For many women, the question “Will I end up with a c-section?” rumbles through their mind as they prepare for childbirth. Regardless of the type of birth you’re planning, the possibility of a cesarean birth looms. Some women require pre-planned cesarean births because of certain medical conditions that make vaginal birth unsafe, or positional factors like baby being breech. In other situations, mothers move into labor intent on having a vaginal birth, but end up needing a c-section because of unforeseen medical circumstances that create a tenuous situation for mother’s or baby’s health. Regardless of how much a woman prepares, it’s impossible to know how birth will unfold. And this uncertainty can trigger anxiety.
Adding to that potential anxiety is stress over not knowing what to expect from a cesarean birth. However, much of this fear can be dissolved with information. Learning what this type of birth actually involves, and what the recovery is like, can help you wrap your mind around this potentiality and move towards your baby’s due date with enhanced calm.
What you need to know about a cesarean birth
Following is a breakdown of the key components of a c-section.
- Scheduling. If you and your care provider decide a planned c-section is the ideal option because of a breech baby, or another special circumstance, they will schedule the surgery sometime around your due date.
- Saying yes to an unplanned c-section. If you are having a vaginal birth but something occurs that puts you or your baby at risk, your care provider might recommend a c-section. If it’s not an emergency, ask them to thoroughly explain the reasoning behind their recommendation, so you can make a well-informed decision.
- Consent. Regardless of whether or not your c-section is planned, you will have to provide legal consent before the surgery.
- Remember that you are safe. Know that the team who performs your cesarean birth is made up of trained professionals who are going to keep you and your baby safe. Allow yourself to enter the experience with an energy of trust, as you’ll be in skilled hands.
- Support during the surgery. In non-emergency situations, your birth companion should be allowed to stay with you during the surgery. If they are squeamish, consider asking another friend, family member, or doula (if you’ve hired one) to accompany you. You don’t want the medical care providers having to attend to anyone but you and baby.
- Pain and numbing medication. Before the surgery, an anesthesiologist will review your medical history and pain management options. They’ll likely recommend an epidural or spinal block to numb the lower half of your body. You’ll be awake during the surgery, but shouldn’t be able to feel anything from your waist down, with the potential exception of some pressure.
In some emergency situations (or if you have a condition that would prevent you from being a candidate for an epidural or spinal block) you may receive general anesthesia - but that is rare.
- Further prep. After the epidural is placed your bladder is drained with a catheter, and an IV is started to administer fluids and any additional medication you may require.
You might also receive an antacid to neutralize your stomach acid, and antibiotics to prevent infection after the procedure.
- The screen. To prevent you from witnessing the surgery, a screen will be raised at your waist. You can request the screen be partially lowered when your baby is lifted out. (You’ll find more cesarean birth preferences below.)
- Surgery. When the anesthesia has fully numbed you, antiseptic will be applied to your lower abdomen and the surgeon will make a small horizontal cut above your pubic bone. They’ll then cut through the underlying tissue (manually separating your abdominal muscles) until they reach your uterus. A horizontal incision will then be made in the lower portion of your uterus and the doctor will remove your beautiful baby, in addition to your placenta. This typically only takes 15 to 20 minutes.
- Bonding. If you and baby are in good health, you’ll likely be able to hold them after delivery, while you’re still lying on the operating table.
- Stitches. As you’re oohing and aahing over your baby, the surgeon will apply absorbable stitches to your uterus and stitches or staples to your abdomen. The incision is usually so low a bikini bottom will cover the scar.
After the c-section is complete, you start the road to recovery, which can be a bit different for every woman.
What a c-section recovery is really like
Now that you’ve summoned your courage and had the surgery, it’s time to recover. This journey often takes four to six weeks and requires ample patience and rest.
- Transfer to a recovery room. Once the surgeons have okayed you to leave the OR (operating room), you’ll be taken to a recovery room and monitored for a few hours. It will likely take many hours for the numbing effects of the medication to wear off enough for you to walk. The catheter will stay in place until you’re able to walk to the bathroom.
