Cesarean Section: Overview

What is a cesarean section?

A cesarean section is an operation done to deliver your baby through your abdomen (belly). It may be done when delivery through the birth canal (vagina) is not possible or safe for you or the baby. Your healthcare provider makes a cut in your abdomen and uterus to remove the baby. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

This procedure is also called a C-section.

If you might need to have a C-section to deliver your baby, you and your healthcare provider should discuss C-section delivery during the early part of your pregnancy. This will help you prepare for it if it suddenly becomes necessary.

When is it used?

A C-section may be performed before labor begins if there are medical reasons for not having labor or a vaginal delivery. For example, the health of the mother or the baby may be in danger if the pregnancy continues or vaginal delivery might be impossible or unsafe.

A C-section may also be done when labor begins or during labor if certain problems occur. For example, a C-section may be necessary if the baby is breech, which means that the baby is in a position where the bottom, knees, or feet will come out before the head in a delivery through the vagina (birth canal). Having a C-section for a breech baby is especially likely to be recommended if it is your first baby.

For some women in labor, the cervix can begin to dilate and then stop before it is fully dilated. Oxytocin may be given to try to make the contractions stronger. Despite this drug, however, many women do not dilate fully and cannot deliver vaginally. Other women may dilate fully but may not be able to push their babies far enough down the birth canal for a safe vaginal birth. This may happen because the baby is too large for the woman's birth canal. A C-section may be performed in these situations.

At any time during labor a baby or mother may develop problems that cause the baby's heartbeat to slow down. These problems may indicate that the baby may need to be delivered by C-section.

How do I prepare for a cesarean section?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties and the care of your newborn baby.

No one should smoke. You should especially not smoke when you are pregnant because it can hurt the baby. If you have been smoking during your pregnancy and know you will have a C-section, you should quit at least 2 weeks before the procedure. Smokers heal more slowly after surgery and have more risk for infections. They are also more likely to have breathing problems during surgery.

Follow instructions provided by your healthcare provider. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

If you go into labor, have contractions, or bleeding, then call your healthcare provider right away.

What happens during the procedure?

You are given an intravenous (IV) and a regional or general anesthetic. A regional anesthetic numbs the lower half of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

Your healthcare provider makes a cut below your bellybutton and into the lower part of the uterus to remove the baby. Your provider removes the baby, placenta, and birth sac. Your provider then sews the uterus and abdomen closed.

What happens after the procedure?

Your abdomen will be sore. You may need help with positioning your baby comfortably for feeding. Walking and standing will be uncomfortable for the first few days. Since you will probably be in the hospital for only 2 to 4 days, try to have help at home for the first week or two.

Your provider may give you an antibiotic to take after the surgery to help stop infection.

The cuts made in the abdomen to deliver the baby are usually horizontal, or across the womb. This allows the muscles in the womb to safely stretch for future childbirth. Many women are able to deliver the next baby through the birth canal.

What are the benefits of this procedure?

C-sections can save the lives of newborns and their mothers or prevent the potential complications of a delayed vaginal birth. For example, delivering the baby by C-section may be safer for you and the baby if the baby is having abnormal fetal heart rate patterns or you have severe preeclampsia (high blood pressure caused by pregnancy).

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. In most cases, regional anesthesia is considered safer than general anesthesia.
• A blood vessel may rupture or be cut and bleed inside your body.
• A piece of blood clot may break off, enter the bloodstream, and damage the lungs.
• The cut in the wall of the uterus may leave a weak part in the wall.
• Any future children may need to be delivered by C-section, depending on how this C-section was done.
• You may develop an infection or bleeding.
• The bowel, bladder, or ureter may be injured.
• The baby might be injured during the surgery.

You should ask your healthcare provider how these risks apply to you.

How can I help take care of myself?

• Avoid heavy lifting for 6 weeks. Usually after 6 weeks you may begin an exercise program to regain abdominal muscle tone. Ask your healthcare provider what other steps you should take and when you should come back for a checkup.
• Keep the wound clean and dry. Bathe by shower and gently pat dry with a soft towel.
• Wear loose fitting clothing to keep from irritating the incision.
• Itching around the scar is usually a sign of normal healing. Try not to scratch the area to avoid damaging the incision.
• While most creams, lotions, and powders are unlikely to seriously harm a healing scar, they are not usually recommended because they don't help the healing and may irritate the area.

When should I call my healthcare provider?

If you have just had a C-section, call your provider right away if:

• You develop a fever over 100.5°F (38°C).
• You have bleeding or drainage from your incision, or the incision separates.
• You have heavy bleeding from the vagina.
• You become dizzy or faint.
• You have leg pain, especially if your leg is also swollen and red.
• You have nausea and vomiting.
• You have chest pain.
• You have worsening abdominal pain.
• You become short of breath.

Call your provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.