain on your abdominal muscles. That means no lifting anything any heavier than your baby. Putting some gentle pressure on your incision with a pillow, your hands, or an abdominal binder can relieve some of the pain. Don’t be surprised if you feel numb, sore, and swollen. It comes with the territory. Ice can really help.
One thing that can really help with your post-op recovery is a postpartum support band like the Core Restore Support Band. The support band can be worn straight after c-section and it can be used to speed-up recovery process after abdominal surgery. The band provides help with supporting your surgical incision, holding your abdominal muscles together and increasing circulation at your surgical site to promote healing and decrease swelling.
You’ll also need to keep an eye on your C-section scar recovery. Watch out for increased pain, swelling, redness, drainage, fever, and chills. If you experience any of these, talk to your doctor immediately. In terms of C-section incision care, you’ll want to keep the wound clean and avoid chafing by wearing loose clothing.
If you’re wondering about C-section recovery exercise, it’s good to get moving as soon as you can. Your doctor will clear you to exercise after your incision heals, but in the meantime, you can speed up your recovery by walking around, moving your legs, and doing Kegels.
And, overall, just don’t forget to take care of yourself - yes, even though you have a new baby to take care of. Be gentle with yourself both emotionally and physically. Take recovery day by day. Healing after C-section is hard! It’s normal to struggle. Ask for help when you need it. Take care of yourself. Move around slowly and carefully. Be patient. Eat healthy foods (plenty of fibre will help you stay regular!). Allow yourself to feel your feelings. It will all be okay.
Learn more: Exercising Safely Postpartum
Risks and Benefits of C-Sections
Though C-sections are quite serious and intense, they do also have their pros. Here is a simple breakdown of some of the advantages and disadvantages of C-sections.
- A baby born via C-section will have a round head instead of a cone-shaped one, since it won’t have to squeeze through the birth canal
- You’ll avoid some of the (literal) wear and tear of vaginal delivery, like with episiotomies
- In some situations, C-sections are safer than vaginal births
- You will have given birth and come out the other side with a baby, which is - without a doubt - a cause to celebrate! C-sections are no less legitimate than vaginal deliveries.
- You may have a permanent scar, though it will fade over time and generally be low enough on your pelvis that it’ll be quite easy to conceal
- The recovery time is longer than that of a vaginal birth
- All risks of major abdominal surgery, like blood loss, infection, and injury to surrounding organs, apply
- There is a higher risk of pulmonary embolism with a C-section than with vaginal birth
One other potential long-term effect of C-sections worth mentioning is the fact that, unlike babies born vaginally, C-section babies are not colonised with their mother’s bacteria. Newborns delivered by c-section usually lack certain gut bacteria found in healthy children and, instead, harbour harmful microbes commonly found in hospitals.
However, it’s probably not as serious as it may sound. Within months after being born, the differences between the microbiomes of C-section babies and babies delivered vaginally are nearly eliminated. And as of yet, researchers still haven’t found any long-term health consequences of these early microbiome differences.
As far as we’re concerned, whichever form of delivery leaves you and your baby safe and healthy is the ideal one. C-section or vaginal delivery, planned or emergency, giving birth is a major accomplishment. So kudos to you!