It’s probably not news to you that there are only two ways for a baby to make its entrance into the world – either vaginally or Caesarean Section (C-Section).
Although a C-Section is considered major surgery and may seem daunting, it isn’t necessarily the awful experience it's often made out to be, especially if you’ve got a better understanding of what it actually entails. So, rather than having you consult your Aunt Sally who delights in sharing birth stories that’ll make your toenails curl, we’ve compiled a list of ten things you should know about having a C-Section to put your pregnant mind at ease.
1. What is a Caesarean Section, exactly?
A C-Section is different from a vaginal birth in that the baby is surgically removed from the mother’s uterus through a (surprisingly small) incision. The incision is typically horizontal and low enough on the abdomen that it can be covered up by your bikini bottoms, although you won’t be allowed to hit the pool for at least 6 weeks following your surgery. Sometimes a C-Section occurs in the case of an emergency, and other times a mother may elect to have a C-Section.
2. Why might I need to have a C-Section?
A C-Section may be planned ahead of time for a variety of reasons including the following:
- The mother is carrying multiple babies.
- The baby is a future acrobat and has settled in a breech or transverse position.
- The mother’s placenta covers the opening of her cervix (placenta previa).
- The mother has had a previous C-Section and does not want to or cannot have a vaginal birth (also referred to as VBAC).
- The mother has a health concern that may make vaginal childbirth difficult or dangerous.
A C-Section may be the only option and occur as an emergency for reasons such as the following:
- The baby’s heart rate is dropping or he is otherwise in distress.
- The umbilical cord exits the cervix ahead of the baby.
- There is failure to progress during labor.
3. What is the difference between emergency, elected and “gentle” C-Sections?
Mothers who have experienced C-Section in both an emergency and an elected situation will tell you that the two experiences are quite different.
In an emergency situation, everything moves quickly – you are whisked away to an operating room, where doctors, nurses and an anesthesiologist will work to remove the baby as fast as possible. You may not have the opportunity to ask questions or see what is going on. Chances are, you will have already spent time experiencing labor and be very tired, meaning you will basically be struggling to keep two eyes open at a time once the baby arrives. Depending on the condition of your baby, you may or may not be able to have skin to skin contact, nurse, or make special requests such as delayed cord clamping immediately following the birth.
In an elected C-Section, you and your doctor will be able to monitor your pregnancy and decide on a date to have the surgery performed, which means, essentially, you will get to choose your child’s birthday. It is common for this date to be around the 39 week mark so you don’t go into labor first. Know that, because you have elected to have this surgery, any emergencies that come into the hospital prior to your surgery will bump you later in the day. The pace is much slower than in an emergency situation. You’ll probably be starving from fasting the night before, and the ice chips or soup broth they offer you post op won’t do much to hit the spot.
A “Gentle C-Section” is basically a more personalized elected C-Section. This procedure costs the same as a regular C-Section and only takes about 5 minutes longer. You may be able to choose the music being played in the operating room, be able to request the lowering of the screen so you can see what’s going on, talk with the surgical team, and ask questions about the procedure. The baby will be delivered head first, followed by the body, creating a birth that’s more like a vaginal birth. Following the birth of the baby, skin to skin contact and breastfeeding are encouraged.
In all three scenarios, hospital policy will determine whether you are able to have a support person with you during the surgery.
4. How can I prepare for a C-Section?
Maybe the most important thing you can do to prepare yourself for a C-Section is to acknowledge the fact that you might need to have one.
C-Sections account for about 30% of all births in the U.S., which means you have about a 1 in 3 chance of having one. Talk to your doctor about what this might look like for you, and ask any questions about the process you may have. Have a birth plan, but don’t get so attached to the idea of everything happening exactly as you hope, to avoid feelings of guilt, anger, or sadness if it doesn’t.
If you have elected to have a C-Section, it’s not a bad idea to make meals ahead of time and freeze them so you don’t have to cook (good news: having a C-Section gives you the absolute best excuse to get out of any and all household chores). In the hours (or even days) prior to the surgery, you may want to eat “lighter” foods to give your digestive system a break, as the surgery will slow down your intestines, and post-delivery constipation is NO JOKE. Trust me on that one.
