Caesarean births – all you need to know

A Caesarean birth is when your baby is born during an operation. The surgeon gently lifts your baby out through a short surgical incision made through your abdomen (generally below the bikini-line) and through the wall of your womb. This operation is carried out under anaesthetic which could be spinal anaesthesia, epidural or occasionally by general anaesthetic.

There are many different reasons why a caesarean birth happens. Sometimes the decision can be made during the pregnancy and planned for; this is called an elective caesarean. Sometimes the decision is made during your labour, which is known as an emergency caesarean.

There are a few things you can do that may help you to avoid having a caesarean section, for instance having someone with you throughout your labour, especially a midwife, having a homebirth (if you have no high risk factors like high blood pressure), if your baby is in the breech position during pregnancy - having an external cephalic version (turning your baby while you are about 37 weeks pregnant) if your baby is in a breech position (their bottom coming first), having a senior obstetrician involved in the decision to have a caesarean, testing your baby’s blood before having an emergency caesarean.

Should you require a c- section, there are different types of anesthesia you may have so you do not feel the operation. The most popular is known as a spinal, epidural or combined spinal epidural – this is administrated through an injection into your lower back region. With this type of anesthetic you are awake and can experience your baby being born. This method also carries fewer complications such as a sleepy baby at birth.

General anesthetics (where you go to sleep) are only used if your baby needs to be born very quickly or if you have a rare blood disorder with low platelet levels (these help your blood to clot).

All women undergoing a C-section will usually have an intravenous drip in your arm and a urinary catheter (a tube draining urine from your bladder) put in just before you have your caesarean. This will stay in place for about 24 hours. If you wish to breastfeed you can feed as soon after the delivery as you wish and some mother’s breast feed even while the operation is still going on. It is important that you are pain-free after your caesarean; ask the midwives for more pain-relief if you need it, before the pain builds up. To prevent blood clots forming in your legs (which can be potentially life-threatening) you will be given special injections and then after 24 hours you will be encouraged to get up and walk around.

Once you get home, take it easy, and let your body guide you as to how much you do. You can start gentle exercising as soon as you want. Most hospitals give you information as to which exercises you can safely do. Using your vacuum cleaner, driving and strenuous exercise are definitely not recommended. You can usually drive again after about 6 weeks, but do check with your Insurance Company Policy first.

The reason you had a caesarean will determine the advice from your doctor as to whether you have a VBAC (vaginal birth after caesarean) or have another caesarean for your next baby. If you experience any negative feelings about the birth of your baby, please talk to your Midwife initially who will be able to explain many issues to you, you can also talk to the Doctor who performed the operation or your GP. It is not unusual to feel a sense of disappointment if you had an emergency caesarean when you were expecting a vaginal birth.

Today the caesarean birth rate is 25% in the UK and is rising. There are many different reasons for this. Some women are opting for an elective caesarean before going into labour. Look at the statistics from your hospital to see what the caesarean rate is to help you decide where and how to have your baby.

Caesarean births are not without risks to either you or your baby or even to your next pregnancy. The decision to have a caesarean section is made by weighing up all the risks to you and your baby and then making a decision that is right for you.

The National Institute for Health & Clinical Excellence outline what you may experience this way:

The most common problem affecting babies born by caesarean section is difficulty with breathing. About 35 of every 1000 babies born by caesarean section have breathing problems just after the birth, compared with 5 of every 1000 babies after a vaginal birth. This complication is less common if your baby is born after 39 weeks of pregnancy. For further information go to our Ask a Midwife Service

Other useful links
www.nice.org.uk
www.rcog.org.uk
www.nct.org.uk
www.aims.org.uk
www.BirthChoiceUK.com