(Cesarean Section, C-section, Cesarean Birth)
Cesarean delivery (also called a cesarean section or C-section) is the surgical delivery of a baby by an incision through the mother's abdomen and uterus. This procedure is performed when it is determined to be a safer method than a vaginal delivery for the mother, baby, or both.
In a cesarean delivery, an incision is made in the skin and into the uterus at the lower part of the mother’s abdomen. The incision in the skin may be vertical (longitudinal) or transverse (horizontal), and the incision in the uterus may be vertical or transverse.
A transverse incision extends across the pubic hairline, whereas, a vertical incision extends from the navel to the pubic hairline. A transverse uterine incision is used most often, because it heals well and there is less bleeding. Transverse uterine incisions also increase the chance for vaginal birth in a future pregnancy. However, the type of incision is determined by conditions of the mother and the fetus.
If a woman is unable to deliver vaginally, the fetus is delivered surgically by performing a cesarean delivery. Some cesarean deliveries are planned and scheduled accordingly, while others may be performed as a result of complications that occur during labor.
There are several conditions which may make a cesarean delivery more likely. These include, but are not limited to, the following:
There may be other reasons for your physician to recommend a cesarean delivery.
As with any surgical procedure, complications may occur. Some possible complications of a cesarean delivery may include, but are not limited to, the following:
A woman may or may not be able to have a vaginal birth with a future pregnancy, called a vaginal birth after cesarean (VBAC). Depending on the type of uterine incision used for the cesarean birth, the scar may not be strong enough to hold together during labor contractions.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
A cesarean delivery may be performed in an operating room or a designated delivery room. Procedures may vary depending on your condition and your physician’s practices.
In most cases, you will be awake for a cesarean delivery. Only in rare situations will a mother require general anesthesia (you will be asleep) for this type of birth. Most cesarean deliveries today are performed with a regional anesthesia such as an epidural or spinal. With these types of anesthesia, you will have no feeling from your waist down, and you will be awake and able to hear and see your baby as soon as he/she is born.
Generally, a cesarean delivery follows this process:
You will be taken to the recovery room for observation. Nurses will monitor your blood pressure, breathing, pulse, bleeding, and the firmness of your uterus.
Usually, your baby can be brought to you while you are in the recovery area after surgery. In some cases, babies born by cesarean will first need to be monitored in the nursery for a short time. Breastfeeding can begin in the recovery area, just as with a vaginal delivery.
After about one to two hours in the recovery area, you will be moved to your room for the rest of your hospital stay.
As your anesthesia wears off, you may receive pain medication as needed, either by a nurse or by administering it yourself through a device connected to your intravenous line. In some cases, pain medication may be given through the epidural catheter until it is removed.
In addition to the soreness of your abdomen, you may also have gas pains as the intestinal tract begins working again after surgery. You will be encouraged to get out of bed. Moving around and walking are helpful in relieving gas pains. Your physician may also recommend medication for this. You may also feel some uterine contractions called after-pains for a few days. The uterus continues to contract and get smaller over several weeks.
Your urinary catheter will be removed usually by the next day after surgery.
Depending on your situation, you may be given liquids to drink a few hours after surgery. Your diet may be gradually advanced to more solid foods as tolerated.
You may be given antibiotics in your IV while in the hospital and a prescription to continue the antibiotics at home.
You will need to wear a sanitary pad for bleeding. It is normal to have vaginal bleeding for several days after birth, followed by a discharge that changes from dark red/brown to a lighter color over several weeks.
You should not douche, use tampons, or have intercourse until the time recommended by your physician. You may also have other restrictions on your activity, including no strenuous activity, driving, or heavy lifting.
Take a pain reliever as recommended by your physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Arrangements will be made for a follow-up visit with your physician, usually two to three weeks after the procedure.
Notify your physician if you have any of the following:
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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American College of Obstetricians and Gynecologists