Giving birth can bring with it a lot of emotions. While this can be an exciting time, it can also bring forth some worries or concerns about what will happen during the birthing process. Depending on your particular pregnancy, having a C-section may be necessary, so let’s provide some insights on things you can expect if you are having a c-section. A Cesarean delivery, or a C-section, is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus instead of a vaginal birth. 

There are  many different reasons why you may be having a C-section. Sometimes they are planned ahead of time for a number of different reasons including size of the baby, complications during the pregnancy, or if you have had a previous c-section. Some women for many personal reasons simply choose to deliver their baby by c-section. Other times, the need for a C-section becomes obvious once labor is already underway. Even if you aren’t planning a C-section, it’s good to familiarize yourself with the basics and the surgery in case a need for a C-section arises during your delivery.

Reasons for a C-Section

It may seem scary to consider having to change the entire birthing plan mid-delivery, but if a doctor suggests a C-section it is because at that point in time, it is likely a safer option than a vaginal birth for you and your baby. Some reasons your health provider may suggest a C-section are below:

• Your labor is stalled

• There’s changes in your baby’s heartbeat

• Your baby or babies are in an abnormal position. If your baby is breached, the baby’s feet or buttocks enters the birth canal first, or transverse, the baby is positioned on its side or shoulder first, a C-section may be the safest way to deliver. 

• You're carrying two or more babies

• Your placenta is covering the opening of your cervix. This is called placenta previa. 

• Your umbilical cord is prolapsed. This means the loop of the umbilical cord could slip through your cervix ahead of the baby. 

• You have a health problem like a serious heart condition, a serious brain condition or genital herpes. 

• Mechanical obstruction like a large fibroid, a displaced pelvic fracture or if your baby has an unusually large head. 

• You've had a previous C-section

• You want to have a C-section. Some women choose to have a C-section to avoid labor and the potential complications, or to have the ability to plan the delivery. This is discouraged if it is your first pregnancy and you plan to have more babies after the C-section. Multiple C-sections increase your risk of having problems with your placenta, as well as increasing the chance of significant bleeding, both of which could require a hysterectomy. If you’re thinking about a C-section for your first pregnancy, work with your health care provider to make the best decision for you, your baby and your reproductive future. 

What Should I Expect During a C-Section?

The night before or morning of your procedure your health care provider may ask you to wash yourself with antiseptic soap. It is recommended to avoid shaving your pubic hair within 24 hours of your procedure. At the hospital, your abdomen will be cleansed and a catheter will likely be placed in your bladder to collect urine during the surgery. Intravenous lines will be entered into your arm or hand veins to provide fluids and medications. Most C-sections use regional anesthesia, meaning only the lower part of your body is numb and you stay awake for the procedure and birth. Most people having a C-section use a spinal block or epidural block that is placed by an anesthesiologist.  In the case of an emergency, general anesthesia will be used. 

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What Are the Risks of a C-Section?

A C-section is a surgery, and like all surgeries that means there are some risks involved for both you and your baby. In preparing for a C-section, you should be aware of the potential risk and be sure to discuss these risks with your doctor. Babies born by C-section are more likely to develop a breathing problem called transient tachypnea, meaning your baby may experience abnormally fast breathing during the first few minutes to days (up to 48 hours) after delivery for a brief period of time.. Risks to the person delivering the baby include a risk of infection, postpartum hemorrhage, reactions to anesthesia, blood clots, wound infection and surgical injury. 

Additionally, after a C-section you face a higher risk of potentially serious complications in a later pregnancy than you would after a vaginal delivery. For example, if you choose to have multiple C-sections, you have a higher risk of your placenta abnormally attaching to the wall of your uterus, called placenta accreta, as well as placenta previa. If you decide to have a vaginal birth after a C-section (VBAC), there is a risk of your uterus tearing along the scar line. 

Like many surgeries, a C-section requires a recovery period. You will likely stay in the hospital for a few days, and you can begin breastfeeding whenever you feel ready. When you return home, you may feel weak and fatigued for a few days to a week, so it’s important to take it easy, drink lots of fluids, follow the post-operative instructions that are given, and make sure you are monitoring any changes in your body. It is also recommended to avoid sex for six weeks after giving birth, and to avoid lifting more than 8lbs or significant driving during the 6 week postpartum period. 

There’s a lot to consider as you are preparing for motherhood. Make sure you talk to your doctor to see if a C-section is right for you, and prepare for the possibility of a last minute C-section.