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Caesarean Birth Overview and FAQs

August 12, 2013 by HealthyFamilies BC

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mom with newborn baby, dad at side of bed wearing hospital mask

 

A caesarean birth (or C-section) is the birth of a baby through a cut in your abdomen and uterus. Your healthcare provider may recommend this approach to protect you and your baby.  

Here are the answers to some common C- section questions.


When and why would I have a caesarean birth?

A C-section can be done before or during labour and may be performed if:

  • the cervix does not open completely
  • labour is not progressing
  • the baby is too big to fit through the mother’s pelvis
  • the baby is in distress (not tolerating labour well)
  • multiple babies (twins or triplets) are in difficult positions
  • the baby is in a breech (bottom or feet first) or transverse (sideways) position
  • the mother has a serious medical condition
  • the mother has active herpes lesions on her genitals that make vaginal birth unsafe for the baby  

How is a caesarean section done?

First, an IV is usually started in the mother to offer medicine and fluids as needed during the surgery. Two types of anaesthetic can be used:

Epidural/Spinal anaesthesia numbs your belly and legs but lets you stay awake during the birth. Most hospitals will allow your partner or support person to be in the operating room with you. You'll also be able to breastfeed and cuddle your baby skin-to-skin soon after birth. In some hospitals, you or your partner may be able to put your baby skin-to-skin in the operating room or the recovery room.

General anaesthesia, which is fast-acting, puts the mother to sleep during the birth and is only used in an emergency. In this situation, your partner or support person will not be allowed in the operating room but can usually hold the baby very soon after birth.

What are the risks with a caesarean birth?

You may have a lot of conflicting emotions following a caesarean birth. Some parents feel distressed about not having a vaginal birth. Others are relieved they have a healthy baby. The best way to deal with your feelings is to talk openly with someone you trust.A vaginal birth is the safer and easier option for most women. A caesarean birth is major surgery and carries more risk and issues with recovery.

If you have a caesarean birth, you will have:

  • a greater chance of infection
  • a higher risk of complications to you and your baby from the anaesthesia
  • a longer hospital stay
  • fewer support people with you at the birth
  • a longer recovery time
  • pain from the surgery

Talk to your healthcare provider about where, when and how to deliver your baby. If you're afraid of a long and painful labour, you may want to consider having additional support. This could be a doula , who can provide support to both you and your partner, including support for managing pain during labour. Medications are also available during labour if you need them. In your birth wishes, include your thoughts and feelings about your choices related to caesarean births. Talk to your healthcare provider about your options for pain control during labour.

What happens after a caesarean birth?

  • Pain medication will help you move around more easily. You will probably need it for several days.  Ask for it when you need it. Avoid medications with codeine.
  • You will have an IV in your arm until you are drinking well on your own.
  • You will have a catheter (a tube into your bladder to take away the urine) until you are able to get up to the bathroom.
  • You will be getting out of bed within 24 hours after the birth and will need to have help the first few times you get up.
  • If you had staples, they will need to be removed. If you have sutures (stitches), they will usually dissolve by themselves.
  • If you have small adhesive strips across the incision and they do not fall off within a week, carefully peel them off.

What about breastfeeding after a caesarean?

Getting breastfeeding off to a good start may be a bit more challenging, depending on the type of anaesthetic you were given. You'll also need to experiment to find the most comfortable position for breastfeeding.

If you hold the baby across your abdomen, use a small cushion to protect your incision and keep you comfortable. Some women find lying on their side works best. The side-lying position works better if you have someone to help latch your baby. The underarm (football) position may also work for you and your baby. For more information on breastfeeding after a caesarean section refer to HealthLink BC

How long does it take to recover?

Most women go home three to five days after a caesarean, but full recovery may take six weeks or longer. Women who have vaginal births usually go home in a day or two and are back to their normal activities in one or two weeks. Before you go home, a nurse will tell you how to care for yourself, what to expect during recovery, and when to call the doctor.

Will I need help at home?

Yes. Ask for support from family and friends, especially with caring for other children at home and household chores. If you try to return to your usual activities too soon, you will slow your recovery.

  • Don't lift anything that weighs more than your newborn baby.
  • If you have toddlers, sit down and have them climb up on your knee.
  • You will need to heal from major surgery as well as the birth of your baby.
  • You can resume driving when you feel well enough, are able to twist to look to each side, and can quickly use the foot pedals in an emergency – similar to before you were pregnant.
  • Eating healthy foods and drinking lots of fluids will help you heal.

Find out more about what to expect after a caesarean.


What about future births after a caesarean?

Most women who have had a caesarean can have a vaginal birth for their next child.

You should be offered a "trial of labour" or an attempt to have a vaginal birth if:

  • your hospital has timely access to do a caesarean birth if needed
  • your pregnancy is normal
  • the reason you had a caesarean before no longer applies, e.g., a large baby
  • the incision you had before is across your uterus, not up and down

In rare cases, the scar on the uterus will come apart during labour and cause bleeding. Your healthcare provider will ask if you have constant abdominal pain during labour, heavy vaginal bleeding, dizziness or faintness.


Resources & Links:

HealthLink BC: Labor and Delivery
HealthLink BC: Caesarean Section
HealthLink BC: Vaginal birth after caesarean (VBAC)
HealthLink BC: Childbirth: Reasons for Caesarean Delivery
HealthLink BC: Breast-Feeding After a C-Section

 

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