Essential information about Cesarean Sections (C-Sections)

By Katie Roebuck

September 17, 2020

I am the mother of two children, an RN, Prenatal Educator, Lactation Counsellor, and Sleep Coach. My nursing career has been focused on Maternity and Obstetrics. I am based in the Niagara Region and I enjoy helping moms reach their goals with pregnancy and motherhood!

I feel like cesarean section mamas get inducted to this club that no one really wants to be a part of, but once you get there you realize it’s full of some amazingly strong people.

I am also a member of this club. Both of my children were born by cesarean – one unplanned, one planned. After working in Labour and Delivery for over 12 years, and being a 10-year member of this club, I’m happy to be able to share some essential information about cesarean sections.

THE SURGERY 

First and foremost – a cesarean section is considered major abdominal surgery. Have a cesarean for whatever reason is not the ‘easy way out’. There are some risks involved like any surgery that will be discussed with you beforehand. Cesareans can be life-saving and necessary, and the honest truth is that every pregnant person is a potential cesarean section.

The operating room can be an intimidating place but every person and every piece of equipment serves a purpose. When in the operating room you may hear people chatting about you while the room is prepared, you may hear metal instruments being moved around and the beeping of machines. You will have monitors applied to your body to watch your oxygen, blood pressure, and heart rate. Please know that this is all normal, and while this may be your first time in an operating room, a cesarean is something your healthcare team does on a daily basis. If you have questions or concerns, speak out and we can help guide you through it. You will have a Registered Nurse assigned to you during this process and they will be there to help support you.

There are three types of pain control aka analgesia used for cesarean sections – spinal, epidural, and general (going to sleep). The first two are preferred since you can stay awake and interact with your baby after birth, the last is only used in a very urgent situation. The choice of which one will be used depends on multiple factors that your healthcare team should discuss with you. You should be comfortable during your cesarean, but birth is not sensation free. It is normal to feel tugging, pulling, and pressure at certain parts of the surgery. Nausea is also extremely common and medications can be given to you if needed.

Before the surgery begins, you will have a catheter inserted into your bladder, and a strap will be placed over your numb legs so they don’t slide off the table. Your stomach will be cleaned and sterilized and you will be draped from your chest to your toes. The Obstetrician will ensure you are comfortable before beginning the surgery. You will be asked to state your name and birthday and confirm the surgery you will be having – this is a safety check done in every operating room. When everyone is ready, we begin!

An incision is made near your ‘bikini line’ and is about 10cm long. The Obstetrician will carefully cut through each layer starting at your skin to get to your uterus, and then sew it all back up with dissolvable sutures or “stitches”. Your abdominal muscles are not cut – the tissue connecting the two sides of your abdominal muscles is separated and stretched so the Obstetrician can access your uterus. The average cesarean takes about 45 minutes in total from start to finish, with the time to get baby out typically less than 5 – 10 minutes. Your skin will be closed with either dissolvable stitches or staples, and then covered by a sterile dressing.

After your baby is born in the operating room they will be quickly assessed by the team, and then if all is well you will get some skin to skin time while your cesarean section is finished. Sometimes babies need assistance breathing with a cesarean section and if your baby needs to go to the NICU you will be updated immediately. After your cesarean is complete you will be moved to the recovery room for about one hour where your team will ensure you are stable, and you will be able to feed your baby at this time. You’ll then be moved to a postpartum room where your hospital stay will be about 2-3 days. 

PHYSICAL HEALING

The physical healing from a cesarean section is typically 6 – 8 weeks long. Again, a cesarean section is major abdominal surgery. This means not carrying anything heavier than baby, and no driving for at least 6 weeks or until your prenatal care provider says it’s safe to do so. Because of the extended recovery period, I always suggest to my prenatal clients to have a backup support plan if a cesarean is required. Who will help you around the house and drive you to appointments? Do you have someone who can drop off food for you and run errands? I’m a huge believer in a Postpartum Plan and building a village of support for every mama, and when you are faced with a longer recovery having a village you can call upon can be essential.

You’re going to be sore – trust me on this one. Move slowly initially, remember to breath when you stand up or rollover, and use a pillow on your stomach when you cough or sneeze. Take it easy, use the pain meds if you need them, and know that every day it gets a bit easier. And don’t forget the stool softeners!

You’re still going to bleed after a cesarean section just like a vaginal birth. The bleeding after birth is from the placenta being removed from the uterus, and this still happens with a cesarean. Your bleeding should be the same after the first couple of days as if you had a vaginal birth.

Your breastmilk may be delayed from the surgery, so have a feeding plan in place. If you’re planning on breastfeeding, start with Antenatal Hand Expression (link course) and once your baby is born get them to the breast or pump early and often. Frequent removal of milk is essential for establishing supply, and while you may need to supplement your baby initially, you can definitely feed your baby!

Create a ‘nest’ for you and baby with all the supplies you need at home. I love using a little tote with items like nipple cream, soothers, breast pads, a water bottle, snacks, and other little items so I didn’t have to get up all the time when it was still hard to move around.

GOING FORWARD

If you need a cesarean section, you did not fail. Your body did not fail. Not having a vaginal birth does not make you less of a parent. Please read that again.

There are many things during birth that are out of everyone’s control, your pelvis opening size and shape, or babies that decide to come feet first for example. Sometimes a cesarean birth is the best route to keep you and your baby safe, healthy, and together. Please remember that there is more than one way to give birth, and definitely more than one way to become a parent.

If you require a cesarean section you need to understand the why, especially if it was an emergency. Having a debrief with your prenatal and birth team is critical to understand what happened and why to help you begin to process any potential trauma from your experience.

Sleep and rest are also extremely important. Again you didn’t just have a baby, you had surgery too. You wouldn’t expect someone who had major surgery to be running around alone looking after a newborn a few days after, would you? Be kind to yourself.

It is recommended to wait at least 18 months between your Cesarean before getting pregnant again. If you choose to have another baby, you have the option of trying for a vaginal birth or choose to have another cesarean. The choice can depend on why you had a cesarean the first time and varies from person to person. Speaking with your prenatal care provider, and understanding why the cesarean happened can help you make this decision if you chose to have another child. 

You are an amazingly strong person no matter how you became a parent. Cesareans can be frightening for many people since it represents a lot of unknowns. Taking an informative prenatal class that covers every aspect of birth is important to ensure you are ready and informed about your birth options. Contact your local Mama Coach for your Private Prenatal or Private Cesarean Prenatal class.

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