What to expect when you’re having a c-section

While many women hope for a natural birth, this is not always possible or preferred. Some opt for a caesarean (c-section), an operation to give birth to your baby. This can be a planned procedure, but for some it’s a decision made during birth, known as an emergency caesarean. Both are common and usually safe occurrences.

Here’s what to expect before, during and after a caesarean.

A planned caesarean

A caesarean birth is an operation where your baby is born through a cut in your abdomen and uterus. For some women facing health issues or pregnancy problems this is the safer option. You may choose a planned c-section for the following reasons:

• you have had a previously c-section
• your baby is either in a breech position (bottom or head first) or traverse position (sideways) and can’t be turned
• placenta praevia (your cervix is covered by the placenta)
• you’re having twins and the babies are in breech position
• you’re having multiple births such as triplets, quadruplets quintuplets etc.

Everyone is different and the above reasons do not necessarily mean you have to have a caesarean. This will depend on your individual situation and your doctor’s advice.

Some doctors may also allow you to choose a caesarean for mental health reasons.

What is going to happen?

For a planned c-section, you will arrive at the hospital and be admitted to the maternity ward. You’ll be given compression stockings to wear during surgery to prevent blood clots. Plus, the top of your pubic hair and stomach will be shaved, to prevent infections.

Once in the operating theatre, you’ll be given (most commonly) a spinal anaesthetic or epidural. A drape can be placed across your chest so you and your partner can’t see the surgery.

The operation takes 30 to 60 minutes and involves 10cm cuts in your stomach and uterus. The baby will then be lifted out through the cuts, and you’ll get that first magical glimpse of look of your precious little one. The umbilical cord will be cut and placenta removed, and the doctor or midwife will check your baby.

You’ll be give antibiotics through a drip and the doctor will stitch up the cuts and dress the wound. Most women are left with a small neat horizontal scar just below your undies line that will fade with time.

Why have an emergency caesarean?

An unplanned c-section will happen in a similar way, however the decision to proceed could be made because of the following reasons:

• there is concern for your baby’s wellbeing, such as they become distressed or their heartbeat drops 
• the baby’s head does not move down or ‘fit’ through pelvis during labour
• your labour is not progressing as expected
• there are maternal complications, such as severe bleeding or severe pre-eclampsia 
• there is a life-threatening emergency for you or your baby.

What to expect afterwards?

Skin-to-skin contact with your baby is encouraged as soon as possible after the birth, to start the bonding process and help make your baby feel warm and secure. If you’re unable to do this straightaway then your partner or support person will be encouraged to hold the baby.

It’s normal to experience pain around your stomach area. The midwife or nurse will check in with you regarding how you’re feeling. They’ll also check your blood pressure, wound and any bleeding. You’ll also probably have a drip and catheter for the first 12 to 24 hours.

It can take a little longer for milk to come in after a c-section, but if you’re intending to breastfeed, you’ll be encouraged to start as soon as possible. If you have any difficulties, hospital staff such as a midwife or lactation consultant will be able to offer help and support.

You’ll expect to stay a little longer in hospital after a c-section. Even when you’re ready to go, you still need time for your body to recover. Activities such as housework, exercise and driving may be restricted for up to six weeks. Take the time to be with your new baby, resting, taking relaxing walks and eating well. And maybe organise family or friends to help with shopping, cooking and cleaning.

Are there any possible risks or problems?

Having a c-section is a major operation, which always carries some risk. Problems that can arise from a caesarean birth include haemorrhaging, blood clots, infections, fever, complications form the anaesthetic, and a higher chance of having a caesarean for future births. There is also an increased risk of postnatal depression, so if you find you’re not coping, contact your doctor or healthcare professional for support.

Can I have a natural birth next time?

After a c-section, you may want to attempt a vaginal birth the next time around. While having another c-section carries the normal risks of this procedure, having a vaginal birth after a c-section can be problematic. The main issue is that the scar on the uterus could rupture, a situation that occurs for 1 in 200 women.

However, most women who attempt a vaginal birth after having a caesarean will succeed. About 30% of those planning a natural birth will end up having an emergency caesarean.

It’s certainly possible to go on and have a vaginal birth, but it’s something you’ll discuss with your doctor or healthcare professional and will depend on your individual situation.

At the end of the day, it doesn’t matter how your baby arrives into your arms, as long as it does so, safe and sound.