A cesarean birth (also referred to as a “C-Section) is a surgical procedure used to deliver a baby. Regional anesthesia (spinal or epidural) is routinely given to prevent pain during the surgery. A horizontal ("bikini line") incision is made in the skin of the lower abdomen, to expose the uterus then an incision is made in the uterus to allow delivery of the baby and placenta. Other procedures, such as tubal ligation (a permanent birth control procedure), may also be performed during cesarean birth if you have discussed this with your provider prior to delivery.
Cesarean births can be planned and scheduled before the onset of labor because of maternal or fetal conditions that warrant cesarean birth. Others are unplanned and performed during the course of labor because of maternal or fetal problems that arise at that time. More than 30 percent of births in the United States occur by cesarean.
Common reasons for an unplanned cesarean birth include:
- Labor is not progressing as it should. This may occur if the contractions are too weak, the baby is too big, the pelvis is too small, or the baby is in an abnormal position. If a woman's labor does not progress normally, in many cases, she will be given a medication (Pitocin) to be sure that contractions are adequate for several hours. If labor still does not progress after several hours, a cesarean birth may be recommended.
- The baby's heart rate suggests that the baby is not tolerating labor well.
- Heavy vaginal bleeding. This is a rare condition that can occur if the placenta separates from the uterus before the baby is born (called a placental abruption).
- A medical emergency threatens the life of the mother or baby.
Common reasons for scheduling a cesarean birth in advance:
- The baby is in a transverse (sideways) or breech position (buttocks first).
- The placenta is covering the cervix (called placenta previa; cesarean is always recommended for women with placenta previa).
- The mother has had a previous cesarean birth or other surgery in which the uterus was cut open. A vaginal birth is possible after cesarean birth in some, but not all cases, this can be discussed with your provider.
- There is some mechanical obstruction that might prevent or complicate vaginal birth, such as large fibroids or a pelvic fracture.
- The baby is unusually large, especially if the mother has diabetes.
- The mother has an active infection, such as herpes or HIV, that could be transmitted to the baby during vaginal birth.
- The birth involves multiple gestation (twins, triplets, or more).
Post Op Recovery
When the effects of anesthesia have worn off, generally within one to three hours after surgery, patients are transferred to a postpartum room and encouraged to slowly move around and begin to drink fluids and eat food.
Breastfeeding can usually begin any time after the birth. Most women are able to go home within a few days after giving birth.
The abdominal incision will heal over the next few weeks. During this time, there may be mild cramping, light bleeding or vaginal discharge, mild incisional pain, and numbness in the skin around the incision site. Most women will feel well by six weeks postpartum, but numbness around the incision and occasional aches and pains can last for several months.
After going home, patients should notify our office if a fever (temperature greater than 100.5°F) is present in the first 2 weeks after surgery or, if pain or bleeding worsens.
Your provider will see you back in the office for a post op exam 6 weeks after surgery.
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