Pregnancy can be such an exciting time. As you prepare for your little one’s arrival, you (or your doctor) will have to start making decisions over how they will enter the world. The majority of births are vaginal, but many women have (or choose) to have a C-section. Whether it’s part of your birth plan or an emergency decision, delivering your baby through C-section is a major operation. Around 1 in 4 UK births are caesareans, but it’s believed that the rate should only be at around 10-15% . Many are done because they are the safest choice, and often lifesaving, but some women are choosing to have C-sections when there is no medical need. It’s important to understand the complications that can arise, and to discuss them with your healthcare professional to make an informed decision.
What is a C-section?
A C-section is where you give birth to your baby through a cut made just above your bikini line. A doctor makes an incision, which goes through your womb (and other layers) and then your baby is lifted out.
It begins with anaesthetic. One type you may have is a spinal anaesthetic, which is one injection in the lower part of your back. Another type is an epidural. Similarly, the anaesthetic is put into your back, but it is done through a catheter to give continuous anaesthesia. These will numb the bottom part of your body but you’ll still be awake. You’ll only be given a general anaesthetic in an emergency C-section when your baby needs to be born very quickly, and you’ll be asleep for the birth (but it’s rare). You’ll also be put on an IV drip. Your tummy will be cleaned with antiseptic solution, a urinary catheter will be fitted, and your birthing partner will be dressed in a sterile gown. This might all sound a bit scary, but it’s procedure and something that’s done every single day.
There are two types of C-section:
- Lower segment – the most common, where the doctor makes a horizontal cut.
- Classical – a vertical cut, which is only used in serious emergencies (less than one in 100) where your baby may be lying sideways or your placenta is extremely low.
Your doctor will decide which type is safest for you and your baby.
A screen will be put over your chest, and you can ask for it to be lowered as your baby’s born. You might hear some suction sounds and feel a bit of pulling, but it shouldn’t hurt. After this, your doctor will sew up your uterus and stitch or staple the cut in your tummy. The whole surgery normally takes around 30-60 minutes. You’ll then be ready to meet your beautiful baby!
There are three different cases in which a C-section will be performed instead of vaginal birth:
Planned (elective) C-section
This is when the decision is made for the operation while you’re pregnant. It’s often due to medical needs and recommended by your healthcare professional. Some women may opt for one due to things such as anxieties around vaginal birth, a history of vaginal birth complications, etc. It’s important to discuss this with your healthcare professional as it may not always be the safest option.
Your doctor may recommend a planned C-section if:
- Your baby is lying in a difficult position for delivery, such as the breech position (bottom or feet first), transverse lie (sideways), or unstable lie (they keep changing position).
- You have a low lying placenta (placenta praevia).
- You have pregnancy related high blood pressure (preeclampsia).
- You’re having twins and they share a placenta, or one of them is in a difficult position – but almost half of twins are born vaginally.
- You’re having more than two babies. This is normally the safest option due to their position, the position of your placenta, risks of the umbilical cord compressing or the babies becoming tangled.
- You have HIV or genital herpes (sometimes done to prevent the virus passing to the baby).
This is when the decision is made just before or when you’re in labour. It happens when there are complications, and your baby needs to be delivered immediately. This can all happen very quickly and can be a bit scary, but remember that you’re in the hands of doctors who have done this many times before (around 15% of UK births are emergency C-sections).
You may have to have an emergency C-section if:
- You or your baby are in distress.
- You experience maternal haemorrhage (lots of vaginal bleeding).
- You have a prolapsed umbilical cord (where the umbilical cord goes into the birth canal before the baby, which can compress it and decrease the amount of oxygen and blood getting to your baby).
- You have a placenta abruption (the placenta starts to come away from the wall of the womb, causing distress and/or blood loss).
- You have a uterine rupture (very rare – the wall of the uterus tears and the baby will need to be delivered very quickly).
Similar to an emergency C-section, unscheduled ones are decided upon close to birth, but they’re not due to mum and baby being in life-threatening situations. You may have an unscheduled C-section if:
- Your labour isn’t progressing.
- You’re having weak contractions.
- Your baby is in a breech or transverse position when you go into labour.
What are the risks?
There are times when a C-section might be the safest way for you to give birth. If you’re making the decision to have one without medical reasons, it’s important to discuss your options with your healthcare professional. You should also understand that there are risks that come with them.
Although you will not feel pain during the procedure, 1 in 10 women will feel discomfort for the first few months after. It can also lead to more serious complications. Risks are increased if you’re overweight or have had a C-section before.
- Your doctor will make sure that everything is as sterile as possible during the procedure, but infections occur in around 2-15% of C-sections.
- You may feel generally unwell and weak with flu-like symptoms, depending on the severity of the infection.
- It can take several weeks to fully recover from an infection. If not treated properly, it can lead to serious complications.
Blood clots and bleeding
- You will probably bleed heavily from your vagina for around four days after.
- Bleeding will become lighter from around 10 days after - this can last for up to six weeks.
- It can result in a postpartum haemorrhage which will require further medical attention.
