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A caesarean birth (or C-section) is the birth of a baby through a cut in your abdomen and uterus. Your healthcare provider may recommend this approach to protect you and your baby.  

Here are the answers to some common C- section questions.

When and why might I have a caesarean birth?

A caesarean can be done before labour (elective) or during labour (emergency), depending on the reason for doing it.

• Your cervix does not open completely so labour stops progressing.
• Your baby is too big or not positioned in a way that will fit through your pelvis.
• Your baby is in distress (not tolerating labour well).
• You are having more than one baby (twins or triplets) and your babies are in difficult positions for delivery.
• Your baby is in a breech (bottom or feet first) or transverse (sideways) position.
• You have a serious medical condition.
• You have active herpes lesions on your genitals that make vaginal birth unsafe for your baby.
• In some cases if you have had a previous caesarean birth with a vertical incision on your uterus preventing uterus surgery or the type of incision you had before is unknown.

How is a caesarean section done?

First, an IV is usually started in the mother to offer medicine and fluids as needed during the surgery. Two types of anaesthetic can be used:

Epidural/Spinal anaesthesia numbs your belly and legs but lets you stay awake during the birth. Most hospitals will allow your partner or support person to be in the operating room with you. You'll also be able to breastfeed and cuddle your baby skin-to-skin soon after birth. In some hospitals, you or your partner may be able to put your baby skin-to-skin in the operating room or the recovery room.

General anaesthesia, which is fast-acting, puts the mother to sleep during the birth and is only used in an emergency. In this situation, your partner or support person will not be allowed in the operating room but can usually hold the baby very soon after birth.

After the anaesthesia is working, the doctor makes a cut, usually low across the belly just above the pubic hairline. After lifting the baby out through the opening, the doctor removes the placenta and closes the cut with stitches.

What are the risks with a caesarean birth?

A vaginal birth is the safer and easier option for most women.  A caesarean birth is major surgery and carries more risk and issues with recovery.

With a vaginal birth, mothers:

• have less chance of infection
• avoid surgical pain, have a shorter recovery time, and are less likely to experience ongoing pain
• can have more support people at the birth
• have a shorter a hospital stay
• have less risk of excessive bleeding, hysterectomy (removal of the uterus) or damage to organs or tissue (these events are rare, but are more likely to occur with caesarean)
• have less risk of death (this is very rate, but more likely to occur with caesarean)

With a vaginal birth, babies have:

• less chance of breathing difficulties
• less chance of being admitted to the special care nursery which separates you from your baby
• less chance of having their skin cut—caesarean is a surgery and this can occur

Talk to your healthcare provider about where, when and how to deliver your baby. If you’re afraid of a long and painful labour, you may want to consider having additional support. This could be a doula, who can provide support to both you and your partner, including support for managing pain during labour. Medications are also available during labour if you need them.

In your birth wishes, include your thoughts and feelings about your choices related to caesarean births. Talk to your healthcare provider about your options for pain control during labour.

What happens after a caesarean birth?

• Pain medication will help you move around more easily. You will probably need it for several days. Ask for it when you need it. Avoid medications with codeine.
• You will have an IV in your arm until you are drinking well on your own.
• You will have a catheter (a tube into your bladder to take away the urine) until you are able to get up to the bathroom.
• You will be getting out of bed within 24 hours after the birth and will need to have help the first few times you get up.
• If you had staples, they will need to be removed. If you have sutures (stitches), they will usually dissolve by themselves. If you have small adhesive strips across the incision and they do not fall off within a week, carefully peel them off.
• You can shower or bath as desired.

What about breastfeeding after a caesarean?

Getting breastfeeding off to a good start may be a bit more challenging, depending on the type of anesthetic you were given. You’ll also need to experiment to find the most comfortable position for breastfeeding.  If you hold the baby across your abdomen, use a small cushion to protect your incision and keep you comfortable. Some women find lying on their side works best.

The side-lying position works better if you have someone to help latch your baby. The underarm (football) position may also work for you and your baby. For more information on breastfeeding after a caesarean section refer to HealthLink BC: Breast-Feeding After a C-Section

How long does it take to recover?

Most women go home three to five days after a caesarean, but full recovery may take six weeks or longer. Women who have vaginal births usually go home in a day or two and are back to their normal activities in one or two weeks. Before you go home, a nurse will tell you how to care for yourself, what to expect during recovery, and when to call the doctor.

Will I need help at home?

Yes. Ask for support from family and friends, especially with caring for other children at home and household chores. If you try to return to your usual activities too soon, you will slow your recovery.

• Don’t lift anything that weighs more than your newborn baby.
• If you have toddlers, sit down and have them climb up on your knee.
• You will need to heal from major surgery as well as the birth of your baby.
• You can resume driving when you feel well enough, are able to twist to look to each side, and can quickly use the foot pedals in an emergency – similar to before you were pregnant.
• Eating healthy foods and drinking lots of fluids will help you heal.

Most women who have had a caesarean birth can have a vaginal birth for their next pregnancy.

You should plan to have a vaginal birth if:

• your pregnancy is normal
• the reason you had a caesarean before no longer applies
• the incision you had before is across your uterus, not up and down
• your hospital has timely access to do a caesarean birth if needed

Your care provider will review with you what your specific risks are. The worry with a vaginal birth after a caesarean is that the scar on the uterus may pull apart during labour and cause bleeding. This is a rare complication but your health care provider/team will watch you closely for any signs of this happening such as constant abdominal pain during labour, heavy vaginal bleeding, dizziness, or faintness.

Visit the “Power To Push” website to learn more about vaginal births after caesarean sections in B.C.: http://www.powertopush.ca/

You may have a lot of conflicting emotions following a caesarean birth. Some parents feel distressed about not having a vaginal birth. Others are relieved they have a healthy baby. The best way to deal with your feelings is to talk openly with someone you trust.

Resources & Links:

Labor and Delivery
Caesarean Section
 Vaginal birth after caesarean (VBAC)
 Breast-Feeding After a C-Section