Caesarean Section

 

What is a C-section? 

A Caesarean section (C-section) is a surgical procedure in which a baby is delivered through incisions made in the mother’s abdominal wall and uterus. It is typically performed when a vaginal birth would pose risks to the mother, the baby, or both. Depending on the medical situation, a C-section can be planned in advance (elective) or done as an emergency response during labour.

The procedure usually involves regional anesthesia, such as spinal or epidural block, so the mother remains awake but does not feel pain. After disinfecting the abdomen, a horizontal incision is made just above the pubic area (known as a low transverse or “bikini” cut). The uterus is then opened, the baby is delivered, and the incisions are closed in layers.

C-sections are generally safe, especially when done in well-equipped facilities, but they are still major surgeries and carry more risks than vaginal births. In some cases, a C-section may be the best or only option, for instance, if the baby is in a breech position, if the placenta is covering the cervix (placenta previa), or if labour is not progressing as expected. Some women may also choose to have an elective C-section for personal or psychological reasons, provided they are fully informed of the risks and benefits.

While recovery from a C-section typically takes longer than from a vaginal delivery, most mothers go on to have healthy recoveries and can choose between a repeat C-section or a vaginal birth in future pregnancies, depending on individual circumstances.

What are the different types of C-section?

C-sections can be classified in different ways depending on the reason they are performed and the surgical approach used:

A. Based on Timing and Urgency

Type	Description	When It’s Used
Elective C-section	Planned ahead of time, usually at 39 weeks or later.	Known risks with vaginal birth (e.g. breech baby, placenta previa), or maternal request after counselling.
Emergency C-section	Unplanned and done during labour due to sudden complications.	Fetal distress, stalled labour, uterine rupture, or cord prolapse.
Category 1	Immediate threat to mother or baby’s life; needs delivery within 30 minutes.	Severe fetal distress, maternal hemorrhage, uterine rupture.
Category 2	Urgent, but not immediately life-threatening.	Labour not progressing, signs of baby not coping well.
Category 3	No current threat, but early delivery advised.	Repeat C-section or early scheduling due to other concerns.
Category 4	Elective surgery at a convenient time.	Planned caesarean without any labour complications.

B. Based on Uterine Incision Type

Type	Description	When It’s Used
Lower Segment C-section (LSCS)	A horizontal incision made in the lower part of the uterus.	Most common method; preferred due to better healing and lower risk of future complications.
Classical C-section	A vertical incision made in the upper uterus.	Rarely done today; used in certain situations like very premature birth or abnormal uterus shape.

When should I opt for a C-section? 

You may need to consider a C-section if your doctor identifies a medical reason that makes vaginal delivery unsafe or less advisable. In most cases, the decision is guided by medical necessity, not personal preference, though maternal choice may be considered after thorough counselling.

Common situations where a C-section may be recommended include:

• Placenta previa — when the placenta covers the cervix, blocking the baby’s exit.

• Breech or transverse baby position — if the baby isn’t head-down near delivery.

• Multiple pregnancies — especially if twins or more share a placenta or are not in optimal positions.

• Previous uterine surgery — such as a prior classical C-section or fibroid removal.

• Obstructed labour — when the cervix stops dilating or the baby can’t move down the birth canal.

• Fetal distress — abnormal heart rate or oxygen supply suggesting the baby isn’t coping well.

• Maternal health conditions — such as uncontrolled high blood pressure, heart disease, or infections like active genital herpes.

In some cases, after discussing all risks and options with your obstetrician, you may also opt for an elective C-section, even if there’s no strict medical need. This is usually allowed from 39 weeks onwards, but requires careful planning and informed consent.

What are the side effects of a C-section? 

A C-section is generally safe when performed in a well-equipped setting, but like all major surgeries, it carries certain risks and side effects. These may vary depending on your individual health, the circumstances of the surgery, and your recovery process.

Short-term side effects include:

• Pain and soreness — especially at the incision site, lasting for several days to weeks.

• Fatigue — from both the surgery and blood loss during delivery.

• Constipation or bloating — common after surgery and anesthesia.

• Infection — at the incision site, in the uterus, or urinary tract, though antibiotics are often given to reduce this risk.

• Bleeding — heavier than vaginal birth in some cases; rarely, a transfusion may be needed.

• Blood clots — a small risk exists, particularly in the legs or lungs, if mobility is limited after surgery.

• Delayed bonding or breastfeeding — if mother and baby are separated immediately after birth, though skin-to-skin contact is increasingly encouraged in recovery rooms.

Long-term considerations:

• Adhesions and scar tissue — internal scarring may cause discomfort or affect future fertility or abdominal surgeries.

• Increased risk in future pregnancies — such as placenta previa, placenta accreta, or uterine rupture if attempting vaginal birth after cesarean (VBAC).

• Chronic pelvic pain — chronic pelvic pain is less common, but can occur if nerves are affected during healing. 

Most women recover well after a C-section with appropriate care and rest. However, it’s important to follow medical advice closely and attend postnatal checkups to monitor healing and address any complications early.

Are there any advantages of a C-section? 

While vaginal birth is generally preferred for its faster recovery and lower risk of surgical complications, there are clear advantages to a C-section in certain situations. When medically indicated or carefully planned, a C-section can offer the following benefits:

• Reduces risk in high-risk pregnancies — such as those involving placenta previa, breech presentation, or twin/multiple births where vaginal delivery may be unsafe.

• Can prevent birth trauma — by avoiding prolonged or obstructed labour, which may otherwise lead to distress or injury for the baby.

• Controlled timing — in planned C-sections, the delivery can be scheduled in advance, which helps with logistical preparation and reduces uncertainty.

