Medicine

Overview & Description

A c-section is the delivery of a baby through an incision in the mother's abdomen. C-sections are done when the health of a mother or baby is at risk.

Who is a candidate for the procedure?

A c-section may be done to help the mother if:

the baby's head is too large to pass through her pelvis

labor has gone on too long without enough progress

the baby is in a position that will make a vaginal birth difficult

the mother is having medical problems, such as kidney failure or high blood pressure that can signal a dangerous health condition called pre-eclampsia

the mother is bleeding internally from a traumatic accident

the mother has a history of infertility, especially if she is older than age 40

an earlier pregnancy resulted in the birth of a stillborn baby

serious health problems, such as cancer or a coma, make it doubtful that a mother can withstand the stress of labor

a mother's pelvis is unusually shaped

a mother has had two or more previous c-sections

a mother's water breaks and her baby is not in a head-down position for delivery
A c-section may be done to help the baby if:

the baby is not getting enough oxygen

the baby's heart rate rises to an unhealthy level due to problems such as a fever in the mother or infection in the baby

the heart rate drops too low, possibly because the umbilical cord is wrapped around the baby's neck

he or she is part of a multiple birth, such as twins or triplets

there is placenta abruptio, where the placenta tears away from the uterus too early

there is placenta previa, which happens when the placenta is touching or covering the cervix

the baby has defects or health problems that may cause distress during labor

the baby has not been growing at a healthy rate, which is called intrauterine growth retardation

the mother has an active herpes outbreak in or near her vagina

How is the procedure performed?

The woman is usually awake for a c-section. Spinal or epidural anesthesia may be used to prevent pain in the lower half of the body.
The surgeon makes an incision just above the pubic hair or cuts through a previous abdominal incision. He or she must cut through many layers of the mother's tissues to get to the uterus. Then the lower portion of the uterus close to the bladder is opened. The baby's head is brought out through this incision, followed by the rest of his or her body. The uterus and all the layers of tissue and skin on top of it are then closed with stitches or staples.

Preparation & Expectations

What happens right after the procedure?

After the c-section, the mother:

may try to breastfeed in the recovery room if she and the baby are doing well

will probably get antibiotics and intravenous (IV) fluids for 24 hours

will be encouraged to walk as soon as possible

may be given pain relievers through an IV pump or shots. Once the mother can eat food, she can take pills instead

usually stays in the hospital for at least 48 hours, depending on whether she or the baby has any more problems

Home Care and Complications

What happens later at home?

It takes longer to recover from a c-section than from a vaginal birth. Once she is home, a woman should:

try to get some help from friends and family or from paid employees, for the first few days

try to use the stairs very little for the first week

walk daily to keep blood clots from forming in her legs

use a heating blanket on the incision, if needed to provide comfort

keep taking prenatal vitamins

eat a balanced diet with plenty of fluids to prevent constipation

What are the potential complications after the procedure?

Problems are possible with any surgery that requires anesthesia. These include:

problems with the anesthetic, such as breathing problems or drug reactions

reactions to medicines, such as antibiotics or pain relievers

bleeding

a higher risk that blood transfusions will be needed

a pelvic or wound infection

bladder infection or trauma to the bladder
Any new or worsening symptoms should be reported to the doctor.

Attribution

Author:Eva Martin, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:09/17/02
Reviewer:Kathleen A. MacNaughton, RN, BSN
Date Reviewed:09/15/02