All about C-Sections: A guide for you
You certainly have expectations for your birth. Whether you are making arrangements with a midwife or going with a doctor, you are making plans for the big day. But you should consider the possibility of C-sections.
C-sections may be something you do not want to consider, but some things can arise in the course of a pregnancy that will lead to a c-section. There is no reason why you need to look at a C-section as a completely negative outcome.
C-sections can be performed with minimal trauma for you and your baby. And in some cases, a c-section is precisely what maintains the health of you and your baby. There are ways to make C-sections less traumatic and help speed your recovery.
First, we need to get a firm understanding of what a C-section is. How does a c-section work? Why would you need a c-section? And what are the best ways to prepare and recover from a c-section? This guide is designed to give you all the information you need to properly understand C-sections.
What is a C-Section?
C-section is an abbreviation for Cesarean section. A C-section is a procedure for delivering a baby through abdominal and uterine incisions. A C-section is generally performed when complications arise that can make a traditional birth difficult or impossible. When the baby is in the breech position, for example, a C-section will become necessary.
About a third of all births in the United States are done through C-section. A standard C-section is planned about one week before a woman is scheduled to go into labor. The goal is to perform the C-section before you go into active labor.
Emergency C-sections are performed when there is a danger to the life of the baby or the mother. Several conditions can endanger the life of the mother or the baby, and an emergency C-section will prevent these dangers.
The procedure itself takes only 25-60 minutes, but recovery times from C-sections are longer than a traditional vaginal birth. You will likely need to stay in the hospital longer than if you had a vaginal birth. This is to prevent infection, blood clots, and excessive bleeding. Most women require only 2-4 days in the hospital, but if you experience complications, the stay could last several weeks.
C-sections are performed for two reasons. Sometimes it is for the health of the baby when a vaginal delivery would prove to be too dangerous. Other times a C-section is done to protect the health and safety of the mother. Reasons for a C-section can include:
Your labor is not progressing
Labor can become stalled, and this is the primary reason for a C-section. Stalled labor occurs when the cervix is not opening enough even though there has been a long period of intense contractions often over several hours.
The baby is in distress
A doctor or midwife may call for a C-section if there are dangerous changes in the baby's heartbeat.
The baby is in an abnormal position
C-sections will become necessary when this is the safest way to deliver the baby. If the baby is positioned with the feet or buttocks first, or in the breech position, a C-section may be the only way to safely deliver the baby. Another abnormal position is when the baby is on its side or should first. This is called the transversal position.
You are having a multiple birth
Carrying twins or triplets can prove to be too much for a vaginal birth. In these cases, a C-section might become the only way to safely deliver multiple babies.
Problems with the placenta
Sometimes the placenta can over the cervix. This is called placenta previa, and it can prevent a vaginal birth. In these cases, a C-section is the only way to deliver the baby.
Prolapsed umbilical cord
When the umbilical cord slips through the cervix ahead of the baby, this can endanger the safety of the baby. In these cases, a doctor may order a C-section.
Health concerns for the mother
You may require a C-section if you have a severe heart or brain condition. A C-section is often recommended if you are suffering from active genital herpes to prevent infection at the time of birth.
You might need a C-section if you have a large fibroid obstructing the birth canal, a severely displaced pelvic fracture, or your baby has a condition that can cause the head to be unusually large (severe hydrocephalus).
You had a previous C-section
Depending on the type of incision and some other factors, it is possible to have a conventional vaginal birth even if you had a prior C-section. However, a healthcare provider will often recommend a C-section if your previous birth was done with a C-section.
Some women will ask for a C-section with their first baby. This is to avoid the stress and pain of labor and to avoid potential complications from labor and delivery. Doctors generally discourage this, especially if you plan on having multiple children since a C-section will often dispose of you to have further C-sections in subsequent births.
Women who have multiple C-sections are at risk of placental problems such as heavy bleeding which could lead to the surgical removal of the uterus (hysterectomy). If you are considering a C-section for your first delivery, you should consult your doctor or midwife before making a final decision.
As with any invasive surgical procedure, a C-section comes with some risks. These risks are to you and your baby.
Risks for your baby include:
- Breathing problems: Babies delivered through a C-section are at a much higher risk of developing a condition called transient tachypnea. This is a condition in which the baby develops abnormally fast breathing during the first few days following birth.
- Injury from surgery: This is rare, but babies delivered through C-section can suffer accidental nicks to the skin during surgery.
Risks to the mother include:
- Infection: There is a risk of developing an infection of the lining of the uterus following a C-section.
- Postpartum hemorrhage: A C-section can lead to heavy bleeding during and immediately following delivery.
