A cesarean birth, also known as a “C-section”, is often performed if your baby is not tolerating the stress of labor well or if your baby is too big to come down your birth canal. Other reasons could be that your baby is in a breech presentation, or that there are some other medical conditions present where you or your baby’s life might be in danger unless delivery occurs soon. It is also offered or suggested if you have had a previous cesarean.
The rate of cesareans has risen a lot over the last decade and occurs now in up to 30% of all births in the United States.
Some form of anesthesia is always used for the mother during a cesarean birth. Doctors most often use an epidural or spinal anesthetic, allowing you to be awake during the birth of your baby. If your baby needs to be delivered very rapidly and there is no time to perform one of the above mentioned anesthetics, a general anesthetic will be used to put you completely asleep.
A cesarean is usually performed by making a side-to-side “bikini” cut in your abdomen just above your pubic bone. Your obstetrician will then examine your abdominal cavity and uterus through your incision. Next, in most cases, a low side-to-side incision (called the “lower uterine segment”) will be made in the lower part of your uterus, giving room for your doctor to lift your baby out of the uterus. The surgical assistant will then apply pressure on your abdomen in order to push out the rest of your baby.
After the delivery, all the cut layers will be sewn back. Do note that contrary to common thought, the abdominal muscles are not cut, just separated to their respective sides during the cesarean. The overall time of an uncomplicated cesarean is about 30 to 45 minutes.
After the delivery, expect to stay three to four days in the hospital to heal from your cesarean.
The risk of infection and blood loss is greater with a cesarean birth than with a regular vaginal delivery. However, with modern sterile surgical techniques and with experienced surgeons, the risk is very low.
If you have had a cesarean, you may still have a vaginal birth with your subsequent pregnancy, depending upon the reason for your c-section. This is called a vaginal birth after a cesarean, or VBAC. However, a VBAC entails a slightly increased risk of uterine rupture that can be dangerous for both you and your baby. Do talk it over with your health care provider to see if a VBAC is a feasible option for you. If you chose to have a repeat cesarean, many providers will perform it the week prior to your due date in order to hopefully avoid labor contractions that would put pressure on your uterine scar.