Cesarean birth happens through an incision in the abdominal wall and uterus rather than through the vagina. There has been a gradual increase in cesarean births over the past 30 years. In November of 2005, the Centers for Disease Control and Prevention (CDC) reported the national cesarean birth rate at 29.1%, which was the highest rate ever recorded involving more than a quarter of all births. This means that more than 1 in 4 women are likely to experience a cesarean birth.
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What can I expect in a Cesarean procedure?
The normal cesarean procedure averages 45 minutes to an hour. The baby is usually delivered in the first 5-15 minutes with the remaining time used for closing the incision.
Before surgery, you will be given an anesthetic (general, spinal, or epidural) if you have not already been given one earlier in your labor. A general anesthetic is normally only used for emergency cesareans because it works quickly and the mother is sedated. The spinal and epidural anesthesia will numb the area from the abdomen to below the waist (sometimes the legs can be numb also), so that nothing can be felt during the procedure. In this procedure you will probably receive a catheter to collect urine while your lower body is numb.
The health care provider will make an incision in the abdomen wall first. In an emergency cesarean this will most likely be a vertical incision (from the navel to the pubic area) which will allow the health care provider to deliver the baby faster. The most common incision is made horizontally (often called a bikini cut), just above the pubic bone. The muscles in your stomach will not be cut. They will be pulled apart so that the health care provider can gain access to the uterus.
An incision will then be made into the uterus, horizontally or vertically. The same type of incision does not have to be made in both the abdomen and uterus. The classical incision made vertically, is usually reserved for complicated situations such as placenta previa, emergencies, or for babies with abnormalities. A vaginal birth after cesarean (VBAC) is not recommended for women with the classical incision. Another type of incision that is rarely used is the lower segment vertical incision. This would only be used in cases where problems with the uterus would not allow another type of incision to be made. The most common incision is the low transverse incision. This incision has fewer risks and complications than the others and allows most women to attempt a VBAC in their next pregnancy with little risk of uterine rupture.
The health care provider will then suction out the amniotic fluid and then deliver the baby. The baby’s head will be delivered first so that the mouth and nose can be cleaned out to allow it to breathe. Once the whole body is delivered, the health care provider will lift up and show you your baby. Most health care providers will then pass the baby on to the nurse for evaluation. Finally, your placenta will be delivered (you may feel some tugging) after which the surgical team will begin the close up process.
After the Surgery:
After the surgery, you might begin to experience some nausea and trembling. This can be caused by the anesthesia, by the effects of your uterus contracting or from an adrenaline let down. These symptoms usually pass quickly and can be followed by drowsiness. If your baby is healthy, this is normally when the baby can rest on your chest and you can start breastfeeding and bonding. You and your baby will continually be monitored for any potential complications.
When you are discharged from the hospital you will be advised on the proper post-operative care for your incision and yourself.
What else you should know about Cesarean Birth:
- Reasons for a Cesarean
- Risks of a Cesarean
- Trying to avoid a Cesarean
- Creating a Positive experience
- Cesarean Aftercare
Compiled using information from the following sources:
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 25.
Coalition for Improving Maternity Services (CIMS), www.motherfriendly.org
Centers for Disease Control and Prevention, www.cdc.gov