Understanding Your C-Section & How to Prepare for a Successful Surgery

Caesarean delivery — also known as a C-section — is a surgical procedure used to deliver your baby through an incision in your abdomen. Some C-sections are planned due to pregnancy complications or because you've had a previous C-section. But, in many cases, the need for a first-time C-section doesn't become obvious until labor has already started. Knowing what to expect during the procedure and recovery can help you prepare.

Why it's done

Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your doctor may recommend a C-section if: 

• Your labor isn't progressing

  Stalled labor is the most common reason for a C-section. Perhaps your cervix isn't opening enough despite strong contractions over several hours. Or the baby's head may simply be too big to pass through your birth canal.

• Your baby's heartbeat suggests reduced oxygen supply

  If your baby isn't getting enough oxygen or your doctor is concerned about changes in your baby's heartbeat, he or she may recommend a prompt C-section.

• Your baby is in an abnormal position

  A baby whose feet or buttocks enter the birth canal before the head is in the breech position. If your doctor isn't able to move the baby into a more favorable position before labor begins, you may need a C-section to reduce the risk of complications. A C-section is also needed if your baby is lying horizontally across your uterus.

• Your baby's head is in the wrong position

  If your baby enters the birth canal chin up or with the top of the forehead or face leading the way, he or she may not fit through your pelvis. A C-section may be the safer way to deliver the baby.

• You're carrying twins, triplets or other multiples

  When you're carrying multiple babies, it's common for one or more of the babies to be in an abnormal position. In this case, Caesarean birth is often safer — especially for the second baby.

• There's a problem with your placenta

  If the placenta detaches from your uterus before labor begins (placental abruption) or the placenta covers the opening of your cervix (placenta previa), C-section is often the safer option.

• There's a problem with the umbilical cord

  A C-section may be recommended if a loop of umbilical cord slips through your cervix ahead of your baby or if the cord is compressed by the uterus during contractions.

• Your baby is very large

  Some babies are simply too big to safely deliver vaginally. Typically this is only a factor if you have diabetes.

• You have a health problem

  If you have a condition such as diabetes, heart disease or lung disease, your doctor may induce labor early to reduce the risk of pregnancy-related complications. If the induction isn't successful, you may need a C-section.

• Your baby has a health problem.

  A C-section may be safer for babies with certain developmental problems, such as failure of the spine to close properly (spina bifida) or excess fluid in the brain (hydrocephalus).

• You've had a previous C-section.

  Depending on the type of incision and other factors, you may be able to attempt a vaginal delivery after a previous C-section. In some cases, however, your doctor may recommend a repeat C-section.

In other circumstances, a C-section may be recommended if you have an active genital herpes infection or another condition that your baby might acquire while passing through the birth canal.

In addition, some women request elective C-sections with their first babies — typically to avoid labor or the possible complications of vaginal birth. If you're considering an elective C-section, work with your doctor to make the best decision for you and your baby. 

What you can expect during the procedure of a C-Section

An average C-section takes about 45 minutes to one hour. In most cases, your spouse or partner can stay with you in the operating room during the procedure. 

• Preparation

  Before the C-section, a member of your health care team cleanses your abdomen. A tube (catheter) may be placed into your bladder to collect urine. IV lines are placed in a vein in your hand or arm to provide fluid and medication. A member of your health care team may also give you an antacid to reduce your risk of an upset stomach during the procedure.

  (MORE ON WHAT YOU CAN DO TO PREPARE FOR A C-SECTION.  CLICK HERE.)

• Anesthesia

  Regional anesthesia — one which numbs only the lower part of your body — is most often used during C-sections. One type of regional anesthesia that can be used is a spinal block. With a spinal block, the medication is injected directly into the sac surrounding your spinal cord. Another type of regional anesthesia used during C-sections is epidural anesthesia. With epidural anesthesia, pain medication is injected into your lower back just outside the sac that surrounds your spinal cord. 

  If there's a need to start the procedure quickly, a spinal block is often used because it takes effect faster than epidural anesthesia. 

  If you receive a regional anesthesia, you'll be awake during the procedure and will be able to hear and see the baby right after delivery. 

  In an emergency, you may need general anesthesia. This type of anesthesia is usually started with medication delivered through an IV line in your arm, but sometimes it can be started with a gas that you breathe from a mask. With general anesthesia, you won't be able to see, feel or hear anything during the birth. 

  (WHAT HAPPENS WHEN YOU'RE ASLEEP DURING SURGERY?  CLICK HERE)

• Abdominal incision

  Your doctor makes an incision through your abdominal wall. It's usually done horizontally near the pubic hairline (bikini incision). If a large incision is needed or your baby must be delivered very quickly, your doctor may make a vertical incision from just below the navel to just above the pubic bone.

• Uterine incision

  After the abdominal incision, your doctor makes an incision in your uterus. The uterine incision is usually horizontal across the lower portion of the uterus (low transverse incision). Other types of uterine incisions may be used depending on your baby's position within your uterus and whether you have complications, such as placenta previa.

• Delivery

  If you have epidural or spinal anesthesia, you'll likely feel some movement as the doctor gently removes your baby from your uterus — but you won't feel pain. The doctor clears your baby's mouth and nose of fluids, and clamps and cuts the umbilical cord. The placenta is removed from your uterus, and the incisions are closed with stitches.

Although you may not be able to hold your baby immediately, you'll likely be able to see your baby right away. 

C-Section might not be your first choice for delivery, but it is a healthy and safe way to bring a child into the world.  So take a deep breath and relax.  You'll do great!  For more excellent surgery-preparation resources, checkout our blogs or buy our ebooks and audio-files.