3 Things You Need to Know About C-sections
Medical Disclaimer: Cesarean sections are a life-saving tool. All advice given is general and not specific to you and your pregnancy. Please talk to your healthcare provider to make informed decisions together.
As a midwife I am extremely passionate about ensuring women and their families receive evidence based, informative education and support during the perinatal period, to be able to make informed decisions about their pregnancy, labour, birth and postpartum period.
What are planned and emergency C-sections and when and why are they required?
What is a C-section? “A cesarean section (c-section) is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby…” (medical dictionary).
Planned C-section: There are a multitude of reasons why a woman may need a planned c-section.
Physical complications with baby or mother during pregnancy or labour
Certain fetal positions
Previous C-section (within 18 months)
High order multiples and more
In a planned C-section, you will generally have a date chosen by your Obstetrician (OB), and the delivery details will be organised and timely. You will usually go into the hospital quite early in the day, for an anesthetic consultation, where you will meet the anesthetist looking after you (if you have not already met beforehand). They will run you through some important questions that will give them an idea of you, your health and your baby.
You will then generally be waiting in a hospital room, on a bed, with your partner until you’re ready to be called to the theatre. A midwife, your OB and the anesthetist, as well as theatre staff, will be present. Once bub is born, there may also be a pediatrician to ensure bub is well.
After the birth, depending on hospital protocol, as well as mum and baby’s health - bub may be dried / wrapped and put on mum’s chest while the operation is finished.
After this, generally, mum and baby will go to ‘recovery’ for a short period of time where mum will be closely monitored, before moving to the postnatal ward. Your partner generally cannot come to recovery and will need to wait on the postnatal ward.
Any C-section that is not pre-planned is called an ‘emergency cesarean section’. Even if you and bub are doing well, and it’s simply the best choice at the time, it’s still called an emergency, so don’t let that scare you. An emergency C-section can be a bit more rushed (if urgent) than a planned one, so you and your partner need to be aware that health professionals around you will move very fast. It can feel overwhelming, but education is key. Knowing beforehand what to expect is vital to help in remaining calm.
During an emergency C-section there will almost always be a pediatrician present to help bub if they require. Depending on how bub is doing, they may need to go to the NICU for further observation or help.
Pain relief in a C-section
In terms of pain relief, there are two main options. If you have an effective epidural or spinal already, you can be transferred straight to theatre and the operation can begin. However, if you don’t have an epidural, the decision needs to be made, depending on urgency if there is enough time for the anaesthetist to put a spinal or epidural in. If yes, this is what will happen. However, if there is a major emergency and bub needs to be born immediately, mum will have a general anesthetic which means she won’t be awake for the operation. Unfortunately if this needs to happen, most of the time your partner is not allowed in the operating theatre. However, it is important to remember this is life saving for your baby.
After a C-section, there will be a wound/scar in the pelvic area or otherwise known as under the “bikini” line. It is important to take good care of your C-section scar, keeping it dry and clean, with special care during and after a shower. Your midwife and OB will show you how to care for the wound and inform you of when you need to return for follow up care or what to look for in case of any issues.
Your body will generally take longer to recover after a C-section than a vaginal delivery as a c-section is major surgery. Mums usually remain in hospital for a longer period of time (3-5 days) and the day after delivery midwives encourage mums to be up and walking a bit, so as to prevent blood clots and promote healing.
Tips on how to take care of yourself and your baby after a C-section.
Recovery from a C-section
Take pain relief. It is important to stay on top of the pain, especially the first few days/weeks. Once pain becomes overbearing it can be very hard to get on top of and manage.
Get moving and showered. Generally, if all is straightforward you will be encouraged to get up and showered the day after your C-section (with assistance from midwives and nurses).
Stay hydrated - drink lots of water and electrolytes (coconut water is great for hydration and tastes good! This helps recovery, breastmilk supply and also your bladder sensation. Once you are up and moving around, your catheter (small tube in the bladder, draining urine) will be removed.
Eat light meals that are rich in fiber and help your bowels to get moving. Fruits like kiwis, oranges, pears are a great snack and full of fiber.
Ask for help! This is a tip I really want to emphasise. You have had a major operation mama, never ever feel like you cannot ask for help.
Hold your wound when coughing/laughing - this can help provide support to the wound
Hand express if unable to breastfeed - ask your midwife to show you how to express colostrum from the get-go, and store safely (if this is what you choose and cannot breastfeed for whatever reason).
Don’t lift any objects that are heavier than your baby, for at least 6 weeks if possible.
Rest! This is hard, I know. But it is so important. Your body does need time to heal
Here are some great ways for partners to help mum with recovery after birth; help mum to get in and out of bed, pass the new little bub to her for feeds, provide emotional support, through listening to how she’s feeling and offering encouragement, ensure mum is eating healthy delicious food, change nappies and have some skin to skin time with your baby.
A lot of mothers ask about how to avoid a C-section, here is a note from the World Health Organization: “Caesarean sections can be a lifesaving procedure for mother and baby, but rates beyond 10% of live births are not associated with reductions in maternal and newborn mortality. The trend towards overuse of caesarean sections is a major concern globally, given the risks to the mother and her child associated with unnecessary caesarean birth.”
Some tips to avoiding an unnecessary C-section (this means a C-section delivery is not medically needed and not maternally wanted):
1.) Active & healthy pregnancy
2.) Good support during labour
3.) Stay at home during early labour if you are able to, as this is where you will usually feel calm and safe as it is a familiar environment. However, if at ANY point you feel you need to go to the hospital, it is best to go and be safe.
4.) Antenatal education for mum and partner
5.) Change positions and be active in labour, allow baby to move into an optimal position
6.) Trust in your Body!
To read more from the World Health Organisation, click here.
To watch my 10 Tips for Avoiding a C-section YouTube video, click here.
Photos by Amber May Birth Photography