Pregnancy and baby

Caesarean section

What's involved in a caesarean section?

Media last reviewed: 11/04/2012

Next review due: 11/04/2014

Having a caesarean

Sometimes the safest option for you or your baby is to have a caesarean section. As a caesarean section involves major surgery, it's only performed when there's a 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 needed when complications develop during pregnancy or labour and delivery needs to be quick.

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, for instance if your cervix doesn't dilate fully during labour and birth isn't progressing properly, or if you bleed 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, for example if your baby is in the breech position (feet first).

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 you still feel that you do not want a vaginal birth after you have discussed this, you should be offered a caesarean section. 

How is a caesarean section done?

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 to 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.

If you have a general anaesthetic, you will be put to sleep and only wake up after your baby is born. Your partner will almost certainly not be able to be with you in the operating theatre.

Recovering from 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 by getting out of bed and walking around as soon as possible, and your midwife or hospital physiotherapist will give you advice about postnatal exercises that will help you in your recovery.

You can drive as soon as you can move without pain as long as you can perform an emergency stop. This may be after six weeks or sooner.

Read more about recovering from a caesarean.

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 caesarean section next time. But most women who are advised to try for a vaginal delivery in subsequent pregnancies do go on to have normal deliveries.

Page last reviewed: 11/03/2013

Next review due: 11/03/2015

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

faith12 said on 17 January 2014

Hi, I had my elective C-section in Bristol in 2011 and the team were fabulous! I hadn't thought about music but they had a stereo and a selection of CDs and my baby was born to the sound of 'momma loves you like a rock, she rocks you like a rock oh baby she loves you' ! (Simon and Garfunkel) could not have planned that better! Once in the world my little girl was given a quick check and weighed, it was only mins though it seemed an eternity, then she was placed naked under my gown on my bare chest and immediately started rooting. I did not have to ask for skin to skin they just did this without prompting. It seemed to me that the whole team wanted to make this a pleasant experience and to keep things as natural as possible for babes. I am now expecting my second in a matter of weeks and will again be going for a planned C-section.

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emmafyffe25 said on 12 November 2012

hi there, I had my youngest child 6years ago and im planning my third child in the next year. i had my youngest at home and had trouble delivering the placenta after 3 and a half hours the midwifes rushed me to hospital. as soon as i reached hospital i started to have stomach cramps and heavy bleeding, so then i had to have emergency surgery to have the placenta removed. Im very concerned about having another natural birth and was wondering if they would allow me to have an elective caesarean? if anyone could help me in anyway i would be very grateful.

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xxjojo24xx said on 07 November 2012

hi there just a little question i have brittle bones and have been told by people that i can break my is it cocksit bone or even pelvis bones during a natural birth just wanted to know if any1 nos wether this is true thankyou xx

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amja said on 02 July 2012

I am aware that a planned c section is now available as an option for childbirth according to NICE guidelines published in November 2011.
According to those, if mother is after a review still instisting on having c section, even if obstetrician is unwilling to approve it, he/she will still have to refer the patient to another obstetrician who will do the operation.

Does anyone have any experience of requesting a planned c section under NHS (for non-medical reasons), what was your experience, advice and "willingnes" by NHS staff? Have you had it done at the end?

Many thanx

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alanandnikki said on 09 May 2012

I have requested an elective c-section but not in my local hospital, I feel because of this it seems my local hospital and midwife have basically washed their hands of me and left me in the dark, i have been given no information on how to arrange my visit or any appointments in the hospital of my choice.... any ideas anyone

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User668967 said on 23 April 2012

hi sophia and brixesmith

Sophia: caesarian babies aren't delivered onto the skin for 2 reasons - the need to keep everything sterile this is partly to protect you from infection and partly to protect the babies from infection. The second reason is because the babies have to go to be checked out to make sure they are ok, as caesction babies are more likely to be slow to breath.
Depending on the hospital will depend on whether or not you are able to do skin to skin in the operating room, if you cant maybe your birthing partner can? Otherwise you will definetly be able to do it once you are out of the operating room, as can dad or any other birth partners.

Brixesmith: The risk of your scar rupturing is very very slim. You will be monitored during the labour using a CTG machine your hospital may or may not have wireless monitors so you can still move around instead of effectively being stuck to the bed - its worth asking. The chances of you being induced are very slim as this puts extra strain on the uterine muscles. but again it depends on lots of things such as how long ago your operation was (more time past = more time to heal and strengthen) also the doctors looking after you and the types of drugs used. You'd need to talk to your consultant/ midwife about local policies.

Good luck guys wish you all the best

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Brixesmith said on 09 April 2012

What is the risk of my scar rupturing during a VBAC? What monitoring do I have to have? Can I be induced?

There's really not enough information here to help me make a decision about whether to have VBAC or elective caesarean, in fact this doesn't even tell me whether I have a choice.

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mrsbruffy said on 19 May 2011

Hi Sophia,

Not sure if you have had your babies yet but I recently had a caesarean. I was booked in for an elected caesarean due to baby being breech but ended up having an emergency one due to placental abruption, anyway my plan when I thought I was having an elected c-sect was to do a caesarean birth plan in which you can request things like a cd being played, skin to skin, for them to leave the umbilical cord a bit longer so that my partner could have cut the cord down although I hadn't done this in time and it wouldn't have been appropriate in the end due to the emergency situation, it can still be done. I actually didn't get to do any skin to skin in the operating theatre (or even hold my baby) until we were moved out as the screen was so far up, im not sure if it is a practical request.

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lovejoy1984 said on 14 May 2011

i had my baby by caesarean n when she was born she came to me dressed n wrapped up. as far as i have seen in the programme's no one has had skin 2 skin. u completey have no feeling from just under ur breasts so cant see that u can. but i guess it could be a request but will be up 2the surgeon. hope that helps n its not 2late

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SophiaTWINS said on 20 April 2011

Hi everyone my names Sophia and I am expecting twins! Have been discussing with my midwife about possibly having a caesarian. Does anybody know if you can have the babies delievered straight on to your front as you do with skin to skin in normal labour? This is very important to me and All the caesarian videos iv seen have never been delievered this way, and this concerns me. Any help would be great and much appreciated.

x

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