C-Section

“C-section” is the commonly used shorthand for cesarean section, also known as cesarean delivery. This is a type of surgery in which a baby is delivered through incisions in the mother’s abdomen and uterus. In 2016, nearly 32 percent of all births in the United States were cesarean deliveries, according to the National Center for Health Statistics.

When is a C-section needed?

A cesarean delivery is needed if a baby can’t be born vaginally for reasons such as the positioning of the baby or placenta, or because of other health risks to the mother or baby. Some C-sections are planned, but many are done when unexpected problems occur during labor for a planned vaginal delivery.

What is the procedure and how long does it take?

In most cases, the physician makes a horizontal incision of about 4 to 6 inches in the abdomen, at or near the pubic hairline, then makes an incision in the uterine wall and delivers the baby through that opening. If everything goes smoothly, the procedure takes about an hour. The baby can usually be taken out in 10 to 15 minutes, or even faster in an emergency. After the baby is delivered, the womb and the various layers of the abdomen are carefully stitched up. This stitching takes longer than the delivery and accounts for the majority of the procedure time.

A woman in labor prepares to give birth in a clean white hospital setting, holding the hand of her husband or partner. Detail shot of their hands being held on the white hospital bed linens. A depiction of love and support during pregnancy or any hospital stay. Horizontal image with copy space.

What type of anesthetic will I receive so I don’t feel pain?

According to ASA practice guidelines, a spinal block or epidural is preferred for most cesarean deliveries because the baby is exposed to the lowest amount of medication and the mother can still actively participate in the baby’s birth. However, general anesthesia may be necessary in some cases.

  • For an epidural, a small area on your back will be numbed with the injection of a local anesthetic. Then a physician anesthesiologist inserts a tiny tube called a catheter through a needle inserted in the lower back. The needle is removed and the catheter left in place so anesthesia medication can be delivered through this tube as needed, to numb the entire abdomen for surgery. Although there is no pain, there may be a feeling of pressure as the needle is being inserted.
  • For a spinal block, a physician anesthesiologist injects medication into the spinal fluid through a needle inserted in the lower back. After the medication is administered, the needle is removed. The relief from pain is immediate and lasts from an hour and a half to three hours. You will be numb from your abdomen to your legs and feel no pain.
  • General anesthesia is the only pain relief method used during labor that makes you lose consciousness. You will not be awake for the birth of your baby.  With general anesthesia, your baby may be exposed to some of the medications before delivery.

Whether you have general, spinal or epidural anesthesia for a cesarean birth will depend on your health and that of your baby. It also depends on why the C-section is being performed.

  • For a planned C-section, you may have a choice of anesthetic, although you should be aware that a spinal block or epidural are generally considered the safest options for both you and your baby.
  • In an emergency or when bleeding occurs, general anesthesia may be necessary.
  • If you already have an epidural catheter in place during labor and then require a C-section, your physician anesthesiologist usually can inject a much stronger drug through the same catheter to increase your pain relief.

Consult with your physician anesthesiologist on the best option for you.

What are the risks of the surgery?

Like any surgery, a C-section carries some risk. As explained by the American College of Obstetricians and Gynecologists, these complications occur in a small number of women and usually are easily treated.

These potential complications include:

  • Infection
  • Blood loss
  • Blood clots in the legs, pelvic organs or lungs
  • Injury to surrounding structures, such as the bowel or bladder
  • Reaction to medication or anesthesia

How do I manage my recovery?

Your recovery time will be longer than for a routine vaginal delivery, and you’ll have to follow some physical restrictions during the weekslong healing process (e.g., not lifting anything heavier than your baby). Your medical team will talk to you about signs of infection and how to prevent it, as well as other postoperative care.

For as-needed pain relief in the days and weeks following the operation, consult with a physician anesthesiologist, who is specially trained in pain management.

Will the surgery leave a scar?

Yes, although in the long term it may not be very visible, even in a bikini, because of where the incision is made and because the scar fades somewhat over time. However, this varies from individual to individual. Sometimes during the surgery a vertical incision is required instead of a horizontal one, leaving a more visible scar.

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Physician anesthesiologists work with your physician team to evaluate, monitor and supervise your care before, during and after surgery, delivering anesthesia, leading the Anesthesia Care Team and ensuring your optimal safety.