Also known as a Caesarean section, a C-section is when a mother delivers her baby through an incision made in her abdomen and uterus. C-sections can be pre-planned, or a doctor can order them on the spur of the moment if a complication arises. Studies say that C-sections are on the rise. According to the Centers for Disease Control and Prevention, 30 percent of births were done by Caesarean in 2005, compared to 6 percent in 1975.
Sometimes it’s obvious before labor even begins that a woman will need a C-section. There are several signs before and during the hospital stay that indicate to the doctors how the birth will go. If the labor is prolonged or if the mother isn’t progressing, a planned C-section may take place. Other indications include:
- Overly large baby
- Fetal distress
- Cord prolapse
- Uterine rupture
- Induction failure
- Multiple births
- Pre-eclampsia
- Uncontrolled Hypertension
- Contracted pelvis
- Genital herpes (for more information, see our article on Pregnancy and STDs)
- HIV
- Baby is in a breech position
- Previous invasive uterine surgery
- Baby has a known illness
In many hospitals, partners of the expectant mother are encouraged to take part in the entire process, and are even asked if they’d like to watch as the baby is pulled from the abdomen. It’s important that the mother is supported during this event, and sharing the experience is known to decrease the stress and anxiety associated with the situation. It has also been shown to improve bonding.
Risks of C-Sections
C-section is a major abdominal surgery, which makes it much riskier than vaginal delivery. Other risks involved in the procedure include:
- Infections
- Blood clots
- Excessive bleeding and/or blood loss
- Longer recovery
- Longer hospital stay
- Postpartum pain
- Injury to bladder or bowels
- Post-operative adhesions
- Incisional hernias
- Emergency hysterectomy
- Placenta accreta
- Placenta previa
- Malpresentation
- Uterine rupture
- Preterm birth
- Prolonged labor
- Low birth weight
But these aren’t the only risks. Having a Caesarean birth reduces your chance of being able to give birth vaginally in the future. Although VBACs (vaginal births after Caesarean) are possible and becoming more common, the risks increase with each scar left on your uterus.
Types of Caesarean Sections
There are many different types of C-sections, which mostly differ in the type of incision made in the uterus.
Classical C-Section: Because of the commonness of complications, classical C-sections are rarely performed these days. They involve a midline longitudinal incision that makes a larger opening to deliver the baby. There are specific medical indications for the use of this type of incision. It is never permissible to attempt a VBAC after a classical uterine incision.
Low transverse uterine incision: This is the most commonly performed procedure today. It involves a crosswise cut just above the edge of the bladder. This procedure is proven to result in less blood loss, and women who have it may be allowed to have VBAC with future pregnancies.
Emergency C-Section or Crash C-Section: This can occur for a variety of reasons, but it is always done immediately.
Repeat C-Section: A repeat C-section happens when a patient has had previous C-sections. Generally, doctors will re-enter the womb through the old scar.
Caesarean Hysterectomy: This is a C-section followed by the removal of the uterus. If the placenta cannot be separated from the uterus, or if there is intractable bleeding, a hysterectomy will follow the removal of the baby. This is a life-saving procedure.
During the C-Section
A typical C-section takes about 40 minutes to an hour to complete. Unlike most other surgeries, your spouse or partner is able to stay with you in the operating room during the procedure. The first thing that takes place is the cleaning of your abdominal area. A catheter is usually inserted into your bladder to gather urine, and an IV is placed in one of your veins to provide you with fluids and medications. Then an anesthesiologist will come in and give you a regional anesthesia that only numbs your lower body, leaving you awake during the procedure. Only in an emergency will you be given general anesthesia.
Next an incision is made in your abdomen, and then your uterus. Depending on the baby’s position, your doctor will either make a small incision or a large one to deliver the baby. Even though you may not be able to hold your baby immediately, you will be able to see and hear your baby the moment he or she is born. Hospitals are moving toward immediate “skin to skin” contact between mother and baby following birth. This can occur after a C-section if mother and baby are both stable.
Recovering from a C-Section
Generally, Mom and baby stay in the hospital for up to three days after a Caesarean birth. Within the first 24 hours, Mom is encouraged to walk around to help with constipation and to prevent blood clots. Catheters and IVs are usually removed within 12 to 24 hours. Once you’re home, it’s important that you follow a few simple rules:
- Get plenty of rest
- Drink plenty of fluids
- Support your abdomen
- Avoid sex for up to six weeks
- Take medications as prescribed
- Contact your doctor immediately if problems arise