How to Prepare for a Cesarean Section
A Cesarean section, or C-section, is a procedure during which a baby is surgically delivered. This procedure is carried out when a vaginal birth isn't possible, when vaginal birth will put the mother’s or baby’s life at risk, if the mother has delivered previous children by C-section, or when the mother simply prefers this type of childbirth opposed to natural childbirth.In some cases C-sections are performed upon request. If you are planning for a scheduled C-section or want to prepare yourself in the event an emergency C-section is necessary, you should be aware of the details of the procedure, get the necessary testing done, and create a hospital plan with your doctor.
Understanding the Procedure
Understand why a planned C-section is performed.Depending on your pregnancy, your doctor may recommend a C-section due to a medical issue that may affect the health of your baby. A C-section may be recommended as a preventative measure if:
- You have certain chronic medical conditions like heart disease, diabetes, high blood pressure, or kidney disease.
- You have an infection like HIV or active genital herpes.
- Your baby’s health is at risk due to an illness or a congenital condition. If your baby is too large to move safely through the birth canal, your doctor may advise a C-section.
- You are overweight. Being obese can cause other risk factors and may require a C-section.
- Your baby is in the breech position, where she is feet-first or butt-first and cannot be turned.
- You have had a C-section during a previous pregnancy.
Be aware of how the procedure will be performed by your doctor.An outline of the procedure should be presented so you can mentally prepare for it. In general, most C-sections follow the same steps.
- At the hospital, the staff will clean your abdominal area and insert a catheter into your bladder to collect any urine. You will get an IV in your arm so you can get fluid and medication before and during the procedure.
- Most C-sections are done with regional anesthesia that numbs only the lower part of your body. This will mean you are awake during the procedure and will have a chance to see your baby being taken out of the womb. The anesthesia will most likely be given through a spinal block, where the medication is injected into the sac surrounding your spinal cord. If you need a C-section due to an emergency during labor, you will be given general anesthesia, and you will be completely asleep during the birth.
- Your doctor will make a horizontal incision through your abdominal wall, close to your pubic hairline. If your baby needs to be delivered fast due to a medical emergency, your doctor will make a vertical incision from just below your navel to right above your pubic bone.
- Your doctor will then make the uterine incision. About 95 percent of C-sections occur with a horizontal incision across the lower part of your uterus, as the muscle at the bottom your uterus is thinner, leading to less bleeding during the procedure. If your baby is in an unusual position in your uterus or in a lower area in your uterus, your doctor may make a vertical cut.
- Your baby will then be delivered by being lifted out of the incision made to your uterus. Your doctor will use suction to clear your baby’s mouth and nose of amniotic fluid and then clamp and cut the umbilical cord. You may experience a tugging feeling as the doctor lifts your baby up and out of your uterus.
- Your doctor will remove the placenta from your uterus, check to confirm your reproductive organs are healthy, and close the incisions with sutures. You can then meet your new baby and nurse your baby on the operating table.
Keep in mind the risks associated with the procedure.Some mothers decide to request a planned C-section. However, the American Congress of Obstetricians and Gynecologists (ACOG) recommends that mothers and their doctors plan for a vaginal delivery unless a C-section is medically necessary. Choosing a planned C-section should be done only after you have had a serious discussion with your doctor about the procedure and understand the possible risks of the procedure.
- A C-section is considered major surgery and you will likely lose more blood during a C-section than in vaginal birth. The recovery time is also much longer for C-sections, about two to three days in the hospital. It is still major abdominal surgery and full healing will take six weeks. If you get a C-section, you are more susceptible to complications in future pregnancies. Your doctor will may recommend that you continue to get C-sections for any future births to prevent a uterine rupture, which occurs when your uterus rips along the scar line of your C-section surgery during vaginal birth. However, depending on where you plan to deliver and the reason for your cesarean, some are candidates to try for a vaginal birth after cesarean.
- There are also risks associated with the surgery itself, as you will need to be under regional anesthesia, which can lead to an adverse reaction to the anesthesia. You are at a higher risk of developing blood clots in the veins of your legs or your pelvic organs due to a C-section, and it is possible the wound from the incision could become infected.
- A C-section could lead to medical issues for your baby, including breathing issues like transient Tachypnea, where your baby breathes abnormally fast during the first few days of birth. As well, C-sections done too early, sooner than 39 weeks of pregnancy, can increase your baby’s risk of breathing problems. Your baby is also at risk for a surgical injury, where your doctor accidentally nicks your baby’s skin during the surgery.
Understand the possible benefits of the procedure.A planned C-section can allow you to plan for the birth, have more control over when the birth occurs and be able to have some level of predictability about your labor and delivery. Unlike emergency C-sections, planned C-sections have lower risks of complications, such as infections, and many mothers do not experience a negative reaction to anesthesia or accidental injury to their abdominal organs. As well, a C-section will prevent any damage to your pelvic floor during labor, which can lead to bowel issues.
