Having a baby is an amazing experience. In most cases, vaginal births are usually preferred, but in some cases, a C-section (cesarean section or cesarean delivery) is the only safe option. A C-section carries risks and benefits, which should be discussed with your healthcare provider. Curious to learn more about C-sections?

What Is A C-section?

A C-section is one way to deliver a baby that involves surgical incisions made in the abdomen and uterus.  In the United States, approximately 31% of babies delivered are delivered via a C-section.

Reasons Why A C-section May Be Needed

• If labor isn’t progressing as normal.  This is also known as labor dystocia.  Issues with labor progression can include prolonged dilation or opening of the cervix. Or the issue can be within the second stage when there is a prolonged time of pushing after the cervix is completely dilated.
• Concerns that the baby may be in distress.  For instance, the umbilical cord may become pinched or compressed or fetal monitoring may detect an abnormal heart rate.
• Carrying multiple babies can often result in cesarean delivery.  Especially if the babies are not in good positions in the uterus, or if there are other problems, a cesarean birth may be needed. The chance of having a cesarean birth goes up with the number of babies.
• The baby is presenting in a breech position (feet or buttocks first) or a transverse position (sides or shoulder come first).
• If the placenta covers the opening of the cervix (also known as placenta previa).
• A C-section might be recommended if a loop of the umbilical cord slips through the cervix in front of the baby (prolapsed umbilical cord).
• If the mother has any health issues, such as a heart or brain condition.  
• Any time there is a blockage.  Whether there is a large fibroid blocking the birth canal, a pelvic fracture or a baby who has a condition that can cause the head to be unusually large (severe hydrocephalus) these all may be reasons for a C-section.
• The mother has had a surgical procedure that involved the uterus or had a cesarean delivery previously.  It is possible to have a vaginal birth after a cesarean birth.  However, your healthcare provider may recommend a cesarean birth.

The Procedure

The doctor will make surgical incisions in the abdomen and the uterus to deliver the baby.

1. An incision is made in the abdominal wall.  Generally, it is done horizontally close to the pubic hairline.  Or it could be a vertical incision that starts just below the navel and stops above the pubic bone.
2. Next, the uterine incision is made across the lower part of the uterus (low transverse incision).  There may be other types of uterine incisions depending on the baby’s position or if there are other complications, such as placenta previa.
3. The baby will then be delivered through the incisions.  The baby’s mouth and nose will be cleared of fluids.  Then the umbilical cord is clamped and cut.  The placenta will be removed from the uterus and incisions will be closed with sutures.

The type of anesthesia used will depend on factors such as your health, the health of the baby, and the reason for the cesarean delivery.  The anesthesiologist should talk with you about the benefits and risks of each type of anesthesia.

In most cases when you have regional anesthesia you will be more likely to hold your baby shortly after delivery when you have a C-section.

After The Procedure

When you have a C-section it will generally require a hospital stay of 2 to 3 days. Your healthcare provider will discuss pain relief options with you.

If you decide to breastfeed you may do so as soon as you are ready.  The nurse or a lactation consultant can provide some tips to help you better position yourself while supporting your baby so that you are comfortable.  

The Recovery Process

You may experience some discomfort and fatigue during your C-section recovery process.  

• Try to take it easy.  Rest whenever possible.  Keep everything you and the baby need within reach.
• For a few weeks, do not lift more than 25 lbs.
• Your healthcare provider might recommend using a heating pad and pain medications that are safe for breastfeeding women and their babies to reduce pain.
• After six weeks your doctor may say that it is safe to have sex. 
• You may want to wait to drive.  Especially if you are taking narcotics for pain relief.  Also, it would be wise to wait until you gain full mobility without experiencing pain before you drive.  That can be anywhere from 1 to 2 weeks after your procedure.

Consult with your doctor if you experience the following:

• The incision is red, swollen, or leaking discharge
• If you have a fever
• If your pain worsens 
• Heavy bleeding

The decision for a cesarean birth is for the safety and well-being of you and your baby.  If you plan on having a cesarean birth, your healthcare provider will discuss what to expect with you.  There are times when cesarean delivery is not a part of your birth plan and while that may be a disappointment it is a decision that is made for the safest outcome for you and your baby.

At OB-GYN Women’s Centre of Lakewood Ranch, we are here to help answer your questions in an effort to help you to be well informed. We are committed to caring for women throughout their lives.