What is a cesarean birth?
In cesarean birth, a baby is delivered through an incision made in the abdomen and uterus. Sometimes a cesarean is planned before labor begins. Sometimes it becomes necessary during labor.
Why would a cesarean birth be necessary?
There are several reasons why it may be necessary to have a cesarean birth. These reasons include:
- The baby’s head may be too large for the mother’s pelvis. This is called CPD, which stands for cephalopelvic (seff-uh-lo-PEL-vic) disproportion (dis-pruh-POR-shun). “Cephalo” means head and “pelvic” refers to the pelvis. Disproportion means the sizes don’t go together. CPD does not mean there is anything wrong with the baby or the mother.
- The baby may be in a position that makes it difficult to come through the vagina. Usually the head enters the vagina first. The head is the largest part of the baby. It stretches the vagina so the rest of the baby can come out. If the shoulder, forehead, buttocks, or legs come first, it may be better to do a cesarean delivery.
- The baby may seem to be too stressed by labor. This is called fetal distress. Electronic monitoring during labor records your baby’s heart rate and your contractions. Certain changes in the fetal heart rate pattern may mean fetal distress. This may lead your doctor to decide on a cesarean birth.
- A cesarean birth may become necessary if the placenta (afterbirth) is attached too low in the uterus. If the placenta starts to separate before the baby is delivered, this could also lead to a cesarean birth.
- A cesarean birth may be necessary if you are carrying more than 1 baby. This will depend on the size of your unborn babies and their positions inside the uterus.
- Sometimes the umbilical cord may enter the birth canal in front of your baby. This does not happen often. When it does, the cord can get pinched. This cuts down the oxygen supply to your baby. An emergency cesarean delivery gets the baby out quickly so he or she can begin to breathe to get oxygen.
- There are some other conditions with the mother and/or baby that may require a cesarean delivery. These may include active herpes or complications of Rh disease. Both could cause problems during labor or delivery.
What kind of anesthesia is used for a cesarean birth?
Spinal anesthesia or epidural anesthesia is used most often. These methods numb the body from the waist down. You are fully awake for the actual birth of your baby. The baby’s father or support person may stay with the mother during the cesarean delivery when spinal or epidural anesthesia is used.
If general anesthesia is used, you will be asleep during the delivery of your baby. The father or support person will not be permitted in the delivery room. But he or she will be able to see your baby shortly after delivery.
The cesarean birth procedure
The anesthesia staff will give you oxygen through a plastic mask covering your nose and mouth. This will be removed after the baby is delivered. Someone will be with you during the entire procedure.
An incision is made through your abdomen and then through your uterus. There are 2 types of incisions. One is vertical and goes from the navel down to the pubic hairline. The other is horizontal or “bikini." It goes from side to side, just above the pubic hairline. Your doctor will decide which type of incision you need. Your baby and the placenta are then delivered through the incisions. They are stitched or stapled closed after your baby’s birth.
After your surgery is complete, and if conditions permit, you may hold your newborn. The nurses will closely check your progress and the baby’s.
After the cesarean birth
As with other operations, you may be uncomfortable. Pain medicine will be available. You will need to ask for it. Be sure to ask for pain medicine before the pain becomes too severe.
Hospital length of stay
You and your baby are usually discharged 2 to 3 days after the cesarean birth. You will be encouraged to make follow-up appointments for yourself and your baby before you leave the hospital. It is important to keep these appointments so your doctor can check your incision and your general health. Your baby’s doctor needs to check your baby’s general health.
At first, you will be limited to ice chips. You will then have liquids and will move to solid food before you go home.
You will usually be able to get out of bed in about 6 hours. You can help with the baby’s care as you progress.
As with vaginal births, you may breastfeed your baby shortly after delivery.
When can I resume sexual activity?
It is best to follow your doctor’s advice about when you may safely resume sexual intercourse. You can become pregnant before you have a period, or while breastfeeding. When you do resume sexual intercourse, you must use birth control if you do not want to become pregnant right away.
Can I have a vaginal birth after a cesarean birth (VBAC)?
In the past, if you had a baby by cesarean birth, any future babies also were delivered by cesarean. Today, this is not always the case. More and more women are able to deliver through the vagina even if their other children were delivered by cesarean birth. Talk to your doctor or midwife. The decision will depend on factors such as your medical history, the reason for your previous cesarean birth, and the type of incision you have.