- Feeding. If baby is not in need of medical care, you should be able to begin breast or bottle-feeding soon after you’ve settled into the recovery room. You will probably be cleared to eat a light meal about eight hours after surgery.
- Blood clot prevention. To help prevent blood clots from forming in your legs, a nurse will help you walk around a bit as soon as you’re able.
- Cramping. It is common to feel cramping as the uterus shrinks back to size, in addition to some pain at the incision site. Your care provider will work with you to find the best pain management solution for your unique needs.
- Continual monitoring. You will be monitored closely during your hospital stay (usually four to six days) to ensure you don’t develop an infection, or have excessive bleeding. Vaginal bleeding is common for four to six weeks, but is heaviest in the days following delivery.
- No driving or exercise. When you’re discharged from the hospital they’ll instruct you to not drive for four to six week, and just say no to exercise (no heavy lifting!) for six to eight weeks.
- Continued soreness. It’s common to feel sore for at least a week or two after the c-section. Your care provider will likely provide pain relief options.
- If in doubt, tell your care provider. If at any point during your recovery you feel that something is off – for example, you have a significant amount of bleeding, extreme pain, or a fever – tell your care provider. Don’t worry about bothering them. They’d much rather you be too cautious than not reach out when you need medical care.
- Long-term recovery. After the incision has healed, and you and baby develop a rhythm, you may experience lingering urinary incontinence due to weakened pelvic floor muscles. This is totally normal and can be remedied with the help of a pelvic floor specialist. Ask your care provider for a referral.
As you heal from your c-section, it’s can be common to feel disappointed that you didn’t have a vaginal birth – especially if you had prepared for one. While it can be incredibly healthy to mourn that loss (it’s okay to be bummed!) I also urge you to remember that, just like a vaginal birth, a cesarean birth, requires an incredible amount of courage – which you have! You deserve to honor yourself for that courage. Don’t allow anyone (including yourself) tell you that you “didn’t give birth” because a surgeon was the one to physically help your baby emerge. You spent an amazing amount of time growing the baby, then completely surrendered your body to the type of birth your baby needed to have. That is extraordinary. You are extraordinary.
Cesarean Birth Preferences
A common source of resistance towards a c-section is lack of control. Women often feel that because surgeons perform the delivery, they’ll lose their sense of empowerment. But this doesn’t have to be the case. In the absence of an emergency, many hospitals are becoming more open to moms exercising their right to have a voice in how their c-section plays out. Here are preferences that can help you reclaim a sense of control and empowerment, and have a gentle c-section.
- To have arms free during operation.
Being strapped down isn’t fun. Request that your arms remain unbound so you can hold baby as soon as possible after delivery.
- To have skin-to-skin directly after baby is born.
Skin-to-skin contact in the first hour after baby is delivered stimulates the release of oxytocin in you and baby, and supports the eventual act of breastfeeding, if that’s something you’re wanting to do.
- To have screen dropped the moment baby is lifted out.
Seeing baby’s arrival is a powerful experience, especially for moms who cannot physically feel the emergence. If you’re comfortable having the screen at your waist lowered as baby is pulled out of the uterus, it could help you feel a deeper connection to your birth and baby.
- For medical staff to refrain from personal conversations.
Hearing about the anesthesiologist’s weekend plans is unlikely to hold the supportive messages you want to be hearing as your baby is born. Request that all people in the operating room refrain from personal conversation and instead opt for encouraging words for you.
- To have music or recording of choice playing during operation.
Having your own music or guided meditation playing during the c-section allows you to set the tone for the experience, as sound has a powerful impact over an environment.
- To have nasal cannula instead of facemask for oxygen.
If possible, ask that you be given oxygen via nose plugs instead of a facemask, as the mask can make some mom’s feel claustrophobic.