Cesarean Birth

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Cesarean Birth

Sometimes it isn't possible for babies to be born through the mother's vagina. In such cases, a cesarean delivery may be performed. Cesarean birth is the birth of a baby through surgical incisions (cuts) made in the abdomen and uterus.

Reasons for a Cesarean Birth
There are many reasons why a cesarean birth may be used to deliver your baby. It may be the best approach for both you and your baby. A cesarean delivery may be planned in advance when certain conditions are known. In some cases, if problems arise, the decision is made during labor.

Multiple Pregnancy
Women having two or more babies may need to have a cesarean delivery. Many women having twins are able to have a vaginal delivery. However, if the babies are being born too early or are not in good positions in the uterus, a cesarean birth may be needed.

Failure of Labor to Progress
About one-third of cesarean births are done because labor does not progress normally. In these cases, contractions may not open the cervix enough for the baby to move through the vagina.

Concern for the Baby
The baby could be having trouble during labor and may need to be delivered by cesarean birth. It may be because the umbilical cord is pinched or compressed or not enough blood is flowing to the baby from the placenta.

Problems With the Placenta
Placenta previa is a condition in which the placenta is below the baby and covers part or all of the cervix. This will block the baby's exit from the uterus. Another problem that may arise is placental abruption. This is when the placenta separates before the baby is born and cuts off the flow of oxygen to the baby.

Previous Cesarean Birth
Having had a cesarean birth before plays a part in whether you will need to have one again. Many women who have had a cesarean birth before may be able to give birth vaginally. However, a vaginal delivery after a previous cesarean delivery is not a good option for women when there is a significant risk of rupture of the uterus.

The Procedure
In most hospitals, your birth partner may stay with you in the operating room for the cesarean birth. However, this may depend on whether you are awake for the surgery and the urgency of the surgery.

Preparation
Before you have a cesarean delivery, a nurse will prepare you for the operation.

Anesthesia
Anesthesia will be given so that you do not feel pain during surgery. You will be given either general anesthesia, an epidural block, or a spinal block. If general anesthesia is used, you will not be awake during the delivery.

Delivery
The doctor will make an incision through your skin and the wall of the abdomen. The skin incision may be transverse (horizontal) or vertical, just above the pubic hairline. The muscles in your abdomen are moved and, in most cases, do not need to be cut. Another incision will be made in the wall of the uterus. The incision in the wall of the uterus also will be either transverse or vertical.

The baby will be delivered through the incisions, the umbilical cord will be cut, and then the placenta will be removed. The uterus will be closed with stitches that will dissolve in the body. Stitches or staples are used to close your skin.

Complications
Like any major surgery, cesarean birth involves risks. These problems occur in a small number of women and usually are easily treated.

After Delivery
If you are awake for the surgery, you can probably hold your baby right away. You will be taken to a recovery room or directly to your room. Your blood pressure, pulse rate, breathing rate and abdomen will be checked regularly.

If you are planning on breastfeeding, be sure to let your doctor know. Having a cesarean delivery does not mean you won't be able to breastfeed your baby.

A hospital stay after a cesarean birth is usually two to four days. The length of your stay depends on the reason for the cesarean birth and on how long it takes for your body to recover.

After You Go Home
It will take a few weeks for your abdomen to heal. While you recover, you may have:

• Mild cramping, especially if you are breastfeeding
• Bleeding or discharge for about four to six weeks
• Bleeding with clots and cramps
• Pain in the incision

To prevent infection, for a few weeks after the cesarean birth you should not place anything in your vagina or have sex.

Finally...
There are many reasons why a cesarean birth may be needed to deliver your baby. Many maternity centers have classes for couples who may need cesarean birth. If you have questions or concerns about cesarean birth, talk to your doctor.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.