What to expect with a C-section

While a vaginal birth is preferred, a cesarean delivery doesn’t have to be a negative experience

St. Joseph’s/Candler OB/GYN Dr. Andres Montes hears it quite often: Moms feel bad when they have to have a C-section instead of a natural, vaginal delivery. But he wants moms to know that it is nothing to be ashamed of. It’s a major surgery and then you have to take care of a newborn baby. That’s pretty impressive in itself.

“I think C-section moms are brave. We ask a lot of them,” Dr. Montes says.

Yes, most women and their obstetrician would do anything to avoid a cesarean birth. We know it comes with risks and a longer recovery time. However, due to certain indications, sometimes a C-section cannot be avoided, Dr. Montes says.

A C-section occurs when a baby is delivered surgically through the abdomen instead of vaginally. Unfortunately, most C-sections are unplanned due to an emergency or unforeseen reasons.

Repeat C-sections are often planned due to risk factors associated with a trial of labor after a C-section (TOLAC); however, vaginal deliveries after a C-section can still happen and should be a decision made between mom and doctor.

Another reason for a C-section is the baby’s weight. Macrosomia is when a baby weighs 9 to 10 pounds or more while still in the womb, which can cause shoulder dystocia during delivery – where the baby’s shoulders get caught and the baby is not able to fit through the pelvis. That can be pretty traumatic for both mom and baby, Dr. Montes says.

Fetal distress can also require a C-section, or if mom is laboring for longer than a certain time criteria and hasn’t dilated enough or just can’t push anymore, then a C-section may be needed.

Cesarean deliveries account for about 32 percent of all United States births, according to the Centers for Disease Control and Prevention. A C-section is a major surgery that is not without risks, such as injuries to the organs, bleeding or infection, and requires a longer recovery period. Because of these risks, obstetricians prefer vaginal delivery.

However, whether it’s planned or not, there’s no reason a C-section has to be a negative experience. As your due date approaches, be sure to talk to your physician about the possibility of a C-section and your own plan of care.

While each patient experience differs, having an idea of what to expect can make the situation less traumatic and be the life changing moment all expecting moms look forward to.

Let’s take a look at some of the possibilities you could face regarding a C-section.

Going into a planned C-section

If it’s a scheduled C-section, mom and her obstetrician will select a date and time for delivery. Blood work may be done ahead of time, as well as meeting with the anesthesiologist to discuss any possible issues with anesthetics.

Depending on the time of the planned C-section, mom may be required to fast or consume only clear liquids leading up to the delivery. Patients should fast for at least eight to 10 hours beforehand. Talk to your physician about what he or she recommends.

Those having a C-section at the Telfair BirthPlace at the Mary Telfair Women’s Hospital at Candler Hospital should arrive at least two hours early to complete admissions and pre-operative procedures.

During the C-section

At the Telfair BirthPlace, C-section deliveries are done in the OR suites on the Labor and Delivery unit. Typically, one guest is allowed in the room with mom during a C-section, Dr. Montes says. You will be given spinal anesthesia so you are awake during the procedure. Only in extreme emergency circumstances will mom need to be put to sleep.

In addition to your OB, you also can expect an anesthesiologist and a neonatologist to be in the room, which are both employed around the clock at The Telfair BirthPlace.  

“One of the great things about St. Joseph’s/Candler is we have anesthesiologists who are staffed in labor and delivery 24/7,” Dr. Montes says. “We have anesthesiologists who all they do is obstetrics. I think that’s a really great thing.”

And the same is true for our neonatologists.

C-sections can take anywhere from 20 minutes to an hour, Dr. Montes says. The neonatologist will examine the baby after delivery, and as long as everything went well for mom and baby, you can do skin to skin.

Related Article: What is skin-to-skin contact?

C-section recovery at the hospital

Once the C-section is complete, mom and baby will spend time in a recovery room where labor and delivery nurses care for mom and baby together. After that, as long as both mom and baby are doing well, they will be moved down to the Mother Baby unit for the remainder of their stay.

If baby is underweight or having any complications with breathing or heart rate, for example, baby will be taken to our Neonatal Intensive Care Unit (a Level II Special Care Nursery) and receive around the clock care by our trained staff and neonatologist.

Related Article: What to expect if my baby has to stay in the Neonatal Intensive Care Unit?

The medication given to those who require a C-section is stronger than general anesthesia and can stay with mom up to 24 hours, meaning she may not feel pain right away. However, once the medication wears off, moms who deliver via C-section should expect more pain than a vaginal delivery. Additional narcotics on top of ibuprofen may be prescribed to help mom with pain and moving around.

Typically, a C-section requires a total stay of at least two or three days, Dr. Montes says. This ensures both mom and baby are stable and mom is healing properly. That compares to a vaginal delivery where some moms and babies can go home as soon as 24 hours following delivery, Dr. Montes says.

Recovery time at home

One of the biggest differences between a C-section and vaginally delivery is recovery time. Typically, women who’ve had a C-section require a longer time to heal. Their maternity leave may be longer, closer to 12 weeks versus six weeks. The recovery period may require:

• Limited physical activity
• Not driving for the first few weeks
• Not lifting anything heavier than the baby
• Care of the incision site

Be sure to talk to your obstetrician before you leave the hospital about your recovery needs at home.

Mothers who’ve had a C-section will also need a checkup with their OB within one to two weeks following delivery to make sure the incision is healing properly. Then all moms, regardless of how they delivered, have a six-week postpartum follow-up with their OB.

“It is a major surgery. Imagine having a major surgery and then you’re going to be up all night taking care of baby and breastfeeding or formula feeding and baby is crying,” Dr. Montes says. “In a traditional surgery of the abdominal area, you have at least six weeks to recover. But when you get home with a new baby after a C-section, you are still going to have to move around and get up throughout the night.”

“I think all our moms, whether they have a vaginal delivery or a C-section, are very courageous.”