C-Section (Cesarean Section)

There are a couple of advantages to a planned C-section. You’ll know exactly when your baby will arrive. It makes it easier to plan things such as your last day of work, childcare, and home help. Since it’s scheduled, you can also pretty much guarantee that your obstetrician will be there to deliver your baby.

Emergency C-section

Sometimes, you don’t have a choice other than to have an emergency C-section. Your baby may have trouble breathing or a weak heartbeat. Your doctor will want to get them out of your uterus quickly and into the hospital where they can get crucial medical help to keep them stable.

How Many Layers Are Cut During a C-Section?

When you have a C-section, your doctor cuts through seven layers of tissue. These include:

• Skin
• Subcutaneous fat, or fat located just underneath your skin
• Fascia, the connective tissue that covers your abdominal muscles
• Muscle — your surgeon will cut through your rectus muscles, which are between your ribs and pubic bone at the front of your pelvis.
• Peritoneum, the membrane that lines the inside of your stomach and pelvis
• Uterus — your doctor will make an incision that cuts through muscle to open up your uterus.
• Amniotic sac — if it’s still intact, your doctor will rupture it before they take out your baby.

Why Are C-Sections Performed?

You may plan to have a C-section because of certain health issues with you or your baby:

• If you’ve already had a C-section, you may not be able to deliver your next baby vaginally.
• Mothers can pass on some infections, such as HIV and active herpes, to the baby during a vaginal delivery.
• If you have certain conditions, such as diabetes or high blood pressure, a C-section may be safer.
• The placenta may be blocking your cervix.
• Multiple births may make a C-section necessary.
• Your baby may be too large or in the wrong position for vaginal delivery.
• Your baby may have birth defects that make a C-section safer.
• You may start out delivering vaginally but switch to a C-section if there are problems.
• Your labor may stop progressing.
• The doctor may notice signs of distress in your baby, such as an irregular heartbeat.
• The umbilical cord may get wrapped around the baby, or enter the birth canal before the baby does.
• The placenta may separate from the uterus.

C-Section Risks

A C-section is a common procedure. But as with any surgery, there is a chance something could go wrong. Risks of a C-section include:

• Infection, of either your uterus or the surgical wound
• Heavy bleeding. Up to 2% of women who have a C-section need a blood transfusion.
• Blood clots. Your risk is reduced if your surgeon uses something called an intermittent compression device to squeeze your legs during and after surgery. 
• Reaction to anesthesia
• Damage to organs such as the bladder or intestines, which happens about 1% of the time.
• Injury to the baby

Having a C-section can damage your uterus and make it more likely you’ll have problems with future pregnancies. But many women go on to have healthy pregnancies and safe vaginal deliveries after a C-section.

C-Section Preparation

Your doctor will give you instructions before your C-section. In general, you should:

Stop eating and drinking. Eight hours before your scheduled surgery, you shouldn't have anything to eat. You can drink clear fluids up until two hours before your C-section.

Shower with special soap. Your doctor may give you a special soap that contains an ingredient such as chlorhexidine to kill bacteria on your skin. It reduces the chance of an infection after your C-section. You’ll use it when you shower, either the night before or that morning. Don’t shave your stomach or pubic area, either. It creates small nicks in your skin that raise your risk of infection.

Discuss pain management with your doctor. You’ll want to have a pain control plan in place before you go under the knife. They will be delivered through an epidural catheter or IV during and immediately after surgery. Once you can eat solid food again, you’ll switch to pills.

Pack carefully. You’ll need a nightgown (no PJ bottoms the first night, because of your catheter) as well as comfy cotton pants that come up to your waist. Low-riding pants can rub and irritate your C-section wound. Don’t forget slippers for when you need to walk to the nursery to see your baby.

C-Section Procedure

Before the procedure, you may be given an antacid. It helps reduce stomach acid so that you don’t inhale it during surgery and develop pneumonia. You'll then get an IV placed into your hand or arm so that you can receive medicine and fluids.

Most women who have planned C-sections get local anesthesia, either an epidural or a spinal block. This will numb you from the waist down, so you won’t feel any pain. This type of anesthesia lets you still be awake and aware of what’s going on. Your doctor may offer you general anesthesia, which will put you to sleep, but it’s unlikely for most planned C-sections. After your anesthesia, you’ll have a catheter (a thin tube) put into place to keep your bladder empty during the surgery.

The doctor will place a screen across your waist, so you won’t be able to see the surgery as it happens. They’ll make one cut in your belly, then another one in your uterus. You won’t feel them because of the anesthesia.

But you may feel the doctors pushing or pulling on your middle section as they work to remove your baby from your uterus. You may feel nothing, or it may feel like pressure, but it shouldn’t hurt. Once your doctor opens your uterus, your baby will be removed within seconds.

