Expert answers to common C-section questions

If you or a loved one is expecting, you may be wondering about cesarean sections (C-sections). Here are answers to some of the top questions about this method of delivering a baby through a surgical incision of the mom’s abdomen.

According to the Centers for Disease Control and Prevention, Cesarean (C-section) deliveries account for over one-third of all U.S. births. Still, expectant parents often have lots of questions about this form of delivery, such as when it may be recommended over vaginal delivery and what to expect during the recovery process.

What are some reasons why C-sections might be recommended over vaginal deliveries?

Sometimes, a patient or surgeon may schedule a C-section as a personal preference. Most of the time, however, C-sections are performed when a vaginal birth would be high-risk for the health of the mom or baby, such as when:

• The baby is in a breech or feet-first position.
• The mom has had previous C-sections.
• Twins, triplets or more are expected.
• Labor isn’t progressing or if the baby’s heart rate is slow.
• The mom has one of the following conditions:
  • Diabetes
  • Preeclampsia
  • Human immunodeficiency virus (HIV)
  • An active case of genital herpes

Additionally, if complications, like excessive bleeding or umbilical cord entanglement, arise during an attempted vaginal delivery, an emergency C-section might be necessary.

What are some of the risks associated with C-section delivery?

C-sections are very common and considered routine surgeries. Still, with any major surgery, there are risks involved, including:

• Blood loss
• Infection
• Damage to surrounding organs
• Blood clots

It’s unlikely that the baby will be harmed during a C-section, but small cuts and breathing issues that last a few days post-delivery are possible.

In general, C-sections are very low-risk procedures for mother and baby.

Will I be awake during a C-section?

Most, but not all, moms are awake and alert during a C-section. Most often, the body is numbed below the waist using regional anesthesia (which affects a part or region of the body), such as an epidural, spinal block or both.

During an emergency C-section, a doctor may need to administer general anesthesia, bringing the mom to a sleep-like state so that she won’t feel pain.

Once anesthesia, local or general, is administered, the surgeon will make an incision on the lower part of the abdomen, through which the baby will be delivered.

What kind of scar can I expect from a C-section delivery?

All surgeries, including C-sections, that involve incisions will leave patients with scars. The most common type of incision used in C-sections is called a "bikini incision," and it is done horizontally, just above the pubic hairline, in an area often covered by a swimsuit or underwear.

In some cases, mainly when a large incision is needed, or if the baby must be removed quickly, the surgeon may make a vertical incision just below the belly button. A vertical incision can also be made higher up, particularly if the baby is lying sideways in the uterus.

Whether the first incision is vertical or horizontal, a second incision is then made in the uterine wall, and the baby is delivered through these two openings. If you’ve had a C-section in the past, that will also help your surgeon determine where to make the new incision.

Regardless of the position of the incision, it is usually around 4 to 6 inches long, big enough for the baby’s head and body to squeeze through.

Your medical team will give you instructions on how to care for the incision after surgery, and the amount of scarring can depend on many things, including genetics. Over time, the scar will fade and become smaller. If it bothers you, there are several treatment options to help minimize the appearance, including creams, injections and laser therapy.

Is it possible to deliver a baby vaginally after I have a C-section?

Just because you’ve had a C-section for one delivery does not necessarily mean you will need to have another C-section if you have more children in the future.

If you’re interested in attempting a vaginal birth after cesarean delivery (VBAC), discuss the risks with your doctor. Your chance of success depends on the reasons you had the C-section in the first place and if there were any complications. It may also depend on the type of incision you had. For example, those with a prior vertical incision are more likely to need a second C-section.

What is the C-section recovery process like?

A C-section is a major abdominal surgery, and It generally takes longer to recover from it than a vaginal delivery. Most moms who deliver their babies via C-section spend one or two days longer in the hospital than moms who deliver vaginally.

For days, and even weeks, after the procedure, you might feel tired, sore near the incision, constipated or full of gas. You may also have difficulty getting out of bed or lifting your baby. This recovery period typically lasts between six to eight weeks before you can resume your routine activities.

To help with healing, here are some C-section recovery tips:

• Rest when possible.
• Drink plenty of fluids.
• Avoid sex until your doctor clears it (usually at the six-week checkup).
• Take any medication recommended by your doctors to manage pain.
• Walk as you can to help relieve discomfort and prevent blood clots.
• Use a pillow to support your abdomen when you sneeze, cough or laugh to relieve pressure.

Does delivering via C-section affect breastfeeding?

There are no restrictions on breastfeeding for women who deliver their babies via C-section. Moms can begin breastfeeding as soon as they feel up to it.

Talk to a nurse, doula or lactation consultant if you have any of the following issues with breastfeeding:

• Feel uncomfortable breastfeeding because of your incision
• Feel pain while nursing
• Have issues with milk supply.

These professionals should be able to help you find solutions. However, taking care of yourself is crucial at this time, and if you decide that breastfeeding isn’t right for you as you recover, supplementing or bottle-feeding are healthy options.