C-section: What you need to know

A Caesarean section is an operation that is performed to deliver a baby. Caesarean sections can be carried out electively (planned) or in emergency situations. If you are due to have an elective caesarean section you will have time to discuss the procedure with your midwife, get lots of information and prepare yourself. However, if you should end up having an emergency caesarean section you might have no time to discuss anything. I will try to explain why this might happen and what you can expect.

Elective Caesarean Section

An elective caesarean section is a planned procedure. It can be required if there is an existing medical conditions where a normal vaginal birth may put you or your baby at risk. There are a number of reasons where you will almost definitely be required to have a caesarean section:

  • Placenta Previa – This is where the placenta is low lying and covering part of the entrance to the womb.
  • Breech Presentation – Due to the difficulties and associated risks with delivering a baby in breech position, an elective caesarean section is recommended.
  • Previous Caesarean Section – If you have had two or more caesarean sections you will be required to have all your subsequent babies delivered this way.
  • Infection – If you have genital herpes you may be offered a caesarean section to reduce the risk of transferring the virus to your baby.
  • Medical Conditions – If a vaginal delivery puts the mother at risk because of an existing medical condition, such as a heart problem. Also, if the baby has a medical condition that is unsuitable to vaginal deliveries an elective caesarean section can be planned.
  • Maternal Request – Some women request a caesarean section for personal reasons or because they are anxious about childbirth, if this is the case it is important to talk to your midwife to discuss the fears you are having.

Emergency Caesarean Section

An emergency caesarean section is performed where circumstances in pregnancy can affect the health of you or your baby. This can happen before or during labour. Emergencies are unpredictable and can occur at any time.

  • Bleeding – If you have a large amount of vaginal bleeding during labour or if you have heavy vaginal bleeding with abdominal pain, you may require an emergency caesarean section.
  • Lack of oxygen – If your baby becomes distressed during labour and is suspected of not receiving enough oxygen, you will require a caesarean section as a vaginal delivery can sometimes take too long. This will depend on what stage of labour you are at.
  • Failure to Progress – If the baby fails to move down the birth canal despite your efforts and medical intervention, then there may be no option but to deliver by caesarean section.
  • Failed Induction – There are a number of reasons why your labour may have to be induced. Delivery by caesarean section will be required if medical methods fail to produce contractions strong enough to lead to a vaginal delivery.

Anaesthesia

A caesarean section is usually performed under regional anaesthetic, using either a spinal anaesthetic or an epidural. This numbs the lower part of your body so you won’t feel the operation and allows you to stay awake during the procedure. In some instances, where it is not possible to give a regional anaesthetic, a small number of women are put to sleep with a general anaesthetic.

Preparations

Before your caesarean section takes place you will need to have:

  • a blood test
  • anti-emetics (anti sickness medication)
  • a urinary catheter
  • your bikini line shaved

Theatre

A caesarean section takes between 40-60 minutes. A sheet will be place in front of you so you won’t be able to see the operation. A horizontal cut will be made to the lower abdomen, the top of your bikini line. Your baby will be delivered through this incision. You will get a quick look at your baby before he or she is passed to the midwife to be dried off, weighed and have name tags put on. Some theatres will offer you skin to skin with your baby for the duration of the operation.

Recovery

The incision will then be closed using either

  • stitches that need to be removed or stitches that dissolve
  • staple clips, these also need to be removed
  • skin glue

After the operation you will be moved to a recovery room, where you will be monitored to make sure you are recovering well. Some recovery rooms allow your partner and baby to stay with you. If this is the case you can continue skin to skin and start breastfeeding baby as soon as you are able. You will then be transferred to the postnatal ward. Generally you can eat and drink a few hours after your operation. It is important to drink plenty of water and have fibre in your diet as you are at risk of constipation.

It is important to take pain relief following your caesarean section, especially as you will be caring for a new baby. You are at a higher risk of developing a blood clot in your veins following a caesarean section, so you will most likely receive an injection to help prevent this.

 

Although all of this might sound a little scary, try not to worry. Your medical team will take great care of both you and your baby. If you have any concerns about having a caesarean section, make sure to talk them through with your doctor or midwife.