- Reactions to anesthesia: Some women have an adverse reaction to anesthesia.
- Blood clots: A C-section can increase your risk of developing a blood clot in a deep vein. This happens primarily in the legs and pelvic organs. The danger is that the blood clot could travel to your lungs and block blood flow to the lungs. This condition is called a pulmonary embolism, and it is life-threatening.
- Wound infection: As with any incision, there is always a risk of infection in the incision itself.
- Surgical injury: These injuries are rare, but there is a risk of injury to the bladder or bowels during a C-section. If there is an injury during a C-section, it will likely require more surgery.
- Increased risks for subsequent pregnancies: Once you have had a C-section, you are at a much higher risk for potentially serious complications during pregnancy than if you have a vaginal birth. The more C-sections you have the higher the risks for things like placenta previa and another condition in which the placenta is abnormally attached to the uterus. This condition is called placenta accreta. You also develop a risk of having your uterus tear open (uterine rupture) at the scar line of previous C-sections during delivery.
Preparing for a C-Section
There are ways to prepare for a C-section. If your C-section is scheduled in advance, talk to your doctor about the best way to prepare. Your doctor will likely have you talk to an anesthesiologist about possible medical complications that can arise from the anesthesia.
Your doctor or another healthcare provider may also recommend some specific blood test before a C-section. These tests will provide crucial information on your blood type and your hemoglobin levels that will help them minimize complications from the surgery. These details will also help your medical team in the unlikely event that you require a blood transfusion during surgery for your C-section.
Even if you are planning on a conventional vaginal birth, it is always best to make preparations for a C-section in case you need one. Talk to your doctor, midwife, or other healthcare providers before your due date to discuss the kinds of things that could lead to a C-section. The more information you have, the better prepared you will be should you need a C-section.
After a C-section, you will need time for recovery. Make preparations to have as much help on hand as you can to care for you and your new baby.
If you do not plan to have more children after delivering through a C-section, it makes sense to consider birth control options. Long-acting but reversible birth control may be in your best interests.
You should plan to stay in the hospital for 3-4 days while you recover from a C-section.
Just before surgery, your abdomen will be cleaned, and you will receive intravenous fluids. This allows medical professionals to administer fluids and any medications you may need during and after surgery. You will also have a catheter put in place to empty your bladder.
There are three anesthesia options for a C-section.
- Spinal block: This involves anesthesia that is injected directly into the sac that surrounds your spinal cord. A spinal block numbs the lower part of your body.
- Epidural: The epidural type of anesthesia is common for both vaginal births and C-sections. The anesthesia is injected into the lower back outside the spinal cord.
- General anesthesia: This is anesthesia that puts you into a painless sleep. This is generally administered during emergency situations.
Once you are properly numbed, a surgeon will make an incision just above the pubic hairline. This is a horizontal incision that goes down to the uterus. This entire area will be covered during the procedure so you will not see it. In an emergency C-section, the incision may be vertical.
Once the surgeon has made the first incision exposing the uterus, another incision will be made into the uterus. The baby is then removed from the uterus through the incisions through the uterus and the abdomen.
The doctor will tend to the baby first, clearing the nose and mouth of fluids and cutting the umbilical cord. The baby will then be transferred to other professionals to make sure he or she is breathing properly. The baby will then be placed in your arms.
The doctor will then repair the abdomen and uterus with stitches and close the abdominal and uterine incisions.
Immediately after your C-section, your doctor will have you stay in the hospital for about three days. After surgery, you will be on an IV. This is to allow for the administering of pain medications while the anesthesia wears off.
You will likely be encouraged to walk around. This is to prevent blood clots and to prevent constipation. Much of the time right after a C-section will be spent bonding with your new baby just like after vaginal birth.
Some things you will need to focus on while recovering include:
- 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 cesarean delivery
- 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
Anticipating the birth of your baby is an exciting time. This time also comes with no small measure of anxiety. Whether you mean to or not, you will have expectations, and a C-section may not be one of those expectations.
Nevertheless, C-sections are sometimes necessary. There are cases in which your health and safety or the health and safety of your baby are best served by having a C-section. Your best preparation for the possibility of a C-section is understanding what this procedure is.
C-sections are fairly routine. While a C-section is surgery, it is not usually a serious issue. The procedure for a C-section is relatively simple, and you can generally expect to fully recover within a few weeks.
The main goals are a healthy baby and a healthy mother. C-sections are performed when a regular vaginal birth is likely to cause undue stress to the baby and the mother. The end result will be the same as a vaginal birth. You get to meet your new baby and begin a great life together.