You should be able to hear and see your baby once they are born. The doctor should let you hold them right after the C-section is finished. If you’re planning to breastfeed, you may also be able to try feeding your baby. But not every new mom gets to hold their baby right after a C-section.

Sometimes, babies that are born by C-section have trouble breathing and need help from doctors. If this is the case, you should be able to hold your baby after a doctor decides that they're healthy and stable.

After your baby is born, your doctor will cut the umbilical cord, remove yourplacenta, and stitch you up. The entire procedure should take only about 45 minutes to an hour.

C-Section Recovery

Your catheter will be removed soon after surgery. You’ll be given IV fluids. You’ll probably need a nurse or family member to help you the first few times you get out of bed to go to the bathroom.

You can expect to be sore for the first few days around the incision site. Your doctor can talk to you about medications to help manage pain. A heating pad may help. 

You can expect to stay in the hospital for two to four days. When you go home, your abdomen may still be sore. You may also experience mild cramps, especially when you nurse, as well as vaginal bleeding for four to six weeks. Use pads, not tampons. You should avoid strenuous activity or sex until you’ve been cleared by your doctor.

It’s important to walk around as much as possible. It will help prevent a blood clot. But don’t do more vigorous activities, such as house cleaning, and don’t lift anything heavier than your baby before six weeks.

Call your doctor immediately if you notice:

• Fever
• Chills
• Leg pain
• Trouble breathing
• Drainage from your incision site

Back Pain After C-Section

Back pain after you give birth is common. Research suggests that up to 40% of all women experience it in the first few months after delivery.

Doctors used to think women were more likely to experience back pain after C-section because of spinal anesthesia. But a 2022 study found that wasn’t the case. Women were more at risk of developing back pain after a C-section if they held onto the weight they gained during pregnancy.

Women who have C-sections do have a longer recovery time than women who have a vaginal birth. They can’t lift things, for example, for a longer period. This can weaken your back and core muscles, which may cause back pain.

The best way to minimize back pain in the weeks and months after your C-section is to stay as active as possible. Take short walks during your recovery, and ask your doctor about exercises you can safely do during this time to keep your back and core strong. This will also help you take off any weight you put on during pregnancy.

Swollen Feet After C-Section

Swollen feet and legs are very common after a C-section. Your body stores 50% more fluid than normal during your pregnancy. Once you give birth, it doesn’t automatically leave your body. It can travel down to your legs, ankles, and feet. In addition, IV fluids given after your C-section may cause your lower body to swell up, too.

You don’t need to do anything to treat swollen feet after a C-section. Your kidneys will work hard to get rid of this extra fluid for you. You’ll have to pee more, as fluid leaves your body. When you lie down, try to elevate your legs above your hips. It may help get rid of swelling faster.

Sex After C-Section

Most doctors recommend that you wait six weeks to have sex after a C-section. It gives your body time to heal. It’s still important to spend time with your partner, though. You can cuddle together or make time for a walk together while someone watches your baby.

The first time you make love, you may find it uncomfortable. If you breastfeed, your vagina may be dry. You may also notice pain around your C-section incision. Water-based lubricants and over-the-counter pain relievers may help.

Driving After C-Section

Your doctor will usually advise you to wait for about two weeks after your C-section to drive again. It will be longer if you still take narcotic pain medications. You also shouldn’t drive if you don’t feel well or are very tired.

Takeaways

A C-section is a way of delivering a baby by surgery that opens up the mother’s abdomen and uterus. It’s also known as a cesarean birth. They are very common in the U.S., making up about one-third of all births. Sometimes, C-sections are planned in advance — in situations where the baby is very large, in the wrong position, or the mother has an underlying health condition like high blood pressure or diabetes. Other times, they’re done in an emergency, such as if the baby is in distress. You’ll need to stay in the hospital for two to four days after a C-section. You should be fully recovered within six to eight weeks.

C-Section FAQs

Is a C-section safer for the baby?

A C-section carries some risks, and possibly complications. But it’s safer for both you and your baby if a vaginal birth is risky or if your baby is in distress during delivery.

Is a C-section very painful?

You won’t feel pain during a C-section. You’ll be numbed from the waist down due to an epidural or spinal anesthesia. You may experience some discomfort after surgery. You and your doctor can discuss a pain medication plan.

How many layers are cut during a C-section?

Seven. Your doctor will cut through your skin, fat, fascia, muscle, and peritoneum until they reach your uterus and the baby’s amniotic sac.

What happens to a baby after a C-section?

Your baby should be able to be delivered right into your arms. You may be able to breastfeed them. Sometimes, a baby born by C-section has some trouble breathing. Your doctor will help them and then hand them to you once they are stable.

What is the best last meal to eat before a C-section?

You can have your last meal six to eight hours before your planned C-section. It’s best to eat lightly. Soup or a smoothie are both good choices. Avoid meats and dairy. They can worsen bloating after your procedure.