What is a Cesarean section?
Cesarean section, C-section, or Cesarean birth is the surgical delivery of a baby through a cut (incision) made in the mother's abdomen and uterus. Health care providers use it when they believe it is safer for the mother, the baby, or both.
The incision made in the skin may be:
- Up-and-down (vertical).This incision extends from the belly button to the pubic hairline.
- Across from side-to-side (horizontal).This incision extends across the pubic hairline. It is used most often, because it heals well and there is less bleeding.
The type of incision used depends on the health of the mother and the fetus. The incision in the uterus may also be either vertical or horizontal.
What happens during a C-section?
A C-section will be done in an operating room or a special delivery room. Procedures may vary depending on your condition and your healthcare provider's practices.
In most cases, you will be awake for a C-section. Only in rare cases will a mother need medicine that puts you into a deep sleep (general anesthesia). Most C-sections are done with a regional anesthesia such as an epidural or spinal. With these, you will have no feeling from your waist down, but you will be awake and able to hear and see your baby as soon as he or she is born.
Generally, a C-section follows this process:
- You will be asked to undress and put on a hospital gown.
- You will be positioned on an operating or exam table.
- A urinary catheter may be put in if it was not done before coming to the operating room.
- An intravenous (IV) line will be started in your arm or hand.
- For safety reasons, straps will be placed over your legs to hold you on the table.
- Hair around the surgical site may be shaved. The skin will be cleaned with an antiseptic solution.
- Your abdomen (belly) will be draped with sterile material. A drape will also be placed above your chest to screen the surgical site.
- The anesthesiologist will continuously watch your heart rate, blood pressure, breathing, and blood oxygen level during the procedure.
- Once the anesthesia has taken effect, your provider will make an incision above the pubic bone, either transverse or vertical. You may hear the sounds of an electrocautery machine that seals off bleeding.
- Your provider will make deeper incisions through the tissues and separate the muscles until the uterine wall is reached. He or she will make a final incision in the uterus. This incision is also either horizontal or vertical.
- Your provider will open the amniotic sac, and deliver the baby through the opening. You may feel some pressure or a pulling sensation.
- He or she will cut the umbilical cord.
- You will get medicine to help the uterus contract and expel the placenta in your IV.
- Your provider will remove your placenta and examine the uterus for tears or pieces of placenta.
- He or she will use sutures to close the incision in the uterine muscle and reposition the uterus in the pelvic cavity.
- Your provider will close the muscle and tissue layers with sutures. He or she will close the skin incision with sutures or surgical staples.
- Finally, your provider will apply a sterile bandage.
What happens after a C-section?
In the hospital
In the recovery room, nurses will watch your blood pressure, breathing, pulse, bleeding, and the firmness of your uterus.
Usually, you can be with your baby while you are in the recovery area. In some cases, babies born by Cesarean will first need to be monitored in the nursery for a short time. Breastfeeding can start in the recovery area, just as with a vaginal delivery.
After an hour or 2 in the recovery area, you will be moved to your room for the rest of your hospital stay.
As the anesthesia wears off, you may get pain medicine as needed. This can be either from the nurse or through a device connected to your intravenous (IV) line called a PCA (Patient Controlled Analgesia) pump. In some cases, pain medicine may be given through the epidural catheter until it is removed.
You may have gas pains as the intestinal tract starts working again after surgery. You will be encouraged to get out of bed. Moving around and walking helps ease gas pains. Your healthcare provider may also give you medicine for this. You may feel some uterine contractions called after-pains for a few days. The uterus continues to contract and get smaller over several weeks.
The urinary catheter is usually removed the day after surgery.
You may be given liquids to drink a few hours after surgery. You can gradually add more solid foods as you can handle them.
You may be given antibiotics in your IV while in the hospital and a prescription to keep taking the antibiotics at home.
You will need to wear a sanitary pad for bleeding. It is normal to have cramps and vaginal bleeding for several days after birth. You may have discharge that changes from dark red or brown to a lighter color over several weeks.
Do not douche, use tampons, or have sex until your healthcare provider tells you it’s OK. You may also have other limits on your activity, including no strenuous activity, driving, or heavy lifting.
Take a pain reliever as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase bleeding. So, be sure to take only recommended medicines.
Arrange for a follow-up visit with your healthcare provider. This is usually 2 to 3 weeks after the surgery.
Call your healthcare provider right away if any of these occur:
- Heavy vaginal bleeding
- Foul-smelling drainage from your vagina
- Fever or chills
- Severe abdominal (belly) pain
- Increased pain, redness, swelling, or bleeding or other drainage from the incision
- Leg pain
- Trouble breathing, chest pain, or heart palpitations
Your healthcare provider may give you other instructions, depending on your situation.