Ultimate guide to C sections

A caesarean section is an operation to deliver your baby through your tummy, we look at everything you need to know about caesarean delivery. 

What is a C section?

A C section, also known as a caesarean section or caesarean, is surgical procedure in which a baby is born through an incision (cut) made in the mother’s abdomen and womb. 

You can plan in advance to have a caesarean section, which is called a planned C section or elective caesarean. Or, you may need an emergency C section because of complications that develop, which means delivery needs to happen quickly. This may be before or during your labour.  

 

Why are C sections used?

If it's not possible for you to give birth to your baby vaginally, you will need a C section. There are several reasons why you may have a C section delivery.

  • Your labour has been going on for some time and isn't progressing.
  • Your baby isn't getting enough oxygen, or there’s another problem putting them at risk. This is called fetal compromise or fetal distress.
  • The placenta partly or completely covers your cervix (the neck of your womb). This is called placenta praevia.
  • You’re expecting more than one baby, for example, twins or triplets.
  • Your baby is lying with their feet or bottom first rather than their head downwards (called the breech position), and is not able to be turned by the doctor. This makes giving birth vaginally more difficult or sometimes impossible.
  • Your baby is lying sideways and is not able to be turned by the doctor. 
  • There are complications, such as heavy bleeding or pre-eclampsia. 
  • You have certain viral infections that may be transmitted to your baby, such as genital herpes.
  • You’ve previously had several C-section deliveries. 

To meet your individual needs, your care may differ from what’s described here. Your obstetrician will discuss the reason they are recommending a C section with you based on your situation and preferences. 

Types of caesarean delivery

There are two main types of C section delivery: 

  • Lower uterine segment C section is the most common type. A horizontal cut is made across the lower part of your abdomen and womb, usually parallel to your bikini line. There’s usually a smaller amount of blood lost with this type of C section, the cut heals better, and the scar that forms tends to be smaller and stronger.
  • A classical caesarean section, which is less common nowadays. The cut to your womb is made vertically. It's likely that you will only need this type of caesarean section in extreme emergencies, or if there are reasons why a lower segment C section can’t be done. For example, your placenta may be in the way at the front (placenta praevia) or your baby is very small. 

Preparing for a caesarean delivery

Don’t be afraid to ask questions or to tell the doctors or midwives if you are feeling worried about having a C section. If you have any special preferences, talk to your doctor or midwife beforehand because you may be able to choose some aspects of the C section delivery. You may be able to choose how and when your baby is passed to you, and you may even be able to choose to have music playing during your operation. 

In the lead up to your C section, your obstetrician or midwife will arrange for you to have blood tests before your operation. This will determine your blood type and show whether you have anaemia. Anaemia is a condition in which your blood can't carry enough oxygen to meet the needs of your body. This may put you at a higher risk of needing a blood transfusion during the operation. 

Right before the surgery, you’ll be given a special pair of stockings to wear until after the operation. These will reduce your risk of developing blot clots while you’re not moving around. You may also be given a dose of antibiotics before the surgery starts – this will help prevent you from developing an infection.

Pain relief for a caesarean delivery

The anaesthetist will provide you with the most appropriate form of anaesthesia during the  C section operation. This may be an epidural, spinal block or a general anaesthesia. An epidural or spinal block will numb the feeling below your waist and stop you feeling pain, but you will still be awake – this is called regional anaesthesia.

For more information on epidurals check out our Guide to Epidural for childbirth here.

If you have a general anaesthetic, you will be a sleep during the C section operation.

Medical instruments sitting on an operating table

What happens during a caesarean delivery?

When you arrive in the operating theatre to have your C section, there will be several people present. All of them have an important role to play to ensure the safety of you and your baby.
 
A drip will be inserted into a vein in your hand or arm to give you fluids and medicines. Your anesthetist will then give you the anaesthetic. A tube, called a catheter, will also be put into your bladder to keep your bladder empty during the operation. 

Once the anaesthetic has taken effect, your tummy will be cleaned with antiseptic and any hair near the operation site will be shaved. Your surgeon will make a cut through your abdomen and your womb, and your baby will be carefully delivered. If you’ve had a regional anaesthetic, you won’t feel any pain but you may feel some pushing or pulling. Usually, you’ll be able to see and hold your baby immediately after they are born. 

As your baby is being delivered, you may be given an injection of syntocinon. This is an artificial form of oxytocin, a hormone that causes your womb to contract. As your womb contracts, your surgeon will deliver the placenta. 

Your surgeon will then close your abdomen using stitches or clips and cover your wound with a dressing. Depending on the technique your surgeon uses, you may need to have your stitches taken out, or they may dissolve on their own. 

It usually takes about 5-10 minutes to deliver your baby. From start to finish, the operation can last up to an hour. It can take longer if you’ve had surgery before because of any scar tissue you may have. 

What to expect after a caesarean delivery

After having a caesarean section, it’s common to feel uncomfortable for a few days, but this can be managed with medications. Your anaesthetist will provide you with a number of options to help control any pain and discomfort.  

If no complications arise during your C section and you’re recovering well, you can drink when you feel ready. Your doctor or midwife will then let you know when you can eat again. After about 24 hours, the dressing on your wound will also be taken off.

Your catheter, drip and wound drain (if you have one) will be removed in the first couple of days, depending on your recovery. Once these have been removed, it’s important to take a gentle walk – a midwife will help you the first time you get out of bed.   

If you’ve had an emergency C section, you will have the chance to talk to your doctor about why you needed to have the operation. They can explain the reasons for your caesarean section and answer any questions you have about your recovery and your baby’s health. 

It's usual to stay in hospital for about three or five days after having a C section. This can vary between hospitals or if there are problems with your recovery. If you’re recovering well and can have your follow-up care at home, you may be able to leave hospital sooner. 

Recovering after a caesarean delivery

When you leave hospital after having a caesarean section, you’ll be given advice about how to manage any pain and discomfort when you get home. Make sure you read the patient information leaflet that comes with your medicine, and if you have any questions, have a chat with your pharmacist. 

Make sure you keep your wound clean and dry, and wear loose clothing. Look out for signs of infection (such as redness, pain, swelling or an oozing discharge from the wound) and report these to you doctor or midwife.

Looking after a new baby is hard for all women, but it can be harder when you are recovering from a caesarean section. The length of time it takes to recover fully from a C section will be different for every woman. It's important that you don't try to do too much before you’re ready. This includes lifting and carrying heavy objects, doing vigorous exercise and driving. You can have sex once you have fully recovered from your operation and feel comfortable.

For more information on how to look after yourself after having a C  section read our article here.

 
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