- Blood clots can form after the operation. There is a chance of them travelling to the lungs (pulmonary embolism) which can be fatal. If you experience swelling and pain in your legs after a C-section, it’s important to contact your healthcare professional.
Damage to your body
- There might be injury to the bladder or intestines during the procedure, which can cause problems later. One in 1,000 women experience damage to their bowel or bladder.
- You may experience inflammation of the uterus which, in rare cases, can lead to endometriosis, a painful chronic illness.
- If the incision isn’t big enough for the baby, it can cause accidental tears which can lead to heavy bleeding. These may need another surgery to fix them.
Complications for baby
- Your baby is less likely to have skin-to-skin contact immediately after birth (this contact has been found to have many benefits).
- There’s a small risk of injury, such as scrapes, during the procedure.
- The anaesthetic can make it more difficult to initiate breastfeeding.
- It puts them at an increased risk for breathing problems (particularly if your baby is pre-term).
Risks for future pregnancies
Having a C-section doesn’t mean you will always have to deliver babies in this way, and many women go on to have vaginal deliveries in the future. Three out of four women who have had one C-section and then go on to have a straightforward pregnancy are able to go into labour naturally and deliver vaginally.
But there are still some complications that can occur:
- It’s been found that, unfortunately, late stage C-sections performed in the second stage of labour (see our post on delivery day for more) can increase the risk of preterm birth in future pregnancies (by as much as six times).
- In some rare cases, doctors may need to perform a hysterectomy after the delivery. This is normally to save the mother’s life due to excessive bleeding that can’t be controlled in any other way. Although this is extremely rare, it can be heart-breaking and life changing.
Tips for your recovery period
After a C-section, the physical and emotional recovery generally takes longer than it does with a vaginal birth. You will probably have to stay in the hospital for three or four days, and it can take a further four to six weeks for you to recover at home. It may be difficult with a new baby to look after, but it’s important to take it slow, and don’t be shy about asking for help. You’ve just had a major operation and your body and mind need to recover!
- Check with your doctor and insurance company for when you can start driving again after giving birth.
- Avoid lifting anything heavier than your baby for several weeks.
- Avoid strenuous activity – don’t push yourself – as this can lead to even more recovery time.
- When holding your little one, try placing a pillow over the incision to keep that area safe.
- Avoid having sex until you feel able to do so.
- Take the pain relief medication that your doctor or midwife has given you (this should be safe for breastfeeding).
Reduce risk of infection
- Make sure to wash your hands both before and after changing your sanitary towel.
- Avoid using tampons.
- Keep your nails short.
- Avoid touching your stitches.
- Wear loose clothing.
Try to relax
- It may be difficult, but you really need to take it easy so that you can recover properly.
- This is the time to call upon partners, friends and loved ones to give you an extra helping hand.
- Make sure you’re getting plenty of rest and as much sleep as you can.
- Take some ‘me’ time – catch up on that series you’ve wanted to watch, read your favourite book, or get online and swot up on your parenting knowledge.
- You may be advised to massage your scar once it’s healed. To do this, rub non-perfumed cream in small circular motions over your scar a few times a day.
- A Bluebell baby monitor can be an extra helping hand at this time with baby tracking, monitoring and also looking after yourself.
Watch what you eat and drink
- Avoid food and drink that you know makes you gassy (such as fried foods and fizzy drinks). They can cause your intestine to put pressure on your incision which can be uncomfortable.
- Eat foods rich in fibre to avoid constipation (fruit, vegetables, whole-grains, nuts, seeds, beans, etc.).
- Try foods that are easier to digest (soup, cottage cheese, yoghurt, etc.).
- Eat plenty of protein to help with the healing process (meat, fish, eggs, beans, nuts, etc.).
- Vitamin C can help to fight infections and speed up the recovery process (oranges, strawberries, tomatoes, broccoli, etc.).
- Help to restore blood lost in delivery by eating iron-rich foods (egg yolk, dried fruit, red meat, figs), although too much can lead to constipation, so limit these types of foods.
- Calcium rich foods can also help (milk, yogurt, tofu, spinach, etc.).
- After a few weeks, you may be able to start exercising again (but always check with your doctor).
- Start by walking around the house to build up stamina and improve circulation.
- You can also help your circulation and muscle tone by flexing and stretching your feet and legs. And, of course, you can do pelvic floor exercises (which you’re probably used to).
Contact your doctor if you experience:
- Intense pain
- Pain when weeing
- Heavy or increased vaginal bleeding
- Leaking urine
- Swelling, redness and pain around your wound
- Discharge or unpleasant smelling fluid coming from your wound
- A high temperature or you feel generally unwell
- Shortness of breath
- A cough or chest pain
- Unusual smelling or coloured vaginal blood
- Swelling or pain in your legs
We hope this has helped you to understand why it’s necessary for some women to have C-sections, and that it may or may not be the safest option for you. Remember to discuss your options with your healthcare professional, and weigh them out before making a decision, as a C-section can result in many avoidable complications.
However far along you are, we hope your delivery day goes well!
Let us know in the comments below if you’ve got any further tips for recovering from a C-section.