A caesarean
section, or C-section, is an operation to deliver your baby
through a cut made in your tummy and womb. The cut is usually made across your tummy, just
below your bikini line.
A caesarean is a major operation that carries a
number of risks, so it's usually only done if it's the safest option for you
and your baby. Around one in every four to five
pregnant women in the UK has a caesarean.
Why caesareans are carried out
A caesarean may be recommended as a planned
(elective) procedure or done in an emergency if it's thought a
vaginal birth is too risky. They're usually performed after the 38th week of
pregnancy. A caesarean may be carried out because:
- your
baby is in the breech position (feet
first) and your doctor has been unable to turn them by applying
gentle pressure to your tummy, or you would prefer they didn't try this
- you
have a low-lying placenta (placenta
praevia)
- you
have pregnancy-related high blood pressure (pre-eclampsia)
- you
have certain infections, such as a first genital herpes infection
occurring late in pregnancy or untreated HIV
- your
baby isn't getting enough oxygen and nutrients – sometimes this may mean
the baby needs to be delivered immediately
- your
labour isn't progressing or there's excessive vaginal bleeding.
If there is time to plan the procedure, your midwife
or doctor will discuss the benefits and risks of a caesarean compared with a
vaginal birth.
Asking for a caesarean
Some women choose to have a caesarean for
non-medical reasons. If you ask your midwife or doctor for a caesarean when
there aren't medical reasons, they will explain the overall benefits
and risks of a caesarean compared with a
vaginal birth.
If you are anxious about giving birth, you
should be offered the chance to discuss your anxiety with a healthcare
professional who can offer support during your pregnancy and labour.
If after discussion and support you still feel that
a vaginal birth isn't an acceptable option, you're entitled to have a planned
caesarean.
What happens during a caesarean
Most caesareans are carried out under spinal
or epidural anaesthetic. This mean you'll be
awake, but the lower part of your body is numbed so you won't feel any pain. During the procedure:
- a screen
is placed across your body so you can't see what's being done – the doctors
and nurses will let you know what's happening
- a cut
about 10-20cm long will usually be made across your lower tummy and
womb so your baby can be delivered
- you
may feel some tugging and pulling during the procedure
- you
and you birth partner will be able to see and hold your baby as soon as
they've been delivered.
The whole operation normally takes about 40-50
minutes. Occasionally a general anaesthetic, where you're asleep,
may be used, particularly if the baby needs to be delivered more quickly.
Recovering from a caesarean
Recovering from a caesarean usually takes longer
than recovering from a vaginal delivery. You might need to stay in hospital for
three or four days, compared with one or two days for a vaginal birth. You may experience some discomfort in your tummy
for the first few days, and you'll be offered painkillers to help with
this.
When you go home, you'll need to take things easy
at first. You may need to avoid some activities such as driving for six
weeks or so. The wound in your tummy will eventually form a scar. This may be red and obvious at first,
but it should fade with time and will often be hidden in your pubic hair.
Risks of a caesarean
A caesarean is generally a very safe procedure, but
like any type of surgery it carries a certain amount of risk.
It's important to be aware of the possible
complications, particularly if you're considering having a caesarean for
non-medical reasons. Possible complications include:
- infection
of the wound or womb lining
- blood clots
- excessive
bleeding
- damage
to nearby areas, such as the bladder or the tubes that connect the kidneys
and bladder (ureter)
- temporary
breathing difficulties in your baby
- accidentally
cutting your baby when your womb is opened.
Future pregnancies after a caesarean
If you have a baby by caesarean, it doesn't
necessarily mean that any babies you have in the future will also have to be
delivered this way. Most women who have had a caesarean section can
safely have a vaginal delivery for their next baby, known as vaginal birth
after caesarean (VBAC).
However, you may need some extra monitoring
during labour just to make sure everything is progressing well. Some women may be advised to have another caesarean
if they have another baby. This depends on whether a caesarean is still the
safest option for them and their baby.
Source: NHS Choices