The Steps of a Cesarean Section

What You Need to Know About a C-section

Newborn holding mum's hand at hospital
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Very few women would choose a cesarean for their birth experience, however, more than a third of the women in the United States will have a cesarean. (Many other countries tend to have lower cesarean rates.) Therefore, it is important that every pregnant woman is aware of the procedures that surround a cesarean section. This will give those who do birth by this process more choices, and hopefully, less fear.

The Procedures:

Some of these may go in a different order, and a few left out, but these are the basics:

  • An intravenous line inserted
  • Pre-operative medications may be used to calm you down. They can also make you groggy, if you wish to avoid them, be sure that you discuss this with your operative team.
  • An antacid for your stomach acids, to attempt to reduce the dangers should you aspirate during the surgery (Generally not a problem with regional anesthesia (epidural/spinal).).
  • Monitoring leads (heart monitor, blood pressure)
  • Anesthesia (Spinal anesthesia may be recommended for several reasons when epidural isn't previously in place, or the cesarean is planned.)
  • A catheter inserted to collect urine (insist that this is done after your anesthesia so that you don't feel it)
  • Anti-bacterial wash of the abdomen, and partial shaving of the pubic hair
  • Skin Incision (Low transverse is the most common.)
  • Uterine Incision (Low transverse is the most common.)
  • Breaking the Bag of Waters
  • Disengage the baby from the pelvis
  • Birth!!!! (Accomplished by hand, forceps, or vacuum extractor)
  • Cord Clamping and cutting
  • Newborn Evaluation
  • Placenta removed and the uterus repaired
  • Skin Sutured (Usually the top layers will be stapled and removed within 2 weeks.)
  • Postoperative medications (Ask about Duramorph.)
  • You will be moved to the Recovery Room (If the baby is able s/he can go with you.)

We also have a cesarean photo gallery, if you care to see the details.

Family Centered Cesarean Births

Family centered birth is a word that is used to describe a birth that is more towards a family setting. People usually believe that this cannot apply to a surgical procedure. This is not true.

Even with a cesarean surgery, you can have a family centered birth, if you know your options and choose to apply them. Some of the options will be the same as for a vaginal birth. You may have to work harder to have a family centered birth in the event of surgery, but planning ahead (even if you don't foresee a cesarean) can go a long way.

  • Bringing your partner (and sometimes one or two other people)
  • Using a mirror during the birth or having the screen dropped, or use of a clear screen
  • Using music during the delivery
  • Pictures, videotaping
  • Partner cutting the cord
  • Skin to skin or minimal separation from the baby
  • Breastfeeding in the operating room or recovery room
  • LeBoyer bath after birth
  • Freeing one of your hands to touch the baby after birth
  • Partner carrying the baby to the warmer after birth
  • Seeding the baby from your microbiome

    Tips for Recovery

    Everyone's recovery will be different, depending on your age, body type, and general health. However, some basics of recovery will be to remember that you have just had major abdominal surgery as well as given birth to a new baby. You may experience:

    • Gas pains from being opened
    • Incisional pain
    • Uterine contractions (your uterus will still need to work to get back to its original shape).
    • You may be extremely tired from medications, labor (if you had one), or just in general.

    Try to take everything easy. Although walking as soon as possible is very helpful in your recovery. Doing as little else as possible is important.

    The rule of thumb is to not lift anything heavier than your baby. When you get home, take the steps only once a day (if at all). Make a nest on the couch and nap there during the day. Get as much help as you can with your cleaning, food preparations, and other children. Make a list and keep it handy, when someone offers to help it is easier to read off a list than to think of something you need done. It also prevents you from feeling like you are begging for help. You will need help. (I recommend this for anyone having a baby.)

    You can start doing breathing and kegel exercises the first day in the hospital, someone will show you how. Then each day you can gradually find small exercises to do to get back into shape. Do not return to your previous exercise routine without permission of your care provider. Overdoing it will only slow your recovery.

    By the end of six weeks, some people say they are feeling pretty good, although still dealing with some pain and sleeplessness. After this period you can usually resume most activities. (Some doctors will allow you to drive after about two weeks, others request that you wait the entire six.) Let your body be your guide.

    Some women, not all, will need more help with emotional recovery after a surgical birth. While it is very important that you and your baby had a healthy delivery, you may still have emotions that need to be dealt with surrounding the experience. It may be that you feel left out of the decision-making process, or that you would have preferred a different type of birth. Whatever the reason, please do not ignore these feelings or let anyone belittle you for experiencing them. There are many organizations that you can contact for support, likeĀ ICAN.

    Congratulations on the birth of your baby! Make sure stop by and let us know all about it.