A cesarean birth is a surgical procedure used to deliver a baby when vaginal delivery is not a safe option.
Whether planned or unexpected, understanding the circumstances that make a cesarean necessary and what the procedure entails is crucial for expectant parents.
This guide will cover when a cesarean birth might be needed, what to expect during the procedure, and key information you should know to feel prepared.
Reasons for a Cesarean Birth
A cesarean birth may be necessary for several medical reasons, which can either be planned in advance or decided during labor due to unforeseen complications.
Planned Cesarean Births
- Medical Conditions: Certain medical conditions make a planned cesarean birth the safest option. These include placenta previa, where the placenta covers part of the cervix, or when the baby is in a breech position and cannot be safely turned. Additionally, mothers with a history of uterine surgeries, such as a previous cesarean or fibroid removal, may be recommended a cesarean to avoid the risk of uterine rupture during vaginal delivery.
- Multiple Pregnancies: When expecting twins, triplets, or more, a cesarean birth is often recommended to reduce risks associated with vaginal delivery. The positioning of the babies and potential complications during delivery often make a cesarean the safer choice.
- Previous Cesarean Birth: If you’ve had a cesarean in a previous pregnancy, your healthcare provider might suggest a repeat cesarean to minimize risks like uterine rupture during a vaginal birth after cesarean (VBAC). However, this decision is usually made after evaluating the mother’s health and the specifics of her prior cesarean.
Emergency Cesarean Births
- Fetal Distress: An emergency cesarean may be necessary if the baby shows signs of distress, such as a significant drop in heart rate. In these cases, a cesarean is performed quickly to ensure the baby is delivered safely.
- Labor Complications: Complications during labor, such as prolonged labor or the baby not progressing down the birth canal, can make a cesarean the safest option. When labor isn’t progressing, or if the mother or baby shows signs of distress, a cesarean is often the best course of action.
- Maternal Health Concerns: Sudden maternal health issues, such as preeclampsia (a dangerous rise in blood pressure), can necessitate an emergency cesarean to protect both the mother and baby. Other conditions, like a uterine rupture or placental abruption, also require immediate cesarean delivery.
What to Expect During a Cesarean Birth
Knowing what to expect during a cesarean birth can help you feel more prepared and less anxious about the process.
Preparation for Surgery
Before the surgery begins, you’ll be prepped in the operating room. This includes receiving an IV line in your arm or hand to administer fluids and medication, including antibiotics to prevent infection.
You’ll also have a catheter placed to keep your bladder empty during the procedure. If necessary, your healthcare provider will shave or trim the area around the incision site.
Anesthesia is administered next, with most cesareans performed under regional anesthesia, such as an epidural or spinal block, which numbs the lower part of your body. This allows you to stay awake during the birth and see your baby as soon as they are born.
In some emergency cases, general anesthesia may be used, which will put you to sleep for the procedure.
The Surgical Process
Once anesthesia is effective, the surgeon will make an incision in your abdomen, usually just above the pubic hairline.
This is typically a horizontal incision, known as a “bikini cut,” but in some cases, a vertical incision may be made. After the abdominal incision, a second incision is made in the uterus to access the baby.
The baby is then delivered through these incisions, which is usually a quick process. You might feel some pressure or a pulling sensation, but there should be no pain due to the anesthesia.
After the baby is born, the umbilical cord is cut, and the placenta is removed.
Closing the Incisions
Once the baby and placenta are delivered, the gynecologist or surgeon will close the incisions in your uterus and abdomen with sutures or surgical staples. The entire procedure typically takes about 45 minutes from start to finish.
If you’re awake, you may be able to hold your baby shortly after delivery, depending on the specific circumstances and hospital protocol.
Immediate Post-Surgery Care
After the surgery, you’ll be moved to a recovery area where you’ll be monitored closely. Nurses will check your blood pressure, heart rate, and other vital signs, as well as the firmness of your uterus.
You’ll likely experience some pain as the anesthesia wears off, and pain management will be provided.
Depending on the hospital’s procedures, you may be able to start breastfeeding in the recovery room.
Preparing for a Cesarean Birth
Taking steps to prepare for your cesarean birth can help you approach the experience with greater confidence and peace of mind.
Creating a Birth Plan
Even if you’re planning a cesarean, it’s helpful to have a birth plan in place.
This plan should include your preferences for the procedure, such as whether you want to have skin-to-skin contact immediately after delivery or your choices for pain management.
Discussing these details with your healthcare provider well before your due date ensures that your wishes are known and respected during the birth.
Discussing Anesthesia and Pain Management
Talk to your healthcare provider about the type of anesthesia that will be used during your cesarean.
Most cesareans are performed with regional anesthesia, like a spinal block or epidural, which allows you to be awake during the birth.
Discuss any concerns you may have about pain management during and after the procedure, so your care team can tailor their approach to your needs.
Packing for the Hospital
When preparing for a cesarean birth, packing the right items can make your hospital stay more comfortable.
Include loose-fitting clothing that won’t press on your incision site, such as high-waisted underwear and soft, breathable pajamas.
You may also want to pack items that provide comfort and support during recovery, like a nursing pillow, supportive slippers, and your preferred toiletries.
Preparing Your Home for Recovery
Since recovery from a cesarean can take several weeks, it’s important to prepare your home in advance. Arrange for help with household tasks and childcare if you have other children.
Set up a comfortable recovery area at home with easy access to essential items like water, snacks, pain medications, and entertainment.
Consider placing frequently used items within arm’s reach to avoid unnecessary strain on your incision
Research the Procedure and Recovery
Educating yourself about the cesarean procedure and what to expect during recovery can help ease any concerns.
Attend any pre-surgery appointments and ask your healthcare provider about the steps involved, from the incision to the closure of the surgical site.
Knowing what to expect can help you feel more in control and confident as you approach your delivery day.
Feel Confident for Your Birth Experience, No Matter the Method
Whether your cesarean is planned or happens unexpectedly, being informed and prepared will help you approach the experience with confidence.
By focusing on what you can control and communicating openly with your healthcare team, you can create a positive and empowering birth experience, no matter the delivery method.