• May lower the risk of pelvic floor injury — especially for women at high risk of incontinence or pelvic organ prolapse due to anatomy or previous trauma.

• Life-saving in emergencies — when quick action is needed due to fetal distress or uterine rupture, a C-section can prevent serious complications.

Although not without risks, a C-section can be a medically sound and even life-saving procedure when used appropriately. The decision should always be made in close consultation with your obstetrician after weighing both your preferences and clinical indications.

What can I expect before a C-section? 

Whether your C-section is planned or done on short notice, there are important steps your medical team will take to get you ready. These measures help reduce complications and ensure that both you and your baby are well cared for during and after the procedure.

Here’s what usually happens before a C-section:

• Pre-operative assessment — your doctor will review your medical history, discuss the reason for the surgery, explain the procedure, and answer any questions. Consent will be taken.

• Blood tests — to check your hemoglobin levels, blood type, and clotting profile.

• Fasting — you will likely be asked not to eat or drink for around 6–8 hours before the procedure to reduce the risk of aspiration under anesthesia.

• Shaving and skin prep — the lower abdomen may be shaved or cleaned to reduce the risk of infection.

• IV line and medications — an intravenous (IV) line will be inserted for fluids, antibiotics, and any necessary medications.

• Anesthesia discussion — you will meet with the anesthetist, who will explain the type of anesthesia (usually spinal or epidural) and what you may feel during the procedure.

• Fetal monitoring — your baby’s heart rate will be monitored to ensure they are doing well before surgery begins.

• Hospital gown and support person — you will change into a surgical gown. In most cases, your partner or support person can be present in the operating room, but they must wear protective clothing.

These steps help ensure a safe and well-managed procedure. Staying informed and asking questions can also help ease anxiety before your C-section.

What happens during a C-section? 

A C-section typically takes between 30 to 60 minutes and is carried out in a sterile operating room with a full surgical and neonatal team present. Here’s what usually happens during the procedure:

• Anesthesia is given — you will receive spinal or epidural anesthesia, which numbs the lower half of your body while allowing you to remain awake and alert. In rare emergency cases, general anesthesia may be used.

• Monitoring and preparation — you will lie on an operating table with a screen placed in front of you. Your abdomen is cleaned and sterilised, and your vital signs will be continuously monitored throughout the procedure.

• Abdominal incision is made — a horizontal incision (known as a bikini cut) is usually made just above the pubic bone. In some cases, a vertical incision may be required for medical reasons.

• Uterine incision follows — the surgeon carefully opens the uterus, usually with another horizontal cut, to reach the baby.

• Baby is delivered — the baby is gently lifted out through the uterine opening. You may feel some tugging or pressure, but not pain.

• Immediate baby care — once delivered, the baby’s airway is cleared, and the umbilical cord is clamped and cut. If stable, the baby may be placed on your chest for skin-to-skin contact.

• Placenta is removed — the placenta is delivered, and the uterus is closed with dissolvable stitches. The abdominal layers are then sutured one by one, and the skin is closed using stitches or surgical staples.

• Recovery begins — you will be transferred to a recovery area for observation. Pain relief will be provided, and if you are awake and stable, you may begin breastfeeding or holding your baby within the first hour after birth.

What should I expect after a C-section? 

Recovering from a C-section takes time, as it is a major abdominal surgery. While many women recover without complications, it’s important to understand what to expect in the hours, days, and weeks after the procedure.

• Immediate post-op monitoring — you will spend the first 1–2 hours in a recovery area, where your vital signs, bleeding, and pain levels are closely monitored. If you are awake and well, you may be able to hold and breastfeed your baby during this time.

• Hospital stay — most women stay in the hospital for 2 to 4 days. During this period, you will receive pain relief, antibiotics if needed, and help with getting up and moving to prevent blood clots.

• Pain and mobility — some soreness around the incision site is normal. You will be encouraged to move gently as soon as possible to aid circulation and healing. Simple movements like walking short distances can help prevent complications.

• Wound care — the incision should be kept clean and dry. You may be given instructions on how to clean it at home. Watch for signs of infection such as redness, swelling, warmth, or discharge.

• Bleeding — vaginal bleeding (lochia) is normal and may continue for a few weeks. It gradually changes from red to pink to brownish before stopping.

• At-home recovery — full recovery can take 6–8 weeks. During this time, avoid heavy lifting, strenuous exercise, and driving until your doctor gives the go-ahead. Rest, eat nourishing food, and keep follow-up appointments to ensure proper healing.

• Emotional well-being — it’s normal to feel overwhelmed or emotional after delivery, especially if your C-section was unplanned. If you are struggling with mood changes, don’t hesitate to speak with your healthcare provider.

While C-section recovery requires more time than vaginal delivery, most women heal well with the right support and self-care.

Summary 

A Caesarean section (C-section) is a surgical method of childbirth that may be planned or performed urgently when a vaginal delivery is not safe for the mother or baby. It involves making incisions in the abdomen and uterus to deliver the baby and is typically done under spinal or epidural anesthesia. While the procedure carries risks such as infection, bleeding, and longer recovery time, it can be life-saving in certain medical situations. 

Women may be advised to consider a C-section in cases like placenta previa, breech presentation, multiple pregnancies, or previous uterine surgery. Before the operation, mothers undergo medical assessments, fasting, anesthesia planning, and preparation for surgery. During the procedure, the baby is delivered through carefully made incisions, followed by placenta removal and wound closure. 

Recovery involves hospital observation, pain management, wound care, and a gradual return to normal activity over 6–8 weeks. If you are exploring your birth options or have been advised to consider a C-section, schedule a consultation with Holistic Gynae & Fertility Clinic to receive guidance according to your pregnancy needs.