Cesarean Birth

(C-Section)
  • Click here to view an animated version of this procedure.
  • Definition

    In a cesarean birth (C-section), the baby is delivered through an incision in the mother's abdomen. In the United States, some estimates suggest almost half of all births are delivered by C-section.
    Cesarean Delivery
    Cesarean Delivery
    Copyright © Nucleus Medical Media, Inc.
  • Reasons for Procedure

    The following situations may require a C-section:
  • Possible 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
    • Bad reactions to anesthesia
    • Risk of additional surgeries, including hysterectomy, bladder repair, or repeat C-sections with future pregnancies
    Factors that may increase the risk of complications include:
    • Prior cesarean section
    • Prior surgery of the uterus
    • Abnormal placenta
    • Smoking
    Cesarean birth also has risks for babies. Babies born prematurely have more risks. 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

    Prior to Procedure
    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
    You may be given:
    • General anesthesia—You will be asleep.
    • 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 Procedure
    Your doctor will make incisions 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 could also be used to close the abdomen.
    Immediately After Procedure
    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 Will It Take?
    45-60 minutes
    Will It 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. Ask your doctor about medication to help manage pain after the procedure.
    Average Hospital Stay
    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.
    • Do not drive until your doctor says it is all right to do so.
    • Ask your doctor when it is safe to shower, bathe, or soak in water.
    • Delay having sexual intercourse or putting any objects in the vagina until you have had your 6-week check-up.
    • Breastfeeding is encouraged.
    • Consider joining a support group for new mothers. You can get encouragement and learn new parenting strategies.
    • Be sure to follow your doctor’s instructions.
    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

    After you leave the hospital, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Excessive bleeding, redness, swelling, increasing pain, or discharge from the incision site
    • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery
    • Pain that you cannot control with the medications you have 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 http://www.acog.org

    American Pregnancy Association http://www.americanpregnancy.org

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    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. Accessed July 19, 2013.

    Cesarean procedure. American Pregnancy Association website. Available at: http://americanpregnancy.org/labornbirth/cesareanprocedure.html. Updated January 2013. Accessed July 19, 2013.

    Cesarean section. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 16, 2013. Accessed July 19, 2013.

    7/21/2009 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed/what.php: 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's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed/what.php: 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's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed/what.php: 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 . 2009 Nov 12. [Epub ahead of print]

    6/2/2011 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed/what.php: 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.

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