Labor and Delivery

Cesarean Section Delivery

Sometimes it isn't possible for a baby to be born through the birth canal. In such cases, a cesarean delivery is performed. With this type of delivery, your baby is born through surgical incisions made in your abdomen and uterus.

There are many reasons why a cesarean birth may be used to deliver your baby. These include:

  • Having two or more babies
  • Your labor does not progress normally
  • Your baby having trouble during labor
  • Problems with the placenta that can cause heavy bleeding, such as placenta previa and placental abruption
  • Previous cesarean deliveries and your doctor feels there is a threat of your uterus rupturing during a vaginal delivery
  • Your baby is too large to be born vaginally
  • Baby in the breech or feet first position
  • Maternal infections such as human immunodeficiency virus or herpes that may be passed to your baby.

Whether or not your cesarean delivery is planned in advance or decided upon during labor, your doctor will explain why this type of delivery is best for you and your baby and discuss how the birth will be performed.

Sometimes a woman requests a cesarean delivery. This is a complex decision that the doctors at Capital Women's Care can help with.

The Cesarean Delivery

Before your cesarean birth, a nurse will prepare you for the delivery. Your abdomen will be washed and may be shaved. A catheter (tube) will be placed in your bladder. Keeping the bladder empty lowers the chance of injuring it during surgery. An intravenous (IV) line will be put in a vein in your arm or hand to allow you to receive fluids and medications during the delivery.

You will receive anesthesia so that you do not feel pain during the delivery. You will be given either general anesthesia, an epidural block, or a spinal block. If general anesthesia is used, you will not be awake during the delivery. With both the epidural and spinal blocks, the lower half of your body will be numb but you will be awake.

The type of anesthesia used depends on many factors, including your well-being and that of your baby. Prior to your delivery, your doctor will talk with you about the types of anesthesia and will take your wishes into account if at all possible.

The doctor will make an incision through your skin and the wall of the abdomen. The skin incision may be horizontal or vertical, just above the pubic hairline. The muscles in your abdomen are moved and, in most cases, do not need to be cut.

Another incision will be made in the wall of the uterus. The incision in the wall of the uterus also will be either transverse or vertical. When possible, a transverse incision in the uterus is preferred because it is done in the lower, thinner part of the uterus and results in less bleeding and better healing.

Your baby will be delivered through the incisions, the umbilical cord will be clamped and cut, and then the placenta will be removed. The uterus will be closed with stitches that will dissolve in the body. Stitches or staples are used to close your abdominal skin.

After The Delivery

If you are awake for your cesarean delivery, you can most likely hold your baby right away. You should also be able to begin breastfeeding right away if you choose.

You will be taken to a recovery room or directly to your room. Your blood pressure, pulse rate, breathing rate, and abdomen will be checked regularly. Soon after surgery, the catheter will be removed from your bladder. You will receive IV fluids after your delivery until you are able to eat and drink.

In most cases, your birth partner will be with you during your cesarean delivery.

You may need to stay in bed for a while. The first few times you get out of bed, a nurse or other adult should help you. Your abdominal incision will be sore for the first few days after your delivery. Your doctor can prescribe pain medication to alleviate as much of the pain and discomfort as possible.

A hospital stay after a cesarean birth is usually two to four days. The length of your stay depends on the reason for the cesarean birth and on how long it takes for your body to recover.

Recovery

When you go home, you may need to take special care of yourself and limit your activities. It will take a few weeks for your abdomen to heal.

While you recover, you may have:

  • Mild cramping, especially if you are breastfeeding
  • Bleeding or discharge for about four to six weeks
  • Bleeding with clots and cramps
  • Pain in the incision.
Many maternity centers have classes for couples who may need cesarean birth. If you have questions or concerns about cesarean birth, talk to your doctor.

To prevent infection, for a few weeks after your cesarean birth, you should not place anything in your vagina or have sex. Allow time to heal before doing any strenuous activity. Call your doctor if you have a fever, heavy bleeding, or the pain gets worse.

Possible Complications

Like any major surgery, cesarean birth involves risks, most of which can be managed and treated. Your doctor will discuss all risks with you prior to your cesarean delivery.

Complications from cesarean delivery occur in a small number of women and usually are easily treated.
  • The uterus, nearby pelvic organs, or skin incision can get infected.
  • Loss of blood, sometimes enough to require a blood transfusion.
  • Blood clots in the legs, pelvic organs, or lungs.
  • Your bowel or bladder can be injured.
  • A reaction to the medications or types of anesthesia that are used.