Few moms-to-be begin their pregnancies anticipating a Cesarean birth—delivering a baby surgically—but one in three will have one. Birth on an operating table may not be what you envisioned when you imagined what your labor and delivery would be like, but cesareans are done to protect you and your baby. Some even save lives. Learn what to expect and how to prepare—just in case.
When - Your doctor may feel the need to schedule a cesarean delivery before you go into labor due to maternal illness, such as preeclampsia, diabetes, or an active herpes infection; when the baby is in a breech (feet or buttocks first) or transverse (sideways) position; and when the placenta is blocking the cervix (placenta previa) or beginning to tear away from the uterine wall (placental abruption). Reasons for unexpected cesareans include signs of fetal distress during labor; a baby who won't fit through the birth canal; an umbilical cord wrapped around the baby's neck or dropping through the cervix (either of which may cut off the baby's oxygen supply); or labor that's failing to progress, even with Pitocin.
In the past - Once a woman had one cesarean, she'd be expected to deliver all of her children that way. Now vaginal birth after cesarean (VBAC) is an option for some moms. While VBAC can pose less risk and offers a faster recovery than a surgical birth does, concerns have been raised about the safety of a VBAC when labor is induced. Talk to your doctor about whether you should try for a vaginal delivery if you previously delivered by c-section.
How - Cesareans are usually performed with epidural anesthesia. In such a case, you'll be awake and your partner will probably be able to stay with you. In an emergency, however, you may require general anesthesia, leaving you unconscious and your partner in the waiting room. In preparation for a cesarean, you may need to have your abdomen shaved, a catheter inserted in your urethra to drain your bladder, and an IV line put into your arm to administer fluids. Your doctor will make two incisions, the first in your skin, and the second in the wall of your uterus. The baby will then be pulled out, followed by the placenta. The procedure often takes less than 15 minutes.
What's next - Recovery from a surgical birth is more difficult than a vaginal delivery. After all, it's a major surgery. In addition to bleeding and discharge, constipation, fatigue, and hormonal shifts, you can expect incision pain, severe gas pain (walking around often helps), and possible anemia due to the additional blood loss, which can make your postpartum exhaustion even worse than it would otherwise be. Taking prescription pain medication for the first week and ibuprofen after that can help. Talk to your doctor about which medications are safe while nursing.