What is a cesarean section?

A cesarean section is an abdominal operation performed to deliver a baby when delivery through the birth canal (vagina) is not possible or safe. The doctor makes a cut in the mother's 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. In the U.S. 15% to 25% of all births are by cesarean section.

You and your health care provider should discuss C-section delivery during your pregnancy so you are prepared if it becomes necessary.

When is it used?

A cesarean 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 cesarean section may also be done when labor begins or during labor if certain problems occur. For example, if at the time of delivery the lowest part of the baby is the face, brow, shoulder, or buttocks (breech), instead of the head, a cesarean section is usually necessary.

For many women in labor, the cervix begins to dilate and then stops before it is fully dilated. Oxytocin may be given 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 cesarean section may be performed in these situations.

At any time during labor a baby may develop problems that cause the baby's heartbeat to slow down. These problems may indicate that the baby cannot tolerate further labor and a cesarean section may be necessary.

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What are the benefits of this procedure?

Cesarean sections can save the lives of newborns and their mothers or prevent the potential complications of a delayed vaginal birth. Delivering the baby by cesarean section may be safer for you or the baby when:

In addition, some of the pain of labor may be avoided, and it may be possible to schedule the time of the delivery.

What are the risks associated with this procedure?

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

How do I prepare for a cesarean section?

Plan ahead 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.

Follow instructions provided by your health care provider or office nurse. 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 of the procedure. Do not even drink coffee, tea, or water.

Cesarean Section Pre-Operative Instructions

If you go into labor before your scheduled surgery date, call your health care provider or go to Triage (734-764-8134).

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What happens during the procedure?

Preparation for Your Support Person

If your support person is planning to attend the birth, operating room clothing (scrub suit, hair cover, shoe covers, and mask) will be provided.  Your support person should eat something before coming in to the hospital with you (or before going into the operating room). 

In the Operating Room

Once you are in the operating room, the staff will assist you in moving onto the operating table.  You can expect the room to be cool, but warm blankets will be provided.  You health care provider and other nurses, anesthesiologists, obstetricians and pediatricians will be with you in the operating room.

The two anesthesia options are general and regional anesthesia.  General anesthesia puts you to sleep.  Regional anesthesia stops feeling from the top of your uterus down to your feet.  With regional anesthesia you can be awake during the entire birth and you will not feel the surgery.

A small pillow or blanket roll will be placed under your right hip to tilt you toward your left side.  This position promotes increased blood flow to the uterus for the baby.  Your arms will be positioned so your IV can be observed and so your support person can hold you hand.  A safety belt will be placed around your thighs. 

Various monitors will be used so the anesthesiologist can continually observe your blood pressure and pulse.  Your nurse may listen to your baby's heart rate again.  You may be given oxygen to breathe through a mask or tubing placed by your nose.

The nurse will wipe your abdomen with an antiseptic solution, while other staff prepares for your surgery.  Sterile drapes will be placed and you and your support person will be unable to see the incision area.  If you would like to see the baby at birth, the drapes can be lowered in front of you as the baby is delivered.

Once surgery begins, your baby will be delivered within five to fifteen minutes. The doctor makes a cut below your belly button and into the lower part of the uterus to remove the baby. The doctor removes the baby, placenta, and birth sac. The doctor then sews the uterus and abdomen closed.  Caregivers will immediately examine your baby at the infant warming bed.  Matching identification bands will be placed on your baby, you and your support person.  Your baby will be weighed, wrapped in warm blankets and brought to you to be cuddled and touched.  It may be possible for the baby to remain in the operating room and accompany you to the surgical recovery room.

After the baby is born it will take about 45 to 60 minutes to finish your surgery.  Your incision will be closed with staples or stitches and a dressing will be placed over the incision.  You will be moved onto a stretcher and taken to the recovery room. 

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What happens during my hospital stay?

You will be in the recovery room for one to three hours usually.  Your blood pressure and pulse will be checked frequently as will the amount of bleeding you are having.  You will be given pain medication.  The anesthesiologist will talk to you about the options for post-operative pain management.  You may receive narcotics from injections every few hours (such as morphine), have intravenous (IV) narcotics through a PCA (Patient Controlled Analgesia) pump, or will be given a narcotic in your epidural catheter before it is removed (called Duramorph). 

When you are ready to be discharged from recovery room care, you will be transferred by stretcher with your baby to your postpartum room.  You will be admitted to a semi-private room in the Birth Center Extension on the 7th floor of Mott Hospital for your postpartum stay.  Your support person may stay with you and your baby in your room overnight. Since there is no nursery in the Birth Center, your baby will be in your room with you during the entire hospital stay.  Your nurses will assist you with your recovery from the surgery and with providing care for your baby.  Your blood pressure and temperature will be monitored frequently.  You will be assisted to get out of bed shortly after your surgery.  Your diet will be advanced to solid foods by the second day.  The nurses will provide expert guidance with breastfeeding and newborn care to assist you in your transition to motherhood.  

You will stay in the hospital for 2 days unless you have a medical problem requiring on-going hospitalization.  You and your baby will receive a home visit with one of our mother/baby nurses from the Michigan Visiting Nurses.

Once you go home, avoid heavy lifting for 6 weeks. After 6 weeks you may begin an exercise program to regain abdominal muscle tone. Ask your health care provider what other steps you should take and when you should come back for a checkup.

Postpartum Care at Home After Cesarean Section

When should I call my health care provider?

If you have just had a cesarean section, call your health care provider immediately if:

Call your health care provider during office hours if: