Learn the reasons this surgical procedure to deliver a baby is done, the risks and tips for recovery.
Cesarean delivery (C-section) is used to deliver a baby through surgical incisions made in the abdomen and uterus.
Planning for a C-section might be necessary if there are certain pregnancy complications. Women who have had a C-section might have another C-section. Often, however, the need for a first-time C-section isn' clear until after labor starts.
If you're pregnant, knowing what to expect during and after a C-section can help you prepare.
Health care providers might recommend a C-section if:
Some women request C-sections with their first babies. They might want to avoid labor or the possible complications of vaginal birth. Or they might want to plan the time of delivery. However, according to the American College of Obstetricians and Gynecologists, this might not be a good option for women who plan to have several children. The more C-sections a woman has, the greater the risk of problems with future pregnancies.
Like other types of major surgery, C-sections carry risks.
Risks to babies include:
Risks to mothers include:
Increased risks during future pregnancies. Having a C-section increases the risk of complications in a later pregnancy and in other surgeries. The more C-sections, the higher the risks of placenta previa and a condition in which the placenta becomes attached to the wall of the uterus (placenta accreta).
A C-section also increases the risk of the uterus tearing along the scar line (uterine rupture) for women who attempt a vaginal delivery in a later pregnancy.
For a planned C-section, a health care provider might suggest talking with an anesthesiologist if there are medical conditions that might increase the risk of anesthesia complications.
A health care provider might also recommend certain blood tests before a C-section. These tests provide information about blood type and the level of the main component of red blood cells (hemoglobin). The test results can be helpful in case you need a blood transfusion during the C-section.
Even for a planned vaginal birth, it's important to prepare for the unexpected. Discuss the possibility of a C-section with your health care provider well before your due date.
If you don't plan to have more children, you might talk to your health care provider about long-acting reversible birth control or permanent birth control. A permanent birth control procedure might be performed at the time of the C-section.
A C-section can be done in various ways. But most C-sections involve these steps:
Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body. This allows you to be awake during the procedure. Common choices include a spinal block and an epidural block.
Some C-sections might require general anesthesia. With general anesthesia, you won't be awake during the birth.
A doctor makes surgical incisions in the abdomen and the uterus to deliver the baby.
If you have regional anesthesia, you're likely to be able to hold the baby shortly after delivery.
A C-section usually requires a hospital stay for 2 to 3 days. Your health care provider will discuss pain relief options with you.
Once the anesthesia begins to wear off, you'll be encouraged to drink fluids and walk. This helps prevent constipation and deep vein thrombosis. Your health care team will monitor your incision for signs of infection. The bladder catheter will likely be removed as soon as possible.
You can start breastfeeding as soon as you're ready, even in the delivery room. Ask your nurse or a lactation consultant to teach you how to position yourself and support your baby so that you're comfortable. Your health care team will select medications for your post-surgical pain with breastfeeding in mind.
During the C-section recovery process, discomfort and fatigue are common. To promote healing:
Check your C-section incision for signs of infection. Pay attention to any symptoms. Contact your health care provider if:
If you have severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your health care provider if you think you might be depressed, especially if your symptoms don't go away, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
The American College of Obstetricians and Gynecologists recommends that postpartum care be ongoing. Have contact with your health care provider within three weeks after delivery. Within 12 weeks after delivery, see your health care provider for a postpartum evaluation.
During this appointment your health care provider likely will check your mood and emotional well-being, discuss contraception and birth spacing, review information about infant care and feeding, talk about your sleep habits and issues related to fatigue and do a physical exam, including a pap smear if it's due. This might include a check of your abdomen, vagina, cervix and uterus to make sure you're healing well.
A C-section includes an abdominal incision and a uterine incision. The abdominal incision is made first. It's either a vertical incision between your navel and pubic hair (left) or, more commonly, a horizontal incision lower on your abdomen (right).