What to expect before, during and after a caesarean...
What is a C-section
A caesarean section, or C-section, is an operation where a doctor delivers your baby through a cut in your abdomen and womb. The cut is usually just above your bikini line.
Around 1 in 4 pregnant women in the UK delivers by C-section. It is a major operation, which is usually performed only if it’s the safest option for both you and baby.
There are two types of C-section:
- Planned (or elective) C-section, which is decided before you go into labour.
- Emergency C-section, decided at short notice, often once you are in labour and a vaginal birth is considered too risky.
Planned caesareans are usually performed after the 39th week of pregnancy, although you may have a C-section earlier if you’re expecting more than one baby or if there’s a medical reason why you should deliver early.
There are a number of reasons why you may need a planned C-section, including:
- Your baby is in a difficult position for labour, such as breech (feet first)
- Your have a low-lying placenta (placenta praevia)
- You are expecting more than one baby
You will have an opportunity to meet with and talk to an obstetrician and your midwife, who will discuss the benefits and risks of a C-section, compared with a vaginal birth.
Some women request a caesarean for non-medical reasons. If you ask your midwife or doctor, they will talk to you about your reasons and explain the benefits and risks to you and your baby. You will have the chance to make an informed decision based on all of the facts – if you still feel unable to go ahead with a vaginal birth you should be offered a planned caesarean. Some hospitals aren’t able to perform C-sections without a medical need, due to funding, so if this happens you can ask to move to another hospital in another area.
Emergency C-sections do sound a bit frightening, but it really just means aC-section that isn’t planned.
Some of the reason why you might have an emergency C-section are:
- Your labour isn’t progressing
- There’s excessive vaginal bleeding during labour
- You go into labour before a planned C-section
- There are concerns about your, or your baby’s, health
How to prepare for a C-section
If you’re having a planned C-section you can write your own birth plan and your healthcare team will try and follow it as much as possible.Think about who you want present, if you want any music playing, if you’d like to take a camera so your midwife can take photos, whether you’d like the screen lowered so you can see your baby being born, delayed cord clamping (to increase the amount of blood your baby gets from the placenta) and whether you or your birth partner would like initial skin-to-skin contact.
It’s helpful to get things in place at home, to make your recovery smoother too. It’s recommended you have someone at home to help you day and night for at least the first two weeks. If you have other children at home, explain to them how you won’t be able to pick them up for a while and how they must be very careful with your tummy.
Stock up on large, comfy cotton pants that come up to your waist – you don’t want any knickers rubbing on your C-section wound. Make sure you pack loose clothes and a loose nightgown for hospital – you’ll have to have a catheter for a minimum of 12 hours after the operation, so PJ bottoms are a no-no to begin with.
You can’t wear make-up, nail polish, jewellery (apart from a plain ring, which needs to be taped over) or contact lenses during your C-section.Many hospital trusts ask that you don’t shave or wax your pubic area before the surgery, as it poses a risk of infection. One of the healthcare team will shave the top of your bikini line just before your C-section. Honestly, it’s nothing to be embarrassed about!
Before you go into the operating theatre, you’ll be given a hospital gown and compression socks to wear.
What happens during a C-section?
The majority of C-sections require a spinal or epidural aesthetic, which is an injection into your spine to numb the lower part of your body. The anaesthetist will ask you to either lie on your side or sit forward, curving your back, while they insert a very fine needle. The anaesthetic works very quickly.
You will be awake throughout the operation, but you won’t feel any pain – just some pressure or a tugging sensation. Some women liken it to a feeling of someone doing the washing up in their tummy – unusual but not painful.
If your baby needs to be delivered immediately you may need a general anaesthetic, so you will be asleep for the operation.
There will be a number of people inside the operating theatre, including two obstetricians, an anaesthetist, a midwife and support staff.
You will lie on your back, slightly tilted to your left, before the doctor makes the cut along your bikini line and womb (about 10-20cm)and lifts your baby out. You should be able to enjoy some skin-to-skin with your baby while the doctor removes the placenta and stitches your wound up.
The whole operation takes about 40 to 50 minutes.
What happens after a C-section?
Recovery from a caesarean tends to take longer than that of a vaginal birth, with an average stay of around 3- 4 days in hospital. A C-section is major surgery, so you will need help lifting your baby and getting out of bed for at least the first day.
Once your anaesthetic has worn off, your midwife will encourage you to sit up and eventually stand and go for a short walk. It’s natural to feel a bit wobbly and sore, so make sure you have someone with you when you first get out of bed. Moving around is important to help reduce the risk of blood clots.
Your catheter will be removed after about 12 hours and you’ll be encouraged to drink plenty of water. Your midwife will want to keep an eye on how much urine you pass, so you may be asked to place a cardboard pan over the toilet each time you go.
There will be some pain or tenderness in your tummy area fora few days, but your midwife will provide pain relief. It’s important to keep on top of your pain medication when you go home.
You may also experience some trapped wind and constipation, as your bowel starts to work again after your C-section. Plenty of water and peppermint tea will help ease the discomfort.
Once the dressing of your C-section wound has been removed, keep the area clean using water (avoid soap) and a gentle pat dry with a soft towel.Wear loose clothes and pants that sit high above your wound.
As with a vaginal delivery, you will experience vaginal bleeding for two to six weeks after the birth, which is totally normal. Just be sure to stock up on maternity pads.
At home you will need yo take it easy with no heavy lifting r bending for a few weeks. You should also avoid driving until you've had your post-natal check up with your GP at 6 weeks.
Written by our guest blogger, Sarah Dawson.
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