Having a caesarean section

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What is a caesarean section?

A caesarean section is a surgical procedure to deliver a baby by making an incision into the mother’s lower abdomen and uterus.

There are two kinds of caesarean section an emergency caesarean and a planned caesarean section, often referred to as an elective caesarean.

The difference between the two types is essentially when the decision to have a caesarean is made. An emergency caesarean is when the caesarean is not anticipated during the pregnancy and is required after labour has begun. A planned caesarean section is anticipated during the pregnancy and able to be scheduled prior to labour commencing.

A planned caesarean section is termed as an elective procedure because it is scheduled and not an emergency. Many people confuse the medical category of “elective” as meaning a preferential decision rather than a caesarean section which is medically required; this is not the case.

Who may need to have caesarean section?

A woman may be advised to have a caesarean section to deliver her baby if her health or the health of her baby may be at risk during a natural birth. For some of the conditions listed below a caesarean section may be the only option. However, depending on the condition and your specific risk factors a vaginal delivery may be possible. Your doctor can give you specific advice.

Some reasons a woman may need to have a caesarean section include:

  • if her placenta is covering her cervix, known as placenta praevia;
  • if she has preeclampsia or eclampsia;
  • if she has diabetes;
  • if she is morbidly obese;
  • if she has had heavy bleeding during pregnancy;
  • if the placenta is not functioning well and restricting oxygen or nutrients to the baby, known as intrauterine growth restriction;
  • if her uterus has ruptured;
  • if she has had a previous caesarean section;
  • if induction of labour has failed;
  • if she has an infectious disease, such as active herpes, AIDS or HIV;
  • if a previous vaginal birth has been traumatic;
  • if she is not able to cope with labour;
  • if her baby is too big to pass through their pelvis;
  • if her baby is not in a suitable position for a vaginal delivery;
  • if her baby is distressed and if continuing a vaginal delivery may lead to more distress;
  • if her labour is not progressing, and
  • if it is a multiple pregnancy.

Are caesarean sections dangerous to me or my baby?

There are always risks associated with any surgical procedure; however there are rarely complications with caesarean section deliveries. If your doctor recommends a caesarean section it is because they have identified risks to you or your baby which outweigh the risks of the surgical procedure.

Could my partner be present at the caesarean section birth?

Most hospitals try to accommodate partners being present during a caesarean delivery. Most caesarean sections are performed under local anaesthetic and partners can be present. However, if you require general anaesthetic they may not be able to be in the theatre. Also, in some emergency caesarean cases, due to the urgency or complexity, your partner may not able to be present. Medical staff are aware of the importance of having partners present for such a momentous occasion and do not restrict partners being at the birth of their baby unless there are very important medical reasons.

What kind of anaesthetic would I be given during the operation?

Most women only need to have an epidural or spinal block and can therefore still enjoy the birth of their child. Occasionally women may need to have general anaesthetic, if an epidural or spinal block may not take effect quickly enough, although this is rare.

Can you describe what will happen during the procedure?

First a drip will be placed in your arm. Next, you would be given an anaesthetic and then a catheter will be placed into your bladder to drain your urine. When you are ready for the procedure to begin a large drape will be hung across your chest, so that you and your partner do not have to watch the procedure but can still enjoy the birth of your child. During the procedure it is normal to feel sensations of pushing and pulling, however you will not feel any pain.

How much time does the operation take?

Typically a caesarean section takes approximately 40 minutes. The birth of the baby is relatively quick, usually occurring only five to ten minutes after the surgery begins. Most of the time required for the procedure is for stitching the layers of uterus and abdominal muscle after the baby has been delivered.

When could I hold my baby?

Ideally once the umbilical cord is clamped and cut the baby can be given to you for your first cuddle. A nurse would then take the baby for general tests, which take approximately ten minutes. Depending on the hospital, the baby may then stay with you in the recovery room or be taken to the postnatal ward with your partner while you begin to recover.

How much time does it take to recover from a caesarean section?

The recovery period after a caesarean section varies for each individual, but can take between six weeks and six months. Immediately after a caesarean section most women feel a degree of discomfort and pain relief is available. The woman would also have a drip and a urinary catheter in place for at least 24 hours after the surgery and often the epidural will be kept in place for up to 48 hours.

Women who have a general anaesthetic may feel fairly ‘groggy’ afterwards and may find it difficult to focus on their baby, this is quite normal. After a caesarean section women require plenty of rest and your doctor may recommend some gentle exercises to help with your recovery.

How much time would I need to spend in hospital?

Usually women who have had a caesarean section stay in hospital for approximately five days to recover. This may vary depending on your recovery rate.

When can I begin breastfeeding after a caesarean section?

Most hospitals encourage breastfeeding as soon as possible after delivery. You may be able to begin feeding your baby in the recovery room or when you arrive in your room on the postnatal ward. Staff will support you and ensure that you feel comfortable during feeding.

Is it normal to feel emotional after a caesarean section?

Often women feel highly emotional after birth and these emotions can be compounded if they have also had an unplanned surgery. It is important to talk about these feelings. Your doctor and staff on the postnatal wards are there to support you.

If I have a caesarean section once, does it rule out having future vaginal deliveries?

Not necessarily. Depending on the reasons for having a caesarean section in the first place, you may be able to have a vaginal birth for future deliveries; this is referred to as a vaginal birth after caesarean section (VBAC). Your obstetrician will be able to discuss your particular risks for future deliveries.