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What to know about C-sectionsYou may think you don’t need to know about cesarean sections, or “C-sections.” That’s what I thought, too. But after several days of labor with a Pitocin and a failed epidural, my cervix was only partially dilated and my contractions were causing trauma to my baby. Suddenly, I was having a C-section. And suddenly, I wished I knew more.

While you are still more likely to have a vaginal birth in this state (74 percent of all births from 2003 to 2005 were vaginal), there is always a possibility you’ll have a C-section. For this reason, Dr. Hilary Gammill, an associate professor with the University of Washington Department of Obstetrics and Gynecology, recommends being prepared. “Even if it is not a probability that you will have a C-section,” she explains, “the possibility is still very real.”

So how can you prepare? First, talk to your doctor now about both the medical aspects and how the experience of a C-section might differ from a vaginal birth. For example, if your oldest child is planning to bring his new camcorder in order to record your every groan, he might have to cool his heels in a waiting room due to age restrictions.

But Gammill also notes that most doctors are flexible and will work with you to make the experience as positive as possible. Talk to your doctor about what you would like and find out what she’s able to do. A little advance knowledge and preparation can help reassure you.

What to expect
A C-section is major surgery. But what does that really mean? In nearly all cases, you won’t be asleep. Most women have a spinal block or epidural to numb them from the shoulders down. Even so, you will be awake and alert.

Typically, you’ll have an IV and a catheter inserted. The C-section takes place in an operating room, where a drape blocks the incision from view. Some women still want to see the baby being delivered. If that’s you, ask your doctor if you can have the drape lowered at the moment of birth, and ask your partner to remind her of that wish.

After making an incision in your abdomen, the doctor parts the muscles, tissues and organs to reach the uterus and your baby. You can expect to feel some pressure as this occurs. You’ll feel a lot more when the doctor gently pushes the uterus, now cut open, down around the baby’s head to allow her to be pulled out. Once that is done and the baby’s mouth and nose are cleared, the umbilical cord is cut.

For most people, this is the first time they’ll get to hold their baby. Sometimes, however, a little more medical attention is required. For example, in a vaginal birth, the fluid in the baby’s lungs is normally pushed out as the baby passes through the birth canal. With a C-section, doctors might have to take steps to suction out that fluid.

Healing after a C-sectionNow that the baby is secure, it is time for you to be closed up. Again, you likely will feel some tugging. At last, your top incision will be sewn or stapled shut. For most women, the entire process will take about an hour.

Taking care of you
While vaginal births aren’t a walk in the park, C-sections are harder on your body and require more recovery. Your time in the hospital will usually be longer (two to three days) and you can expect four to six weeks to pass before you are close to full speed again. During that time, you’ll be told to check the incision and monitor for infection.

There will be limits on what you can lift safely to avoid ripping your stitches. And even if you feel well enough to have sex, you may not be able to do so for a while — just ask your doctor to be sure. There are exercises you can do to get back in shape, but make sure you talk with your doctor first (see Resources).

You should also keep in mind that it is not just your body that needs healing. Some studies have suggested a link between increased risk of postpartum depression and C-sections, although a 2006 study from New Zealand disagreed. But if your C-section is unplanned, you might feel grief, depression, anger or frustration over not getting the birth experience you’d planned. Some women report feeling like their body “failed” because they couldn’t have a baby the “normal” way.

If you have any of those feelings, there is help. Online resources and books can be a good place to start, and your doctor should have information about support groups. Remember, even though you are busy adjusting to your new life, taking time to recover both your physical and emotional strength now will give you the ability to be a better mom later.

Kathryn Russell Selk lives, works, writes and plays with her 7-and-a-half-year old and 27-month-old (both born through C-section) in Seattle.


C-section resources:
Most parenting and pregnancy websites have general information on C-sections that you can access by searching from their home page. StorkNet has an especially great C-section “cubby,” with general information and a section on exercises to help your body recover. The Mayo Clinic also has a section on C-section basics. And check out Medline Plus, a free public health site from the National Institutes of Health and the U.S. National Library of Medicine.

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