To protect your or your baby's health, you may need a cesarean section birth. A cesarean section or C-section delivery is a surgery in which the doctor delivers your baby through a cut in your abdomen. The procedure comes with greater risks compared to vaginal delivery, but it can be the safest option for some births.
A cesarean surgery, or C-section, is a procedure to deliver a baby through a cut in the belly. It is an alternative to a vaginal birth that doctors only recommend if medically necessary.
Depending on why you need a cesarean section, you and your obstetrician may plan it before you go into labor. Or, you may find out you need a C-section after labor starts.
What are the types of C-sections?
You shouldn't feel pain during the C-section because you'll have pain medication (anesthesia). You may feel some pressure or pulling, however.
You will feel some pain during your C-section recovery period after the anesthesia wears off. At this point, you'll get pain medications as a pill or in your vein through an IV. After you leave the hospital, you'll continue to take oral pain medications as needed as you recover at home.
A C-section is a common and generally safe surgery. About one in three births in the U.S. happen via C-section. However, like any major surgery, a C-section comes with risks.
An obstetrician may recommend a C-section for many reasons. They may be planned ahead of time or done as an emergency option during a planned vaginal delivery or induction.
Your doctor may recommend a scheduled C-section if:
You may have an emergency C-section if:
Some people wish to have a C-section because they are worried about the pain or recovery of a vaginal birth. But if a C-section isn't necessary, vaginal birth is better for the health of the pregnant person and the baby. Plus, a C-section recovery takes longer than a vaginal birth recovery.
If you want an elective (not medically recommended) C-section, your provider will take time to discuss the risks. They can also provide information to help reassure you about a vaginal birth. For example, if you're worried about pain, they can help you make a birth plan that includes your choice of pain medication.
It's your choice to give birth vaginally or by C-section, but your provider will make sure you're fully informed.
Doctors only recommend C-sections when the risks of giving birth vaginally outweigh the risks of surgery. Your medical team will take steps to reduce complications and treat them right away if they occur.
Complications of a C-section include:
C-sections also increase the risk during future pregnancies.
Risks to future pregnancies include:
If you have a planned C-section, your doctor will schedule delivery for when your pregnancy reaches 39 weeks. However, doctors might need to perform a C-section earlier if you go into labor or health issues mean an earlier delivery would be better for your baby.
Emergency C-sections happen very quickly. If a baby is in serious distress in labor, a surgical team can begin a C-section in minutes.
You must avoid eating eight hours before your C-section. Clear liquids, like tea, apple juice, and water, are OK up to two hours before your appointment. Your hospital will also ask you to remove jewelry so it doesn't interfere with surgical equipment.
Your provider will discuss the risks of C-section with you, and you will sign a consent form. (In case of an emergency C-section, your partner may sign the form on your behalf, or the provider will request verbal consent.)
Your medical team will attach monitors to check your blood pressure and blood oxygen. They will also place a monitor on your belly for your baby's heart rate.
Before the C-section, you'll get an IV in your arm. Doctors will use the IV to deliver antibiotics, fluids, and any other medications you may need. A nurse will insert a catheter to drain your bladder during surgery.
Finally, you'll need compression sleeves around your legs. These squeeze your legs periodically to promote circulation and reduce your risk of blood clots.
If you already have an epidural from labor, your doctor can increase the dosage so that you don't feel any pain during the C-section.
If you're having a planned C-section, the provider will most likely administer a spinal block. The spinal block is pain medication injected into the fluid around the lower spine. It works in minutes to numb your abdominal and pelvic areas and legs.
About five percent of people get general anesthesia during a C-section instead of an epidural or spinal block. General anesthesia makes you sleep through the surgery. You are fully awake with an epidural or spinal block.
Although general anesthesia isn't as safe as other forms of pain medication, you might need it if:
Your surgical team will wash and may shave or clip hair on your skin. Usually, the surgeon will make a horizontal cut, about four to six inches long, in the lower pelvis. This cut is typically near where the top of a bikini bottom would be.
Sometimes, doctors make a vertical cut instead of a horizontal cut. They may do this if the baby is in an awkward position.
Next, your surgeon will cut your uterus. Then, they will carefully pull out the baby with gloved hands. Many hospitals offer clear surgical drapes if you wish to see this special moment.
Shortly after the birth, your nurse will clamp and cut the baby's umbilical cord. (Let your team know if your partner wants to do the cutting part). Then, they'll remove the placenta. Your surgeon will stitch up your uterus and skin. During this time, your partner can hold your baby.
You can hold your baby as soon as you feel ready — even right after your C-section. You can also try to breastfeed within hours of your surgery if you like. A lactation consultant can help you find a position that won't affect your stitches.
It takes about 10 to 15 minutes for the doctors to make the incisions and deliver the baby. In an emergency C-section, this process may only take a few minutes. Your doctor takes another 30 minutes to stitch up the incisions.
A C-section can take longer if there is significant scar tissue from a previous C-section, or if there is any bleeding that needs to be controlled.
Once the effects of the pain medication wear off (within three hours of surgery), you can eat, drink, and walk around. Getting your body moving quickly helps reduce the risk of blood clots. Your nurse will help you sit up and stand, as you may feel unsteady at first.
Your nurse will also offer oral or, if needed, IV pain medication as you recover in the hospital. You'll stay at the hospital for two to four days so you can rest and heal from surgery. Your team will monitor your health and make sure you don't develop any signs of complications.
Before you go home, your nurse will teach you how to care for the wound on your skin. The stitches in your uterus will dissolve on their own over a week or two. As the uterine wound from the placenta heals, you'll bleed from your vagina for up to several weeks. This bleeding is called lochia and happens after both vaginal and surgical births.
Doctors advise that you don't lift anything heavier than your baby as you recover. You should also avoid sex until the time your obstetrician advises it is safe for you. It takes six to eight weeks to recover fully from a C-section.
Recovering from a C-section while taking care of a newborn can be physically and emotionally tough. Be sure to ask friends and family for support. Your obstetrics care team can also link you to support groups, therapy, and other resources to help you.
