FAQs about Cesareans

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I am feeling very upset about my cesarean. How can I find help?

If you feel so upset that you fear that you might harm yourself or your baby, please seek professional help immediately by calling 911 or contacting your doctor. Postpartum mood disorders are more common in mothers after cesareans, so please seek professional help immediately if you feel you are in danger.

ICAN believes that women deserve and need support after birth, especially if their birth experience was less than ideal. Women are often made to feel guilty for feeling bad about their births even if their baby was born healthy. You have the right to mourn any trauma you may feel about your birth while still celebrating your baby. Different ways that ICAN can support can be found under the “Support” tab.

Local chapter leaders provide support through Facebook, message boards, email groups and in-person meetings. Find a local chapter using the “Find A Chapter” tab.

Repeat c-section or VBAC?

Studies show a 60-80% rate of vaginal birth for those laboring after a cesarean. Finding a care practitioner who is supportive is key to having an empowered, respectful birth.

Uterine rupture is the common fear of those planning to labor after a cesarean. The overall risk of uterine rupture after one or two cesareans with a low-transverse incision is low. The risk of rupture after 3+ cesareans is not well known.  Talk to your healthcare practitioner about the risks and benefits of VBAC versus Repeat Cesarean.

Can I still breastfeed if I had a cesarean?

Certainly you can. It may take some more effort on your part, but do not hesitate to ask for help. Your hospital should have a lactation consultant on hand to help you get started. Start breastfeeding as soon as possible, for some this will be in the recovery room, for others you may have to pump for a sickly baby or to encourage your milk supply. There are different positions that will be helpful to you in breastfeeding after a cesarean, like the football hold, or any other position that keeps the baby off of your incision.

What will my recovery be like?

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 be plagued with gas pains from being opened, incision pain, uterine contractions (your uterus will still need to work to get back to it’s original size). Your staples or steri-strips will usually be removed about 4-7 days postpartum. Try to take everything easy. Get as much help as you can with your cleaning, food preparations, and other children.

By the end of six weeks, some people say they are feeling better, although still dealing with some pain and sleeplessness.

What is a CBAC?

CBAC stands for “Cesarean Birth After Cesarean”. This is usually used to refer to an unplanned cesarean after a precious cesarean.

What is a Repeat Cesarean (RCS)?

A  repeat cesarean is a scheduled cesarean after having had a previous cesarean.

What is a Planned Cesarean?

A planned cesarean is simply one that is scheduled ahead of time.

What is an Emergency Cesarean?

Basically, an emergency cesarean would be one that meant a matter of minutes was all that remained before the serious threat of loss of life or damage became imminent. Generally, this would be a placental abruption, a prolapsed cord, ruptured uterus, etc. General anesthesia is usually used, in combination with a vertical incision (for the matter of time), and your partner is generally not allowed to accompany you.

What is a partner’s role during a cesarean?

Most hospitals will allow you to go into the operating room with your partner, or if you feel unable to, she may be accompanied by one other person (some hospitals will allow two if one is the doula). Contrary to popular belief, most people do not faint in the operating room. The mother will be provided a drape to block her view of the surgery, feel free to stay behind the curtain with her if you are worried. Just being there for her and telling her what is going will help her. Sometimes the doctor will allow you to cut the cord, carrying the baby to the nursery, and take pictures. Make sure that you ask about these particular things.

How long will it be until my baby is born?

Every surgeon has a different procedure for c-sections, including the type of incision and closure. You should discuss this with your doctor to determine their typical plan. It is generally 5 minutes from the time that they make the initial incision until the baby is born. The rest of the surgery will take between 30 and 40 minutes, including repair.

What is the procedure for a cesarean?

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

  • A catheter inserted to collect urine
  • An intravenous line inserted
  • An antacid for your stomach acids
  • Monitoring leads (heart monitor, blood pressure)
  • Anesthesia
  • Anti-bacterial wash of the abdomen, and partial shaving of the pubic hair
  • Skin Incision (vertical or midline(most common))
  • Uterine Incision
  • 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.)
  • You will be moved to the Recovery Room (If the baby is able s/he can go with you.)

Help! I’m being forced or pressured to have a cesarean. What can I do?

Mandated surgery is unethical. You have the right to receive unbiased counseling on the risks, benefits, and alternatives of each recommended treatment or procedure. You then have the right to informed decision making, which means saying ‘yes’ or ‘no’ to the procedure or treatment.  If you feel you are being pressured or forced into having a cesarean you should contact the patient advocate at the hospital, an attorney, or hire an independent advocate to attend appointments or your birth with you.

What type of pain relief is offered before and after a cesarean?

If you have not already had a epidural or spinal anesthesia for labor, or this is a scheduled cesarean, and not an emergency cesarean, you will most likely be given a regional anesthetic (epidural or spinal). If there is a reason that you can’t get regional anesthesia or it is an emergency you will be given a general anesthetic. You may be offered or want to watch for someone giving you a pre-operative sedative. If you are not particularly nervous about the cesarean, you may want to forego this medication. It can reach the baby and make it harder to start the baby breathing after a narcotic (usually), and it can make you groggy an unaware during the birth. After the birth your regional anesthesia will help you be pain free for a few hours, after which you will be prescribed some other type of pain medication (narcotic or otherwise).

What are some common reasons a provider might recommend a cesarean?

Obstetrical emergencies like:
-prolapsed cord (where the cord comes down before the baby)
-placental abruption (where the placenta separates before the birth)
-placenta previa (where the placenta partially or completely covers the cervix)
-placenta accreta (where the placenta is too deeply embedded in the uterine wall and has potential for maternal hemorrhage)
-eclampsia/pre-eclampsia (pregnancy-induced high blood pressure, causes severe swelling due to water retention, and can impair kidney and liver function. If it progresses to eclampsia, toxemia is potentially fatal for mother and child.)

Other common reasons we hear for cesarean are:
-fetal malpresentation such as transverse lie or breech (many women are not given a full range of options such as vaginal breech birth with a skilled provider or external cephalic version to turn a malpositioned baby)
-suspected cephalopelvic disproportion aka CPD – (meaning that the head is too large to fit through the pelvis. Actual condition is very rare. This is often over diagnosed, and many women do go on to have vaginal births after a cesarean for CPD)
-Maternal medical conditions (active herpes lesion, severe hypertension, diabetes, etc.)
-fetal distress. (This is a hot topic with the recent studies indicating that continuous electronic fetal monitoring increases the cesarean rate and does not show a relative increase in better outcomes. Discuss with your care provider how they define fetal distress and what steps are used to remedy the situation before a cesarean.)