- If your baby is very large, has fetal macrosomia, or if you are having twins or multiples, your doctor may recommend a C-section as the safest option for your delivery. A C-section will lower the risk of passing an infection or a virus to your baby.
Creating a C-section Plan with Your Doctor
Receive the necessary medical testing.Your doctor will likely recommend certain blood tests to prepare you for your C-section. These tests will give your doctor important information, such as your blood type and your hemoglobin level, that she may use in the event you need a blood transfusion during the surgery.
- You should also tell your doctor if you are on any medication, in the event your medication could complicate the surgery.
- Your doctor will recommend that you talk with an anesthesiologist to rule out any medical conditions that may increase your risk of complications while under anesthesia.
Schedule your C-section.Your doctor will recommend the best time for you to schedule your C-section, based on your medical needs and the medical needs of your baby. Some mothers schedule their C-sections at 39 weeks, based on their doctor’s recommendation. If you are having a healthy pregnancy, your doctor will likely suggest a date closer to your due date.
- Once you choose a date for your C-section, you should include the date in your birth plan and fill out any pre registration forms at the hospital in advance.
Know what to expect the night before the surgery.Your doctor should discuss the protocol for the night before surgery, as you will not be allowed to eat, drink, or smoke after midnight. Avoid even a small piece of food like candy or gum and do not drink water.
- You should try to get a good night’s sleep before the surgery. You should take a shower before going to the hospital, but do not shave your pubic hair as this can increase your chances of an infection. The nursing staff may shave your abdominal area and/or your pubic hair at the hospital, if necessary.
- If you have an iron deficiency, your doctor may recommend that you increase your iron intake through iron rich foods and supplements. As a C-section is considered major surgery, you will lose blood and having high levels of iron will help your body recover.
Decide who will be in the room during the surgery.During your planning for your C-section, you should let your spouse or your support person know what to expect before, after, and during the surgery. You should specify if your spouse or support person will be present for the delivery and if he or she will stay with you and your baby after the surgery.
- Many hospitals allow the support person to sit next to you during the surgery and take pictures of the birth. Your doctor should allow at least one support person to be in the room with you during the delivery.
Recovering from the Cesarean Section
Plan to stay and recover in the hospital for at least two to three days.As the anesthesia wears off, you will be given a pump that allows you to adjust the dose of the pain medication via your IV. Your doctor will encourage you to get up and walk around soon after your C-section, as this can speed up your recovery and help prevent constipation and blood clots.
- The nursing staff will also monitor your incision from the C-section for signs of an infection as well as how much fluid you’re drinking and how your bladder and bowels are functioning. You should start to breastfeed your baby as soon as you feel well enough to do so, as skin-on-skin contact and breastfeeding are important bonding moments between you and your baby.
Ask your doctor about pain medication and home care.Before you leave the hospital, your doctor should outline any pain medications you can take and any preventative care you might need, such as vaccinations. Your vaccinations should be up to date to protect the health of you and your baby.
- Keep in mind if you are breastfeeding, you may want to avoid medications or ask your doctor for medications that are safe for you and your baby.
- Your doctor should also explain the "involution" process in your uterus, where your uterus shrinks back to its pre-pregnancy size, called lochia. There will be heavy bleeding of bright red blood for up to six weeks. You will need to wear extra-absorbent menstrual pads, often provided by the hospital after delivery and do not wear tampons as you recover.
Take care of yourself and your baby as you heal at home.It can take one to two months to recover from a C-section so take it slow at home and limit your physical activity level. Avoid lifting anything heavier than your baby and do not do any housework.
- Use your lochia bleeding to gauge your activity level, it will increase if you are doing too much activity. Over time the bleeding will change from pale pink or dark red to yellowish or light in color. Do not use tampons or douche until your lochia bleeding stops. Do not have sexual intercourse until your doctor says it is safe to do so.
- Stay hydrated by drinking lots of water and eating a healthy, balanced diet. This will help your body heal and prevent gas and constipation. You should keep the changing station and the feeding supplies for your baby close to you so you do not have to get up often.
- Be on alert for a high fever or any abdominal pain, as these can both be signs of an infection. If you start to experience these symptoms, see your doctor.
QuestionCan I get my nails done before a Cesarean Section?wikiHow ContributorCommunity AnswerI have had 3 Cesareans and I was told to have natural nails with no polish for the surgery, but my best advice would be to ask your doctor.Thanks!
- Consider hiring a postpartum doula for after care.
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Video: How To Cope With A C-Section (Cesarean Section)
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