FAQs about Cesareans

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Mercer, B. M., & Gilbert, S., et al. Labor outcomes with increasing number of prior vaginal births after cesarean delivery. Obstetrics & Gynecology. 2008; 111: 285-291.
Silver, R. M, & Landon, M. B., et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstetrics & Gynecology. 2006; 107: 1226-1232.
Nisenblat, V., Barak, S., & Griness, O.B., et al. Maternal complications associated with multiple cesarean deliveries. Obstetrics & Gynecology. 2006; 108: 21-6.

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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.

ICAN believes that everyone needs support after birth, especially if they consider their birth experience to be traumatic.  Your feelings are valid. ICAN chapters facilitate peer-to-peer support through building a community of maternity care consumers in local environments. Different ways that ICAN can support can be found under the “Support” tab.

Local chapter leaders provide support through online, and in-person meetings. Find a local chapter using the “Find A Chapter” tab.

Can I still breastfeed if I had a cesarean?

After a surgery, you may need extra support while breastfeeding. Do not hesitate to ask for help. Your hospital should have a lactation consultant on hand to help you get started. In Family Centered Cesareans, those wishing to breastfeed are encouraged to begin breastfeeding in the operating room.

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 experience gas pains, incision pain, uterine contractions (your uterus will still need to work to get back to its original size). If you have staples or steri-strips, they may be removed about 4-7 days postpartum, but every provider has a different post-op plan, so you should discuss this with them. Try to rest. Get as much help as you can with your daily activities. If you have any questions, or concerns, reach out to your provider immediately. There are no “stupid questions”. It is important to discuss your concerns with your provider so they know how to help you.

By the end of six weeks, some people say they are feeling better, although the timeline is different for everyone.

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 any cesarean that wasn’t scheduled ahead of time. Some may involve a medical emergency, and some may not.

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, they may be accompanied by another person (some hospitals will allow two if one is the doula). Hospitals utilize Family Centered Cesareans, which means involved the family as much as possible. They will encourage you to participate in the birth, both cesarean and vaginal birth. For hospitals that do not support Family Centered Cesareans, you should meet with them to discuss the level of involvement you will be supported in.

How long will my cesarean last?

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 may take between 30 and 40 minutes, including repair, depending on circumstances of the birth.

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.)

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

If you have not already had an epidural or spinal anesthesia for labor, or this is a scheduled 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 may be given a general anesthetic. You also may be offered a pre-operative sedative, and the surgical consent form may say this is a possibility. In family centered cesareans, sedatives are typically not offered, as it can make it more difficult to be alert and present during your birth. After the birth, you may have the option of IV or oral pain medications, which you should discuss with your provider.

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

This is not a comprehensive list.

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 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.)