5. What happens during a C-Section?
More than likely, you will be given a spinal block or epidural and will be awake during the surgery. When I had my C-Section, the nurse who put in my IV prior to the surgery promised me that it would be the most painful part of the entire process, and I actually found this to be true (good news: it hardly hurt at all.)
You will be numb from the waist down and may feel some tugging and jostling, but apart from that, you will have no feeling during the surgery and for a few hours afterward. You will have a catheter inserted as well, but it’s likely that this will be happening behind the big blue curtain that they put up just over your waist, so you can’t see a dang thing.
If they are allowed in, your support person will sit by your head and be able to hold your hand during the process. If you’re like me, you may quietly request that your support person ask the surgeon to give you a tummy tuck when they’re finished, but if you are also like me, they will say no.
As long as there are no complications, you can expect to be seeing your newborn raised overhead, Simba-style in 30 to 45 minutes.
6. What happens during recovery from a C-Section and how long will it take?
- Shortly after you come out of surgery, it’s common to feel cold and to get the shakes.
- You will be given medication to help with the pain. It’s important to remember that the medications you receive can be constipating, so drink plenty of fluids to help prevent this. You will also be offered stool softeners, and it’s highly recommended that you abandon any pride at this point and accept them graciously. You might be surprised at how soon a nurse will have you up and walking. As painful as it sounds, the most difficult part of the whole thing will probably be trying to navigate your way around while attached to an IV and a catheter. Oh, and be warned: the first time you stand up, there will be blood. Probably a lot of it. This is when those sexy maternity undies come in verrrry handy.
- You will either have stitches or staples closing your wound. If you have dissolvable stitches, they will disappear on their own, but if you have staples, you will have to have them removed after a few days.
- Keep wearing your maternity pants or other loose fitting clothing to avoid rubbing your incision.
- Coughing, sneezing and laughing may be tricky while recovering from abdominal surgery, so you may find it handy to apply gentle counter pressure to your incision with a pillow if you feel the urge to do any of the above.
- The recovery time for a C-Section is typically 6-8 weeks, but of course, every person is different.
7. What will I be unable to do while recovering from a C-Section?
A few of the things you should avoid doing for at least 6 weeks include the following:
- Driving (this is probably the trickiest one to avoid)
- Vacuuming (this is probably the easiest one to avoid)
- Lifting anything heavier than your baby in its car seat (this includes toddlers, so in the weeks prior to your surgery, it may be a good idea to get them used to the idea of not being picked up or carried)
- Swimming or baths
- Strenuous exercise
- Intercourse (although you may think that things down there are intact and good to go, you are still healing from major surgery and are more prone to infection, so you’ll just have to Netflix without the chill for a while).
8. Can I ask for a C-Section instead of having a vaginal birth?
You sure can, but your doc probably has the final say. If you have had a previous C-Section or have health concerns, your doctor will be more likely to grant your request, as many hold the belief that C-Sections should be avoided where possible.
9. What are the possible side effects of a C-Section?
- As with any surgery, side effects can occur. Bleeding, infection, blood clots and surgical injury are side effects that some women have experienced.
- As the body heals from surgery, strands of collagen can form, creating adhesions. This can cause discomfort and make future deliveries more difficult. For this reason, women who want to have large families are recommended not to have multiple C-Sections.
- Repeated C-Sections can lead to a higher risk of Placenta Previa and Placenta Accreta.
- There can be a risk of uterine rupture along the line of the incision, particularly if you decide to attempt a VBAC, but your doctor will be able to help you decide if this is a safe option for you in future pregnancies.
10. Should I feel guilty for having a Caesarean Section?
In a word, no. In two words, hell no. Growing a human being and bringing them into the world is no easy feat, regardless of how you do it. Your birth story is an incredible, beautiful one and, as a bonus, your baby will have the roundest head of at least 2/3 of his newborn friends.
Related: Why the F!@# Didn’t Anybody Tell Me a C-Section Was Like This?!