Why is it done?
If you know in advance you are having a caesarean, it's called an elective section. The decision to have a caesarean may be made well in advance or during labour, depending on your particular needs.
You might have one because:
- 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.
- You have twins or triplets.
- There are complications… such as previous surgery on the vagina.
- Your baby is in a position, which makes vaginal birth difficult or impossible.
You might have an unplanned (known as an emergency) section after you've gone into labour because:
- 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 conditions called eclampsia or severe pre-eclampsia, which can be risky for you or the baby. Pre-eclampsia is a serious condition that occurs in pregnancy and can affect both mother and baby. If it develops into eclampsia, the baby may have to be delivered quickly.
- You suddenly become ill, or have very high blood pressure.
- Your labour is making extremely slow progress.
- You’re exhausted.
- The baby's having a hard time coming out because of his position, and this wasn't realised before.
How do we go about it?
- You'll be given an anaesthetic - a spinal or an epidural - that allows you to stay awake without feeling the operation. Or sometimes, they give you a general anaesthetic.
- The surgeon first makes a cut in your abdomen and then through the uterus, in a line just above your pubic hair.
- You may feel some tugging when the baby is lifted out, sometimes by hand, sometimes with a pair of forceps.
- The baby's umbilical cord is cut and clamped, and he's given to you (unless you're under general anaesthetic).
- The placenta and membranes come out next, and the doctor then stitches you up.
- It takes about 10 minutes to deliver the baby and about 30 minutes to stitch you afterwards.
- You may feel very tired for a few days and you may have some pain, especially from wind, just as after any abdominal operation.
- Laughing or coughing will feel uncomfortable to you. You'll be offered pain-relief of a sort that's safe to take while breastfeeding.
You after a caesarean…
In the first days or so, expect to feel tired and to be offered an extra day or two in hospital compared to women who've had a vaginal birth. Here's what else to anticipate:
- Discomfort from trapped wind in your tummy.
- Tenderness on your tummy, where it's been stitched.
- Laughing or coughing may be uncomfortable for you (you'll be shown how to support your scar when you need to laugh or cough to avoid any pressure).
- The need for help at first positioning your baby for feeding, so you can hold him comfortably across your body, at your side or lying down.
- At first, you may be fitted with a small drain, which collects any blood that might otherwise pool under the scar. This is usually removed in a day or so. You may also have an intravenous drip in your arm, to replace lost fluids. At first you won't be able to get up to pass urine, and you will either have a catheter in place, or else be helped to use a bedpan.
How you'll feel…
Sometimes, women feel disappointed if they've had a caesarean birth - especially if it was unexpected. Then, if the baby is fine, they may feel guilty at being disappointed. Your friends and family may think all there is to worry about is the health of the baby and if the baby's okay, why should you be concerned about the way he came into the world?
But maybe you feel you have missed out on something - so do talk about these feelings with your partner and with other mothers who have had caesarean births. In time, you may accept the way things just didn't go as planned - like so much else in life. If you don't know why you had a caesarean section, ask; as this will help your feelings and make you feel more positive about it.