It is also known as an abdominal delivery.
As of 2017, cesarean delivery represented 31.9 percent of births in the United States, with 1,258,581 babies delivered via this method as opposed to 2,684,803 vaginal deliveries.
While some women will choose to have an elective cesarean delivery, also known as cesarean delivery on maternal request (CDMR), most cesarean births occur when vaginal birth would present a risk of seriously harming the mother or child. Only an estimated 2.5 percent of cesarean deliveries occur at the mother's request and not to address a medical problem.
However, this number has increased over the last decade.
This article will help mothers-to-be approach a possible cesarean delivery with full knowledge of how the procedure works, the possible risks, and what to expect during recovery.
- In the United States, 31.9 percent of births are carried out through cesarean delivery.
- They may be carried out if there is an emergency with the fetus or if the mother has complicating conditions, among other reasons.
- The procedure carries the risk of wound infection and blood clots.
- It can take between 2 and 4 days to recover from a cesarean birth.
Why is a cesarean delivery performed?
Cesarean delivery is performed when vaginal birth could prove to be dangerous.
A cesarean birth may be medically necessary for the following reasons:
There are multiple gestations, such as twins or triplets.
- Labor is not progressing.
- There is a fetal emergency or concern.
- The fetus has hydrocephalus, or excess fluid on the brain.
- The fetus is in the breech or transverse position.
- The baby is too large to travel through the cervix.
- The mother has a contagious virus, such as herpes and HIV.
- The mother has complicating conditions, such as diabetes or high blood pressure
- The mother has a uterine condition or a fibroid obstructing the cervix.
- There are abnormalities in the placental or umbilical cord.
- The mother has previously given birth via cesarean delivery.
A cesarean might also be elective, and is often chosen for a complex range of reasons, according to a 2017 study, including the following:
- fear of pain during childbirth or anxiety about vaginal delivery
- previous experience
- interactions with healthcare professionals
- influences including the media, friends, and family
- the feeling of control over the birthing process
A cesarean is a serious procedure that requires a longer healing process than a vaginal delivery. Only opt for a CDMR once you have a full picture of the risks.
It is also worth noting that insurers are likely to decline any claims for reimbursement on a CDMR as the procedure is not medically indicated, and the woman undergoing the operation or her family would have to self-fund treatment on most policies.
What are the risks?
Blood clots can occur as a result of a cesarean section.
A cesarean delivery comes with risks, as with any serious procedure.
Potential problems the mother can experience include:
- wound infection
- blood loss
- blood clots
- injury to an organ, such as the bowel or bladder
- adverse reactions to medication or anesthesia
- potential complications during future pregnancies
Some women may also experience endometritis, an infection of the lining of the uterus.
Risks to the infant include surgical injury and breathing difficulties, such as transient tachypnea or respiratory distress syndrome.
In a cesarean delivery, a cut is made across the abdomen and womb while the mother is under an epidural or spinal anesthetic. Only in few cases is the mother under general anesthesia. The cut is normally between 10 and 20 centimeters (cm) in length.
With the epidural or spinal anesthesia, the lower body of the mother will remain pain-free despite not being unconscious, although they may experience a tugging or pulling sensation.
A drape is sometimes set up to block the view of the operation for the mother, as this could cause distress despite not being painful. Some hospitals allow the use of a drape that you can see through. Talk with your doctor to see if this is an option at your hospital. The birth doctor, or obstetrician, and midwives will keep the mother informed about progress as they operate.
Women who have undergone a cesarean delivery with previous deliveries may be candidates for vaginal birth after cesarean delivery (VBAC). However, this option is not recommended for all women and should be discussed with a healthcare provider.
Cesarean delivery may be planned in advance or unplanned for a multitude of reasons.
Below is a 3-D model of cesarean birth, which is fully interactive.
Explore the model using your mouse pad or touchscreen to understand more about cesarean delivery.
Types of anesthesia
There are various options for anesthesia during a cesarean.
Women can discuss these with a healthcare provider. Options include the use of general anesthesia, epidural block, or spinal block. When general anesthesia is used, the patient will be put to sleep for the operation.
With an epidural or spinal block, only the lower half of the body will be numbed.2 During an epidural block, numbing medication is injected into a space in the spine either with or without a tube that can deliver additional medication as needed.
During a spinal block, the medication is injected directly into the spinal fluid.
Recovering from cesarean delivery
Following a cesarean, a woman and her infant can expect to remain in the hospital for between 2 and 4 days.
It is also likely that the new mother will experience pain at the site of the incision, cramping, and bleeding with or without clots for around 4 to 6 weeks. The severity of these symptoms will vary for different women who have undergone the operation but should improve fairly quickly as time passes.
Visit a doctor with any concerns about the severity of these symptoms, or if they continue for longer than expected. You will see your doctor for postoperative visits following surgery. These are good opportunities to discuss your healing progress.
Healthcare providers will recommend restricting physical activity on returning home. Until a healthcare provider says it is safe to resume normal activity, typically around 4 to 6 weeks after surgery, it is routinely recommended that patients avoid strenuous exercise, lifting heavy objects, placing anything in the vagina, or having sex.
During the recovery period, a woman can take the following steps. It is important to maintain hydration, take any medications as directed, rest as needed, and provide support to the incision and abdomen with the use of a pregnancy belt or pillow.
Symptoms after a cesarean birth
It is important to report any symptoms that could suggest infection or other complications to a healthcare provider. These symptoms could include:
- worsening pain
- increased vaginal bleeding
- increased redness at the incision site
- drainage or swelling of the surgical incision
- breast pain with redness or fever
- foul-smelling vaginal discharge
- pain when urinating
People should be sure to speak with a healthcare provider if they have any additional questions regarding cesarean delivery when trying to decide if it is the right option for them.