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What is a prenatal consultation?
Every pregnant woman hopes for a short labor and delivery with no complications — manageable contractions, some pushing, then a beautiful baby. But it doesn't always work out that way. Some babies need to be delivered via cesarean section (C-section).
Even if you're hoping for a traditional vaginal birth, it may help to ease some fears to learn why and how C-sections are performed, just in case everything doesn't go as planned.
A C-section is the surgical delivery of a baby that involves making incisions in the mother's abdominal wall and uterus. Generally considered safe, C-sections do have more risks than vaginal births. Plus, moms can go home sooner and recover quicker after a vaginal delivery.
But C-sections can help women who are at risk for complications avoid dangerous delivery-room situations and can be a lifesaver in an emergency.
C-sections are done by obstetricians (doctors who care for pregnant women before, during, and after birth) and some family physicians. Although more and more women are choosing midwives to deliver their babies, midwives of any licensing degree cannot perform C-sections.
Some C-sections are scheduled if the doctor knows that a vaginal birth would be risky. A doctor may schedule one if:
Some C-sections are unexpected emergency deliveries done when complications arise with the mother and/or baby during pregnancy or labor. An emergency C-section might be done if:
Of course, each woman's pregnancy and delivery is different. If your doctor has recommended a C-section and it's not an emergency, you can ask for a second opinion. In the end, you most often need to rely on the judgment of the doctors.
Here's a quick look at what usually happens during a scheduled C-section.
Your labor coach, wearing a surgical mask and gown, can be right by your side during the entire delivery (although partners might not be allowed to stay during emergency C-sections). Before the procedure begins, an anesthesiologist will discuss what will be done so that you don't feel pain during the C-section.
To prepare for the delivery, you'll probably have:
After anesthesia is given, the doctor makes an incision on the skin of the abdomen — usually horizontally (1–2 inches above the pubic hairline, sometimes called "the bikini cut").
The doctor then gently parts the abdominal muscles to get to the uterus, where he or she will make another incision in the uterus itself. This incision can be vertical or horizontal. Doctors usually use a horizontal incision in the uterus, also called transverse, which heals better and makes a VBAC much more possible.
After the uterine incision is made, the baby is gently pulled out. The doctor suctions the baby's mouth and nose, then clamps and cuts the umbilical cord. As with a vaginal birth, you should be able to see your baby right away. Then, the little one is handed over to the nurse or doctor who will be taking care of your newborn for a few minutes (or longer, if there are concerns).
The obstetrician then removes the placenta from the uterus, closes the uterus with dissolvable stitches, and closes the abdominal incision with stitches or surgical staples that are usually removed, painlessly, a few days later.
If the baby is doing OK, you can hold and/or nurse your newborn in the recovery room. You may need help holding the baby on the breast if you have to stay lying down flat.
You won't feel any pain during the C-section, although you may feel sensations like pulling and pressure. Most women are awake and simply numbed from the waist down using regional anesthesia (an epidural and/or a spinal block) during a C-section.
That way, they are awake to see and hear their baby being born. A curtain will be over your abdomen during the surgery, but you may be able to take a peek as your baby is being delivered from your belly.
Sometimes, a woman who needs an emergency C-section might require general anesthesia, so she'll be unconscious (or "asleep") during the delivery and won't remember anything or feel any pain.
C-sections today are, in general, safe for both mother and baby. However, there are risks with any kind of surgery. Potential C-section risks include:
Some of the regional anesthetic used during a C-section does reach the baby, but it's much less than what the newborn would get if the mother had general anesthesia (which sedates the baby as well as the mother).
Babies born by C-section sometimes have breathing problems (transient tachypnea of the newborn) because labor hasn't jump-started the clearance of fluid from their lungs. This usually gets better on its own within the first day or two of life.
Having a C-section may — or may not — affect future pregnancies and deliveries. Many women can have a successful and safe vaginal birth after cesarean. But in some cases, future births may have to be C-sections, especially if the incision on the uterus was vertical rather than horizontal. A C-section can also put a woman at increased risk of possible problems with the placenta in future pregnancies.
In the case of emergency C-sections, the benefits usually far outweigh the risks. A C-section could be lifesaving.
As with any surgery, there's usually some degree of pain and discomfort after a C-section. The recovery period is also a little longer than for vaginal births. Women who've had C-sections usually stay in the hospital for about 3 or 4 days.
Right after, you may feel itchy, sick to your stomach, and sore — these are all normal reactions to the anesthesia and surgery. If you needed general anesthesia for an emergency C-section, you may feel groggy, confused, chilly, scared, alarmed, or even sad. Your health care provider can give you medicines to ease any discomfort or pain.
For the first few days and even weeks, you might:
It can help if you support your abdomen near the incision when you sneeze, cough, or laugh. These sudden movements can be painful. You'll need to avoid driving or lifting anything heavy so that you don't put any unnecessary pressure on your incision.
Check with your health care provider about when you can get back to your normal activities (typically after about 6 to 8 weeks, when the uterus has healed). As with a vaginal delivery, you shouldn't have sex until your doctor has given you the go-ahead, usually about 6 weeks after delivery.
Frequent and early walking may help ease some post-cesarean pains and discomfort. It also can help prevent blood clots and keep your bowels moving. But don't push yourself — take it easy and have someone help you get around, especially up and down stairs. Let friends, family, and neighbors lend a helping hand with meals and housework for a while, especially if you have other children.
Although breastfeeding might be a little painful at first, lying on your side to nurse or using the clutch (or football) hold can take the pressure off your abdomen. Drink plenty of water to help with your milk supply and to help avoid constipation.
C-sections scars fade over time. They'll get smaller and become a natural skin color in the weeks and months after delivery. And because incisions are often made in the "bikini" area, many C-section scars aren't even noticeable.
Call your health care provider if you have:
Emotionally, you may feel a little disappointed if you'd been hoping for a vaginal birth or had gone through labor that ended in a C-section. Remember that having a C-section does not make the birth of your baby any less special or your efforts any less amazing. After all, you went through major surgery to deliver your baby!