• Cesarean Birth

    Also known as a C-Section

    Click here to view an animated version of this procedure.

    What is a cesarean birth or C-section?

    A cesarean birth (C-section) is the delivery of a baby through an incision in the mother's abdomen.

    In the United States, some estimates suggest almost one-third of all births are delivered by C-section.

    Cesarean Delivery

    Copyright © Nucleus Medical Media, Inc.

    Reasons for a C-section

    The following situations may require a C-section:

    • Large baby
    • Pregnancy with twins or more
    • Baby is not in a head-down position
    • Maternal medical conditions, for example, diabetes, high blood pressure, active herpes infection or HIV infection
    • Problem with the position of the placenta
    • Failure of labor to progress
    • Baby shows signs of distress, such as an abnormal heart rate during labor
    • Previous cesarean birth
    • Fetal problems

    Possible C-section complications

    Cesarean birth is a surgery. There are some risks involved. The estimated risk of a woman dying after a cesarean birth is extremely small. The risk of death after a vaginal birth is even smaller. Your doctor will review potential problems like:

    • Infection
    • Bleeding
    • Decreased bowel function
    • Damage to other organs in the abdomen
    • Longer hospital stay and recovery time
    • Allergic reactions to anesthesia
    • Risk of additional surgeries, including hysterectomy, bladder repair or repeat C-sections with future pregnancies
    • Prior cesarean birth
    • Prior surgery of the uterus
    • Abnormal placenta
    • Obesity
    • Smoking

    C-sections also have risks for babies. The risk of death for premature babies delivered by elective C-section is very small. The risk of death for premature babies born vaginally is even smaller.

    What to expect

    Before a C-section

    C-sections are often unplanned. If you have a scheduled C-section, you may be asked not to eat or drink after midnight before the procedure.

    Anesthesia

    To help control pain, you may be given:

    • General anesthesia – You will be asleep during the procedure.
    • Regional anesthesia, such as epidural or spinal block – An area of your body will be numb, but you will be awake.

    Many women prefer regional anesthesia, so that they can be awake to see their new baby.

    Description of the C-section procedure

    Incisions will be made in your abdominal skin and uterus.

    After the incisions are made, the baby will be delivered. Your uterus will be closed with stitches that later dissolve on their own. Staples or stitches will be used to close the abdomen.

    Immediately after a C-section

    Your baby will be examined. You may be able to hold your baby. It will depend on the condition of you and your baby.

    How long does a C-section take?

    The C-section procedure typically takes 45-60 minutes.

    Does a C-section hurt?

    Anesthesia prevents pain during the surgery. You may feel some pressure and tugging as the uterus is opened and the baby and placenta are removed.

    Pain and discomfort after the procedure can be managed with medications.

    Average hospital stay for C-section

    3-5 days

    Post-procedure care

    At the hospital

    • Very soon after birth, your baby may be placed on your chest. This skin-to-skin contact may lead to improved breastfeeding success.
    • You may need help learning breastfeeding positions. The correct position will keep you from putting too much pressure on your incision.
    • You may need medication to help with nausea or pain.
    • You will likely experience some uterine cramping and pain.
    • You may be on a clear liquid diet after surgery. You will advance to a normal diet as you are able.
    • Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.
    • You may be given special compression stockings. They will help to decrease the possibility of blood clots forming in your legs.
    • You will be encouraged to walk very soon after surgery. You will be asked not to lift anything heavier than your baby.
    • For lung health, you may be asked to use an incentive spirometer and cough often. These steps will help you breathe deeply.
    • After any delivery, there will be moderate-to-heavy vaginal bleeding. You will need to use an absorbent sanitary napkin.

    At home

    When you return home, do the following to help ensure a smooth recovery:

    • Avoid lifting anything heavier than your baby for the first weeks after surgery.
    • Delay having sexual intercourse or putting any objects in the vagina until you have had your 6-week check-up.
    • Breastfeeding is encouraged for your health and the health of your baby.
    • Consider joining a support group for new mothers. You can get encouragement and learn new parenting strategies.

    You should heal quickly and completely after a C-section. Talk with your doctor about the type of incisions used during your procedure. It may play a role in decisions about future births.

    Call your doctor if…

    It is important to monitor your recovery. Alert your doctor to any problems.

    If any of the following occur, call your doctor:

    • Signs of infection, including fever and chills
    • Excessive bleeding, redness, swelling, increasing pain or discharge from the incision site
    • Persistent nausea and/or vomiting
    • Pain that you cannot control with the medications you've been given
    • Swelling and/or pain in one or both legs
    • Cough, shortness of breath or chest pain
    • Joint pain, fatigue, stiffness, rash or other new symptoms
    • Lightheadedness faintness
    • Heavy vaginal bleeding
    • Foul-smelling vaginal discharge

    If you think you have an emergency, call for medical help right away.


    RESOURCES

    American Congress of Obstetricians and Gynecologists – www.acog.org

    American Pregnancy Association – www.americanpregnancy.org

    References

    Cesarean birth. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq006.pdf?dmc=1&ts=20130719T1543190286. Published May 2015. Accessed March 14, 2015.

    Births – Method of Delivery. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/nchs/fastats/delivery.htm

    Cesarean procedure. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/cesarean-procedure. Updated August 2015. Accessed March 14, 2016.

    Cesarean section. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section. Updated September 27, 2016. Accessed October 10, 2016.

    Quinlan J. Cesarian Delivery: counceling issues and complication management; Am Fam Physician. 2015 Feb1;91 (3):178-184

    7/21/2009 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section: De Luca R, Boulvain M, et al. Incidence of early neonatal mortality and morbidity after late-preterm and term cesarean delivery. Pediatrics. 2009;123:e1064-1071.

    10/23/2009 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section: Abd-El-Maeboud KH, Ibrahim MI, et al. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009;116:1334-1339.

    12/4/2009 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section: Marín Gabriel M, Llana Martín I, et al. Randomized controlled trial of early skin-to-skin contact: Effects on the mother and the newborn. Acta Paediatr. 2010;99(11):1630-1634.

    6/2/2011 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

    3/11/2015 DynaMed Plus Systematic Literature Surveillance. Available at: http://www.dynamed.com/topics/dmp~AN~T116315/Cesarean-section: Girsen AI, Osmundson SS, et al. Body mass index and operative times at cesarean delivery. Obstet Gynecol. 2014;124(4):684-689.

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.


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