Having a caesarean
There are situations where the safest option for you or your baby, or both of you, is to have a caesarean section. As a caesarean section involves major surgery, it is only performed when there is a real clinical need for this type of delivery.
Your baby is delivered by cutting through your abdomen and then into your womb (uterus). The cut is usually made across your abdomen, just below your bikini line. The scar is usually hidden in your pubic hair.
If you are expecting twins, triplets or more, it's more likely that you'll be considered for a caesarean section. This will depend on how your pregnancy progresses, the positioning of your babies and if the babies share a placenta. Whenever a caesarean is suggested, your doctor will explain why it is advised, and any possible side effects. Don't hesitate to ask questions.
Urgent (emergency) caesareans
Urgent (emergency) caesareans are necessary when complications develop and delivery needs to be quick. This may be before or during labour. If your midwife and doctor are concerned about the safety of you or your baby, they will suggest that you have a caesarean straight away. Sometimes your doctor or midwife may suggest an emergency caesarean if your cervix doesn't dilate fully during labour.
Planned (elective) caesareans
A caesarean is elective if it is planned in advance. This usually happens when your doctor or midwife believes that labour will be dangerous for you or your baby.
If you ask for a caesarean when there aren't medical reasons, your doctor or midwife should explain the overall risks and benefits of caesarean section compared with vaginal birth. You should also be able to talk to other members of your healthcare team, such as the obstetrician, to make sure you have accurate information.
If you ask for a caesarean section because you are anxious about giving birth, your midwife or doctor should offer you 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 you do not want a vaginal birth, you should be offered a caesarean section.
The caesarean operation
In the UK, most caesarean sections are performed under epidural or spinal anaesthesia, which minimises the risk and means that you're awake for the delivery of your baby. A general anaesthetic (which puts you to sleep) is sometimes used, particularly if the baby needs to be delivered quickly.
If you have an epidural or spinal anaesthesia, you won't feel pain, just some tugging and pulling as your baby is delivered. A screen will be put up so that you can't see what's being done. The doctors will talk to you and let you know what's happening.
It takes about five to 10 minutes to deliver the baby, and the whole operation takes about 40-50 minutes. One advantage of an epidural or spinal anaesthetic is that you're awake at the moment of delivery and can see and hold your baby immediately. Your birth partner can be with you.
After a caesarean
After a caesarean section, you'll feel uncomfortable and will be offered painkillers. You will usually be fitted with a catheter (a small tube that fits into your bladder) for up to 24 hours. You may be prescribed daily injections to prevent blood clots (thrombosis).
Depending on the help you have at home, you should be ready to leave hospital within two to four days.
You'll be encouraged to become mobile as soon as possible, and your midwife or hospital physiotherapist will give you advice about postnatal exercises that will help you in your recovery. As soon as you can move without pain you can drive - as long as you can perform an emergency stop. This may be six weeks or sooner.
You can contact the Caesarean Support Network for information and support on 01624 661269 (6-9pm daily).
Vaginal birth after caesarean (VBAC)
If you have a baby by caesarean section, this does not necessarily mean that any baby you have in the future will have to be delivered by caesarean. Most women who have had a caesarean section can have a vaginal delivery for their next baby. It depends on why you had a caesarean section the first time.
Women thought to have a small pelvis, for example, may be advised to have a planned (elective) caesarean section next time. Your GP or midwife will be able to advise you. Most women who are advised to try for a vaginal delivery in subsequent pregnancies do have normal deliveries.
