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DefinitionIn a cesarean birth (C-section), the baby is delivered through an incision in the mother's abdomen. In the United States, some estimates suggest almost half of all births are delivered by C-section.
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Reasons for ProcedureThe following situations may require a C-section:
- Large baby
- Pregnancy with twins or more
- Baby is not in a head-down position
- Maternal medical conditions, for example, diabetes , high blood pressure , active herpes infection, or HIV infection
- Problem with the position of the placenta
- Failure of labor to progress
- Baby shows signs of distress, such as an abnormal heart rate during labor
- Previous cesarean birth
- Fetal problems
Possible ComplicationsCesarean birth is a surgery. There are some risks involved. The estimated risk of a woman dying after a cesarean birth is extremely small. The risk of death after a vaginal birth is even smaller. Your doctor will review potential problems like:
- Decreased bowel function
- Damage to other organs in the abdomen
- Longer hospital stay and recovery time
- Bad reactions to anesthesia
- Risk of additional surgeries, including hysterectomy , bladder repair, or repeat C-sections with future pregnancies
What to Expect
Prior to ProcedureC-sections are often unplanned. If you have a scheduled C-section, you may be asked not to eat or drink after midnight before the procedure.
AnesthesiaYou may be given:
- General anesthesia—You will be asleep during the procedure.
- Regional anesthesia such as epidural or spinal block—An area of your body will be numb, but you will be awake.
Description of the ProcedureYour doctor will make incisions in your abdominal skin and uterus.After the incisions are made, the baby will be delivered. Your uterus will be closed with stitches that later dissolve on their own. Staples could also be used to close the abdomen.
Immediately After ProcedureYour baby will be examined. You may be able to hold your baby. It will depend on the condition of you and your baby.
How Long Will It Take?45-60 minutes
Will It Hurt?Anesthesia prevents pain during the surgery. You may feel some pressure and tugging as the uterus is opened and the baby and placenta are removed. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay3-5 days
Post-procedure CareAt the Hospital
- Very soon after birth, your baby may be placed on your chest. This skin-to-skin contact may lead to improved breastfeeding success.
- You may need help learning breastfeeding positions. The correct position will keep you from putting too much pressure on your incision.
- You may need medication to help with nausea or pain.
- You will likely experience some uterine cramping and pain.
- You may be on a clear liquid diet after surgery. You will advance to a normal diet as you are able.
- Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.
- You may be given special compression stockings. They will help to decrease the possibility of blood clots forming in your legs.
- You will be encouraged to walk very soon after surgery. You will be asked not to lift anything heavier than your baby.
- For lung health, you may be asked to use an incentive spirometer and cough often. These steps will help you breathe deeply.
- After any delivery, there will be moderate-to-heavy vaginal bleeding. You will need to use an absorbent sanitary napkin.
- Avoid lifting anything heavier than your baby for the first weeks after surgery.
- Do not drive until your doctor says it is all right to do so.
- Ask your doctor when it is safe to shower, bathe, or soak in water.
- Delay having sexual intercourse or putting any objects in the vagina until you have had your 6-week check-up.
- Breastfeeding is encouraged.
- Consider joining a support group for new mothers. You can get encouragement and learn new parenting strategies.
Call Your DoctorIt is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Excessive bleeding, redness, swelling, increasing pain, or discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you've been given
- Swelling and/or pain in one or both legs
- Cough, shortness of breath, or chest pain
- Joint pain, fatigue, stiffness, rash, or other new symptoms
- Lightheadedness faintness
- Heavy vaginal bleeding
- Foul-smelling vaginal discharge
American Congress of Obstetricians and Gynecologists
American Pregnancy Association
Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
Cesarean birth. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq006.pdf?dmc=1&ts=20130719T1543190286. Accessed July 19, 2013.
Cesarean procedure. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/cesarean-procedure. Updated January 2013. Accessed July 19, 2013.
Cesarean section. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 16, 2013. Accessed July 19, 2013.
7/21/2009 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: De Luca R, Boulvain M, et al. Incidence of early neonatal mortality and morbidity after late-preterm and term cesarean delivery.Pediatrics. 2009;123:e1064-1071.
10/23/2009 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Abd-El-Maeboud KH, Ibrahim MI, et al. Gum chewing stimulates early return of bowel motility after caesarean section.BJOG. 2009;116:1334-1339.
12/4/2009 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed/what : Marín Gabriel M, Llana Martín I, et al. Randomized controlled trial of early skin-to-skin contact: Effects on the mother and the newborn.Acta Paediatr. 2010;99(11):1630-1634.
6/2/2011 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.Am J Med. 2011;124(2):144-154.e8.
3/11/2015 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Girsen AI, Osmundson SS, et al. Body mass index and operative times at cesarean delivery. Obstet Gynecol. 2014;124(4):684-689.
- Reviewer: Andrea Chisholm, MD
- Review Date: 01/2015
- Update Date: 03/11/2015