Caesarean Section - Giving Birth - Knowledge Area

Making the difference from the bottom up

GIVING BIRTH BY CAESAREAN SECTION

Some information about giving birth by Caesarean section - as with all our advice pages, this information is for reference only and you should consult your GP, Consultant or Midwife for more detailed information about you and a Caesarean Section.

___________________________________________________________

What is a Caesarean Section (or C-section)?

Caesarean section is a surgical operation in which an obstetrician (doctor specialising in care of women during pregnancy & childbirth) makes an opening in the mother’s abdomen and womb and removes the baby through this opening.

About 20% of babies born in the UK are by C-section.

There are 3 "types" although the procedure is the same:

Planned - the medical need for one may become apparent during the pregnancy.
Emergency - when labour has already started and medical emergency dictates the need to deliver the baby by c-section.
Elective - the mother chooses in advance to have a c-section, rather than for medical reasons.

___________________________________________________________

Why might I need to have one?

There are various medical reasons for having a C-section - here are the most common:

severe pre-eclampsia (pregnancy-related high blood pressure)
lack of oxygen to the unborn baby - if a quick vaginal delivery is not possible
distress - if labour is not progressing and fails to move the baby quickly down the birth canal and you and the baby become distressed
twins & multiple births - if the babies are premature, in an abnormal position (perhaps blocking the uterus) or if they share a placenta
induction - if your labour has been induced for medical reasons but this is not working
abnormal position - if the baby is breeched (bottom first, rather than head) they can be born vaginally but a c-section is likely; or transverse (lying sideways) or perhaps the head is too large to fit through (ow)
placenta praevia - the placenta is blocking the birth canal
infection - some types of infection can be passed to the baby and a C-section can reduce the risk of transferance (eg genital herpes or HIV)
premature labour - the baby's head may be too delicate to pass through the birth canal and there can be a risk of brain haemorrhage
mother's medical condition - such as a heart problem or diabetes which could put the mother at risk during normal delivery
previous c-section - although vaginal delivery is possible after a C-section you are more likely to have another one (there is the risk of the scar on the womb tearing during a vaginal delivery following a C-section, see below "Can I have a normal delivery....?")

___________________________________________________________

What happens during a Caesarean?

The start will depend on whether this is planned or emergency - the latter may involve being rushed through to the operating theatre from the labour room and the former will be a planned appointment.

The actual procedure usually takes 30-45 minutes and is performed under a general, spinal or epidural anaesthetic - the last 2 involve an injection of local anaesthetic into the fluid around your spine. This numbs the body from the waist down, allowing you to stay awake but without pain.

If you are having a spinal or epidural you are will have a catheter fitted - this takes the wee out of your bladder, and is painless. A small tube is inserted into your bladder via your urethra (where your wee comes out) and is normally taken out the morning after the operation.

The anaesthetist will check you are numb using a very cold spray - when you can't feel the cold any more you are ready to go.

A horizontal incision (side to side cut) is made to your lower abdomen at the top of your pubic bone (along the bikini line - you will be shaved first).

Another horizontal incision is then made in the wall of your womb to deliver your baby. The low incision avoids weakening the womb muscles unnecessarily and allows the operation to be performed in subsequent pregnancies, if necessary.

In cases of an emergency, vertical incisions (from your tummy button down) may be used.

Once your baby has been delivered through the incision made into the womb, the placenta soon separates and is also removed.

The wall of your womb is swabbed and closed with stitches that will later safely dissolve (some surgeons use staples which are painlessly removed later). Your abdominal wound is then closed in layers.

Don't worry - you can't see anything as a screen is put between you and your abdomen.

Some people say that having a Caesarean section, and particularly the closing up stage, feels like someone is washing up inside you. Although you can't feel any pain, you can certainly feel a tugging & pulling sensation.

You should be able to hold the baby straight away, and give the baby his first feed as normal.

___________________________________________________________

Afterwards

Recovery from a C-section is a lot harder than from a vaginal delivery, as not only do you have a newborn baby but you have also just had a major operation. (Ignore people who suggest a C-section is for those that are "too posh to push" - it's not an easy option).

Straight after the operation you are likely to be in a recovery room for a while and then you will go back to the ward. You will have a small/thin plastic tube (a drip) in an arm vein. This gives you salt and sugar and water, and sometimes blood, for a day or so, from a plastic bag on a stand. You will have a sanitary pad in place.

You will be given plenty of pain relief and should be able to get out of bed after a few hours - take it easy, though. Your tummy will be Cuncomfortable and you may suffer from trapped wind.

Make sure you havebig knickers that do not sit on the wound as they can aggravate it and interfere with the healing process. There are some delightful pants that are large and stretchy and designed for those recovering from a Caesarean, the NCT shop has some available, or the hospital may be able to provide some.

You will be advised by the hospital with regards to your recovery but here are some main points:

It will take about six weeks for your wound to heal completely
Try not to lift anything heavier than your baby
Avoid any strenuous activity
Get as much rest as possible
Avoid walking up and down stairs too much
Take gentle walks every day to reduce the risk of blood clots
Do not drive until you feel comfortable and check your car insurance - some insist on a GP certifying that you are fit to drive
Try to wait til after the six week check to drive, but some women do drive earlier (you may find it easier driving an automatic car)
If anyone offers help - ACCEPT IT!

___________________________________________________________

Can I give birth "normally" after a Caesarean?

This depends on the reason for the Caesarean - if it was for a health reason that will not have changed (such as a small birth canal) then C-sections are likely for all subsequent births.

However, most women can go on to have a normal delivery, but it is important that the scar on your uterus is not put under pressure or it may open up and which is dangerous for you and the baby. You will not be allowed to have a long and strenuous labour and would be closely monitored.

Discuss your options with your GP or midwife.

___________________________________________________________

How many Caesareans can I have?

There is no limit to how many C-sections you can have but the risks of complications do increase each time. Once you have had 2, however, you are likely to be advised not to try for a vaginal delivery.

___________________________________________________________

I didn't want a Caesarean but had to have one...

Often women can feel let down or that they have failed if they have to have a Caesarean. It is important to understand why it was required and remember that the medical reasons for having a Caesarean section far outweigh the potential risks to the health of you and your baby.

Talk about it to health professionals - and look at your baby. The fact that you have grown another human being inside you is pretty amazing - well done!

___________________________________________________________

Personal Experiences

Please do let us know of your experiences with a C-Section.

Jess - there is so much to say, having had 2 C-sections and another planned for this summer, but much of it is covered here already. Even though you can't see what is happening, my husband happily watched both taking place - yuk - but it is easy for your partner not to witness the op. After number two, the trapped wind was more painful than anything that had gone on before. I just wanted someone to get a large needle and burst me (they do this with sheep, apparently) but all I got was a peppermint drink which helped a little bit.

___________________________________________________________

Back to Knowledge Area Home Page...

QUICK SHOP

MAY OFFERS & SALE!

We have some great offers this month - you can save over £20!!