Pregnancy – Caesarean section

Caesarean Section

What you need to know…

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What is a Caesarean Section (CS)?

This is the operative delivery of a baby via a surgical cut made usually across the bikini line. Although a vaginal birth is more common than a Caesarean, around 1 in 3 of all babies at Auckland Hospital require delivery by CS. A CS may be planned in advance (elective) usually performed 7 to 10 days before the baby’s due date, or it can be undertaken as an emergency due to unforeseen problems during labour.

When might I have a Caesarean Section (CS)?

In some cases, a CS may be the only safe option to deliver the baby.

Some of the possible reasons include:

  • Two or more previous CS’s or other womb surgery. If you have only had one previous CS, it is possible to have a vaginal birth after caesarean section (VBAC) and your obstetrician will discuss this with you in detail during your antenatal visits
  • Breech presentation (baby having its bottom lowermost in the womb as opposed to its head). Many of these babies can be turned (by a method called External Cephalic Version) but a CS is also an option. Your obstetrician will discuss this further with you
  • Your baby becoming stressed during labour (fetal distress)
  • Your baby being too big to pass safely through the birth canal
  • Labour is too slow or stops (failure to progress)
  • The placenta lies too low in the uterus (placenta praevia) and it is blocking the exit to the birth canal
  • Excessive bleeding from the uterus
  • You have a serious medical condition that requires urgent delivery, for example, severe high blood pressure
What happens during a Caesarean Section (CS)?

Your obstetrician, anaesthetist and assistant, and your midwife, scrub nurse, two other nurses and a paediatrician will be present. Your partner or support person will also be present. The CS is usually performed under a spinal or epidural anaesthetic although in some circumstances, a general anaesthetic may be required.

With a spinal or epidural, local anaesthetic is injected through a fine catheter into your back. You will be numb from your chest downwards. You will be awake throughout the operation and you will get to see your baby being born.

You will have a small plastic tube in an arm vein to give you fluids and antibiotics. You will also have a catheter in your bladder to keep it empty. An incision will be made across your bikini line.

The womb is opened and it takes only a few minutes for baby to be born. You will feel pressure and pulling movements during the operation but you will not feel pain. Once the after-birth (placenta) is delivered, your obstetrician will close the womb and other tissue layers. This usually takes between 20-30 minutes.

What are the potential risks?

A Caesarean section is a safe operation for you and your baby. However, it is still a major operation and there are potential risks from the surgery and anaesthetic.

These include:

  • Heavy bleeding during and after surgery – there is a small risk of needing a blood transfusion
  • Wound infection
  • Deep venous thrombosis – developing a blood clot in your leg veins
  • Bladder injury – this is very rare
What happens after a Caesarean Section (CS)?

Most women are up and about within 24 hours of a CS. It is important that you start mobilising early to decrease your risk of developing blood clots in your leg veins. The urinary catheter and drip are usually removed by the next morning. You will be given appropriate pain killers and most women require only simple pain relief such as paracetamol at discharge from the hospital.

It does take longer to recover from a CS section compared to someone who has had a vaginal delivery. Most women stay 3-4 days in hospital after a CS and full recovery usually takes a few weeks. You should avoid driving as well as heavy lifting during this period of time.

Our goal at Birthright is to provide you the best gynaecological care in a friendly and relaxed atmosphere, where you can talk to us about your needs.