When preparing to have a baby, you might create a birth plan for how you hope the experience will go. However, sometimes plans change and that change could involve a cesarean section to deliver your baby.
A cesarean section, or C-section, is an abdominal delivery of an infant, made through a low transverse skin and uterine incision. According to Centers for Disease Control and Prevention (CDC), almost 32% of deliveries in 2019 were by C-section.
Why a C-section?
Dr. Erik Dovre, obstetrics/gynecology physician at Marshfield Clinic Health System, said there are many indications for C-section delivery. The most common reasons are failure to progress in labor, fetal distress and breech positioning of the baby.
At Marshfield Clinic Health System, a C-section is typically performed by the obstetrician on-call. If a midwife is involved in your labor care, they will still be in the C-section room to provide support for you, your family and the care team.
Generally, a C-section can take between 30 minutes to an hour. It also can involve an additional 15 minutes before and 15 minutes after for anesthesia, positioning, skin preparation and recovery.
“In a true emergent C-section, we can often deliver the baby within one-to-two minutes of the start of the procedure,” said Dovre.
If the C-section is planned, preparation involves overnight fasting, abdominal skin prepping with a special solution and admission to the hospital two hours before surgery. During those two hours, you can meet with the nursing and anesthesia staff, Dovre said. Pre-op blood work will be drawn and any other pre-operative medications, like antibiotics, will be administered.
“With an unplanned C-section, many of these steps are still done, albeit much quicker,” he said.
What to expect during a C-section
During a C-section, anesthetics will be used to numb your incision area. Most of the time, providers will use a spinal block, which provides numbness from the ribcage down. Providers also can use a labor epidural if one was placed already, which will give the same numbness throughout the abdomen.
“We always test the level of anesthetic or numbness before we proceed,” Dovre said. “We want to make sure the patient is safe and as comfortable as possible.”
In vaginal and C-section deliveries, you may experience shaking. This is normal and Dovre said is likely a combination of fluid shifts in the body like loss of amniotic fluid, normal blood loss and such, as well as hormonal factors such as endogenous oxytocin release.
Although your birth experience may be different than you planned, providers will offer several ways for you to enjoy those first moments with your baby.
In most cases, you will be offered the option to see the baby delivered. This involves using a clear drape or temporarily dropping the drape. It is a personal preference and you can choose not to see until your baby is evaluated and cleaned. Also, if things are stable and going smoothly like with a scheduled C-section, mothers or their partners can cut the umbilical cord.
After delivery, skin-to-skin contact is still an option for mothers and their babies. If baby is stable, this can be done immediately. In other cases, providers will evaluate and stabilize the baby first, then transfer the baby to the mother’s chest as soon as possible.
“Overall, we strive to maintain most aspects of a normal delivery with our cesarean sections, such as the opportunity for immediate bonding,” Dovre said.
Risks during a C-section
As in any pregnancy or surgical procedure, there are some risks. During a C-section, risks include bleeding, infection, anesthetic risk, blood clots and injury to adjacent organs, such as bladder or bowel.
In addition, C-section can pose a risk for future deliveries or surgeries because of uterine rupture and excessive scar tissue.
Talk to your obstetrician or midwife about any concerns you have about a C-section.
Because most patients are otherwise healthy, Dovre said postoperative recovery from a C-section usually goes quite well. Nonetheless, you will have increased abdominal discomfort compared to a vaginal birth, particularly for the first one or two weeks.
Additionally, Dovre said C-section patients are more likely to require prescription pain medication and will take longer to return to normal bodily functions for bladder and bowel.
“However, after about two weeks, the recovery is fairly similar to a vaginal birth,” he said.
Beyond the additional recovery time, the side effects from a C-section are those potential long-term complications like uterine rupture and abnormal scar tissue. Your provider knows your health and health history to ensure you receive the best care pre- and postnatal.
Talk to your obstetrician or midwife about any additional questions or concerns you have about having a C-section.
Very informative article, but why was there no mention that, depending on the reason for the cesarean, a VBAC (vaginal birth after cesarean) may be an option for future births?
injury to adjacent organs, such as bladder or bowl. Are you sure there's potential injury to the bowl?