A caesarean section is major abdominal surgery, performed by an obstetrician. It involves making an incision of about 15cm into the abdomen and uterus to deliver your baby.
You will think a lot about what kind of birth or labour you may have, but be prepared - not everything goes according to YOUR plan - you may end up having a caesarean. As they say, 'forewarned is forearmed'. Here are the facts behind a caesar:
What is an elective caesar?
An elective caesar is a planned caesarean. You will know in advance the day and time your baby will be born. You may opt for an elective caesarean for personal reasons or for the following medical reasons:
- You have pre-eclampsia or diabetes
- You have had previous birth complications
- You placenta may be lying low or even blockng the cervix (placenta praevia)
- You are expecting more than one baby
- Your baby is in an abnormal position, as in breech (bum down) or transverse lie (shoulder presentation)
What is an emergency caesar?
An emergency caesar will take place if a complication occurs during labour, or if the baby needs to be delivered urgently for any reason. These may include:
- Your baby’s cord prolapses (comes out before the baby)
- Your baby starts showing extreme signs of distress such as a low heart beat or meconium in the amniotic fluid
- There is evidence of cephalopelvic disproportion (baby’s head is too large to push through the pelvis)
- Your labour is not progressing (known as failure to progress which does not constitute a true emergency)
- Any life threatening situation for mother or baby
Always be prepared for the unexpected
Even if you are planning a vaginal birth, you should always make some kind of plan in case you end up in the theatre. Talk to your caregiver about what kind of anaesthetic you would prefer, who will be allowed in theatre with you and how soon you can hold and breastfeed your baby.
What to expect post-caesarean
If you have a spinal block or epidural you won’t feel anything from the nipple line down, except for a slight tugging feeling and some pressure as the baby is eased out. As sensation returns, you will start to feel pins and needles and warmth in your legs. You may need pain relief, and this is usually administered intravenously.
Checks and Apgar score
If all is well with your baby, you can ask to see and hold her immediately. It is usual however, for her to be given straight to the paediatrician for the usual checks and Apgar score. Once she has been given the all clear, she will be brought to you for a cuddle and a kiss. She will be warmly wrapped as it is very cold in theatre.
Breastfeeding your newborn
As with a vaginal birth, try and offer the breast to your baby as soon as you can, usually once you are in recovery, but many moms latch their newborns successfully while still on the operating table. This must be negotiated beforehand as you will help.
After the birth you will need help lifting and carrying your baby. Take is easy and ask for help while in hospital and once you get home. Nurses will help you get up as soon as possible as this aids recovery. Use a pillow to support your tummy when you cough, laugh or sneeze. Move slowly and exercise your legs in bed by wriggling your toes and making foot circles.
Your stay in hospital
It is usual to spend about three days in hospital after a Caesar with no complications. Your wound may have healed by then, or you may have to do some simple dressing at home.
Post-partum vaginal discharge
Your lochia (post partum vaginal discharge) will be the same as if you had had a vaginal birth: bright red to start, becoming muddy brown to clear over 3 to 6 weeks.
Your stomach and scar
You should not drive for 2 weeks and don’t exercise before 6 weeks. Your tummy may not look like it did before you fell pregnant, and there may be a slight bulge of skin over the top of the scar, but don’t despair. The scar will be below your panty line, covered by pubic hair and will fade over time.
You may feel disappointed if you end up having an unplanned caesar. This is why being informed, open-minded and flexible about your options is so important. You can still have a most fulfilling birth experience if you are aware and involved in decisions on the day.