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Caesarean

A caesarean birth or caesarean section means your baby is born by an operation. The surgeon makes an opening in your abdomen and then the uterus, and takes the baby out.

Why Would I have a Caesarean?

If you know in advance that you are having a caesarean, it’s called an elective section. You might have one if:

• Your baby’s head is too big, or your pelvis makes it hard for the baby to be born
• You have a very low-lying placenta (called placenta praevia) which blocks your baby’s way out
• If you have twins or triplets
• For complications, such as previous surgery on the vagina
• If your baby is in a position, which makes vaginal birth difficult or impossible.

If your caesarean is planned your partner will most likely be able to accompany you to the operating theatre and be present for your baby’s birth. It is best to check with the hospital staff if this is possible.

You might have an unplanned (known as an emergency) section after you’ve gone into labour. This may occur if:

• Your baby is suffering from distress (lack of oxygen) and your labour hasn’t progressed enough for a forceps or a ventouse delivery.
• You have the conditions called eclampsia or severe pre-eclampsia, which can be risky for you or the baby.
• You suddenly become ill, or have very high blood pressure.
• Your labour is making very slow progress.
• To avoid a difficult forceps delivery.
• You’re exhausted.
• The baby’s having a hard time coming out because of his position, and this wasn’t realised before.
• The baby is premature.

What Happens to You^*

A Caesarean operation usually takes 45-60 minutes, but the baby is delivered in the first 5-10 minutes; the rest of the time is spent stitching you up.

Preparation^*

Before the operation begins, your pubic hair is shaved, you are given an epidural anaesthetic or spinal block, and an intravenous drip is set up to supply fluids during the operation. Then a catheter (a thin, flexible tube) is inserted up your urethra and into your bladder to drain it of urine. A small screen is placed in front of your face so you don’t have to see the operation. Your abdomen is swabbed to prevent any infection. If time is a factor, for instance, in the case of serious foetal distress, you may be given a general anaesthetic, even if you already had an epidural in place.

The Operation^*

The obstetrician makes a short, horizontal incision along the “bikini line” at the base of your abdomen, and then makes a similar incision in the lower segment of your uterus. The amniotic fluid is drained off by suction, and the baby is gently lifted out. Then the cord is cut, the placenta is removed, and your uterus and abdomen are stitched.

The Effects on Your Baby^*

Not having to pass through the birth canal is both a benefit and a drawback for the baby born by Caesarean section.

Unlike a baby born by vaginal delivery, who initially has a rather squashed appearance after being squeezed through the birth canal, a Caesarean baby has a smooth, round head. But often the Caesarean baby needs more time to adjust to the outside world because of his sudden entry into it, and because he has missed the journey through the birth canal that helps to clear amniotic fluid from a baby’s lungs and stimulates his circulation.

The Effect on You

After a caesarean you will feel very tired for a few days and you may have some pain, especially from wind, just as with any abdominal operation. Laughing or coughing will be uncomfortable for you.

You’ll be offered pain-relief that’s safe to take while breastfeeding. If you have had a general anaesthetic you may find that there is a delay to your milk “coming in”.

You will probably need some help to lift your baby and doing basic things for yourself in the early days. You should not lift anything heavy or drive for about 3-6 weeks after this major surgery.

For more information and support about Caesarean Deliveries visit Caesarean Birth.com

* Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002