C-section Birth

A caesarean section (c-section) is a surgery where an incision is made into a pregnant person's abdomen and into their uterus to birth a baby. In Canada, nearly one in three births is by c-section. It’s usually done using epidural or  spinal anesthesia, where you are awake but anesthetic medication is put into your spine so you don’t feel pain in the lower part of your body. In some cases it’s done under general anesthesia, where you are asleep for the procedure. Some c-sections are planned in advance with your medical team, while others are unplanned emergencies or  are done to avoid an emergency when labour is not progressing normally.

How safe is it?

C-sections are done routinely and are generally safe with low rates of complications.  

Some concerns that differ from vaginal birth are:

• Longer recovery time with a larger incision.
• Longer typical hospital stay (often 48-72 hours).
• More risk of infection of the larger incision.
• In future pregnancies, higher risk of a placenta that implants more deeply than normal into the wall of the uterus (through the scar tissue).
• In future pregnancies, a higher chance of needing to have another c-section.
• Because there’s a surgery happening there is a very small risk of injury to other abdominal organs or blood vessels, and very rarely the baby’s skin can be injured during the procedure.
• Premature babies are more likely to develop breathing problems such as abnormally fast breathing for a few days after birth.
• Lower rates of pelvic floor injury or injury to the vagina or the perineum than with a vaginal birth.

What will happen during a C-section?

For planned C-sections, the pre-operative preparation time may be a couple of hours. In emergency situations, it will happen much faster. A catheter is placed in your bladder to keep it drained throughout the surgery. One or two intravenous (IV) lines are placed inside a vein from your arm or hand. This provides fluids and medications to relieve pain if they are needed. You may also be given medication to reduce the amount of acid in your stomach, and to prevent these acids from entering your lungs and causing problems.

A support person can usually stay with you in the operating room while you are giving birth, but this depends on the urgency of your surgery and whether you will be asleep during the procedure. They may be asked to wait outside of the operating room until anesthesia has been administered and the surgery is about to begin. This separation can sometimes be stressful.

During the surgery, a sheet is placed in front of you so you do not see what is happening. You can ask for this sheet to be lowered to see the baby’s delivery and many hospitals will agree. Once the baby is delivered through the incision, the umbilical cord is cut and the placenta is removed. You can ask for delayed cord clamping and skin-to-skin even with a c-section, if the baby is doing well and does not require urgent care. If you are not able to hold the baby, your support person can do skin-to-skin with the baby if desired, or a support person may be able to hold the baby against your body or face for you.

Your uterus is closed with stitches that dissolve in the body. Your skin is closed up with stitches or staples. The stitches to close the incision after the birth can take 30-60 minutes. A support person can often take photos of the birth for you in the operating room. 

What happens after?

The incision in your abdomen will be sore for at least a few days and sometimes for several weeks. Give yourself the time to heal by taking it slow and avoiding strenuous activities. You will need extra help at home for the first few weeks as you will not be able to lift heavy objects and you may need assistance  even with lifting the baby and managing stairs. 

Future pregnancies

Many people who have previously given birth through caesarean section can still safely have a vaginal delivery. Occasionally, your medical history or circumstances can make a vaginal birth less safe after c-section, and after more than one c-section the risks of trying to have a vaginal birth get higher.. Talk to your health care provider for help deciding what is best for you.