Sometimes things don’t always go to plan and it becomes necessary for your baby to be born via caesarean section. A caesarean section is an operation which means your baby will be born via a cut in your abdomen. The cut is usually just below where your pubic hair starts to grow.
Whilst you might not have planned to have a caesarean, there are many situations during labour where it will become the smoothest option for you and your baby. Your birth partner is normally able to come with you into theatre and you should have the procedure, risks and benefits explained to you. If all goes well in theatre, you may be able to have your baby placed on your chest and have skin to skin contact as soon as your baby has been born. In most cases, you can still ask for your partner to cut the cord which can be left long by the surgeon. It is usually possible for pictures to be taken as your baby is being born or very soon after. It is also possible for cord clamping to be delayed, depending on why you need a caesarean.
Around 1 in 4 births result in a caesarean section in the UK. There are many reasons that an obstetrician (specialist doctor) might recommend you have a caesarean, and some of these may have been known before or during your pregnancy. Known reasons are covered in the planned caesarean birth section.
Babies can keep changing position right up to the birth. If your baby is in the breech position (feet first) it might be recommended that you opt for a caesarean. It is not always necessary to have a caesarean if your baby is breech, as it is sometimes possible to turn your baby before your labour, via a procedure called an External Cephalic Version (ECV). It is also possible to have a vaginal birth if your baby cannot be turned or you don’t want to try to turn them, but it depends on your circumstances. If you’re not sure what is best for you, then discuss your birth options for breech birth with your midwife.
There are many reasons why you might need an emergency caesarean section. For example, if your labour is not progressing, your baby is showing signs of not coping with labour or you are at risk from excessive vaginal bleeding, then your obstetrician (specialist doctor) will recommend you have an emergency caesarean section. If there is enough time, your team will explain the risks and benefits, as well as what to expect from recovery to you and your birth partner. You will always be asked for your consent to have a caesarean.
As a caesarean is an operation and takes place in the operating theatre. You will usually have either a spinal or epidural anaesthetic which means you will be awake but will not be able to feel any pain in the lower part of your body. You may still feel some sensation as the procedure is carried out and your baby is born, but you will not be uncomfortable. A catheter will be placed to help you urinate during the procedure and whilst the anaesthetic wears off.
In some circumstances, it may be necessary for you to have a general anaesthetic during a caesarean and this will be explained to you.
Your team will explain to you and your birth partner what they are doing during the procedure but you will not be able to see, as a screen will cover your lower body. The length of the cut will vary but it is usually around 10 to 20 centimetres long. The entire procedure usually takes just under an hour, depending on how you and your baby are doing.
It is normal for a baby born this way to be quiet and not cry immediately. The baby may be taken to a resuscitaire. This machine has a firm mattress under a warming lamp and light so a midwife or specialist doctor can check your baby’s wellbeing. If needed in an emergency, the resuscitaire has oxygen and suction. In most cases, your baby will be brought back to you within a few minutes.
After your baby is born, you will be stitched up and will need to be monitored closely for a few hours. The length of time you need to stay in hospital after a caesarean will depend on why you needed an unplanned caesarean, but the period can be as short as 24 hours, or you may need two days or more.
Most caesareans are very safe and cause few complications to mother or baby. However, as it is major abdominal surgery, there are risks involved. Even though it might be best for you, your baby or both of you, it is important to know what complications can occur. You can talk about this with your midwife, and your surgeon will make sure you understand the risks before consenting to any procedure.