Delivering your baby by C-section
A C-section, also called a cesarean delivery or cesarean birth, is the surgical delivery of a baby through incisions in the mother’s abdomen and uterus. Once the baby is removed from the mother’s uterus, the uterus and abdomen are closed with stitches that later dissolve.
Mothers who have a C-section are given pain medication with an epidural block, spinal block, or a general anesthesia. Mothers who get a general anesthesia, which is used for emergency C-section deliveries, are not awake during the surgery.
- An epidural block numbs the lower part of the body through an injection in the spinal column; this can provide longer pain relief.
- A spinal block numbs the lower part of the body, but through an injection directly into the spinal fluid; the pain relief usually wears off more quickly.
Why the procedure is performed
A cesarean delivery is performed for a number of reasons:
Labor is not progressing
Sometimes contractions do not open the cervix enough for the infant to move into the vagina for delivery. Some mothers will have their cervix open completely and will push well for several hours, but the baby still does not deliver due to some other problem with the mother’s pelvis.
The infant’s health may be in danger
The umbilical cord, which connects the fetus to the uterus, can become pinched or the fetus may have an abnormal heart rate. When this happens, a C-section allows the baby to be delivered more quickly to address the baby’s health problems.
The baby is in the wrong position
If the baby is breech, meaning that the baby is coming out butt or feet first instead of head first, a C-section may be needed. The baby may also be in a transverse (sideways) or oblique (diagonal) position.
The mother is delivering two or more babies (multiple pregnancy)
If a mother is delivering more than one baby, a C-section may be necessary if labor has started too early, if the babies are not in good positions within the uterus for natural delivery, or if there are other problems. Some twin pregnancies are able to deliver vaginally/naturally.
One common complication during delivery is shoulder dystocia. This is when the baby’s head is delivered through the vagina but the shoulders do not fit and become stuck.
The placenta has problems
Sometimes there are problems that can arise in the placenta. Some of those include:
- The placenta is no longer working correctly
- It is in the wrong place in the uterus (over the opening to the cervix, for example)
- It is implanted too deeply or firmly in the uterine wall
These issues can cause problems such as severe bleeding or preventing oxygen and nutrients from reaching the baby.
The mother has an infection
Diseases such as HIV or herpes can be passed from the mother to the baby during a vaginal delivery. A C-section may help prevent transmission of certain viruses.
The mother has a specific medical condition
A C-section allows the health care team to better manage the mother’s health.
Since a C-section is a surgery, it has possible risks and complications for both the mother and baby.
Those risks include:
- Infection (during or after the C-section; in the uterus or in the incision on the abdomen)
- Blood loss, which can lead to a blood transfusion
- Blood clots in the legs, pelvic organs, or lungs
- Injury to the surrounding structures, such as bowel or bladder, which may require more surgery
- Reactions to anesthesia or other medications used during the C-section
Also, the length of recovery time in the hospital for a mother who has a C-section is usually longer than for a woman who has had a vaginal delivery.
The risk of future medical problems, such as uterine rupture and problems with the placenta, can increase with each cesarean delivery a woman has.
Can a C-section delivery be requested?
Some women want to have a C-section even if they are able to deliver the baby vaginally. Mothers should discuss their options with their health care provider before making a decision about a type of delivery. There are a lot of factors that should be considered when making your decision. The woman should consider the impact of the C-section not only on the current pregnancy but also on their future pregnancies.
An uncomplicated vaginal delivery is the safest method of delivery for both the mother and the child.