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Cesarean Section

Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus.

A C-section might be planned ahead of time if you develop pregnancy complications or you've had a previous C-section and aren't considering a vaginal birth after cesarean (VBAC). Often, however, the need for a first-time C-section doesn't become obvious until labor is underway.

If you're pregnant, knowing what to expect during a C-section — both during the procedure and afterward — can help you prepare.

Why is Cesarian section done?

Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your health care provider might recommend a C-section if:

Your labor isn't progressing. Stalled labor is one of the most common reasons for a C-section. Stalled labor might occur if your cervix isn't opening enough despite strong contractions over several hours.
Your baby is in distress. If your health care provider is concerned about changes in your baby's heartbeat, a C-section might be the best option.
Your baby or babies are in an abnormal position. A C-section might be the safest way to deliver the baby if his or her feet or buttocks enter the birth canal first (breech) or the baby is positioned side or shoulder first (transverse).
You're carrying multiples. A C-section might be needed if you're carrying twins and the leading baby is in an abnormal position or if you have triplets or more babies.
There's a problem with your placenta. If the placenta covers the opening of your cervix (placenta previa), a C-section is recommended for delivery.
Prolapsed umbilical cord. A C-section might be recommended if a loop of umbilical cord slips through your cervix ahead of your baby.
You have a health concern. A C-section might be recommended if you have a severe health problem, such as a heart or brain condition. A C-section is also recommended if you have an active genital herpes infection at the time of labor.
Mechanical obstruction. You might need a C-section if you have a large fibroid obstructing the birth canal, a severely displaced pelvic fracture or your baby has a condition that can cause the head to be unusually large (severe hydrocephalus).
You've had a previous C-section. Depending on the type of uterine incision and other factors, it's often possible to attempt a VBAC. In some cases, however, your health care provider might recommend a repeat C-section.

What you can expect?

Before the procedure

While the process can vary, depending on why the procedure is being done, most C-sections involve these steps:

At home. Your health care provider might ask you to shower with an antiseptic soap the night before and the morning of your C-section.
At the hospital. Your abdomen will be cleansed. A tube (catheter) will likely be placed into your bladder to collect urine. Intravenous (IV) lines will be placed in a vein in your hand or arm to provide fluid and medication.
Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body — allowing you to remain awake during the procedure. Common choices include a spinal block and an epidural block. In an emergency, general anesthesia is sometimes needed. With general anesthesia, you won't be able to see, feel or hear anything during the birth.

After the procedure

After a C-section, you'll probably stay in the hospital for a few days.

Once the effects of your anesthesia begin to fade, you'll be encouraged to drink plenty of fluids and walk. This helps prevent constipation and deep vein thrombosis. Your health care team will monitor your incision for signs of infection. If you had a bladder catheter, it will likely be removed as soon as possible.

You will be able to start breast-feeding as soon as you feel up to it. You will be taught how to position yourself and support your baby so that you're comfortable. Your health care team will select medications for your post-surgical pain with breast-feeding in mind.

When you go home

During the C-section recovery process, discomfort and fatigue are common. To promote healing:

Take it easy. Rest when possible. Try to keep everything that you and your baby might need within reach. For the first few weeks, avoid lifting anything heavier than your baby. Also, avoid lifting from a squatting position.

Seek pain relief. To soothe incision soreness, your health care provider might recommend a heating pad, medications to relieve pain. Most pain relief medications are safe for women who are breast-feeding.

You might also consider not driving until you are able to comfortably apply brakes and twist to check blind spots without the help of pain medication. This might take one to two weeks.

Check your C-section incision for signs of infection. Pay attention to any signs or symptoms you experience. Contact your health care provider if:

Your incision is red, swollen or leaking discharge
You have a fever
You have heavy bleeding
You have worsening pain

If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your doctor if you think you might be depressed, especially if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.

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