Caesarean Section

What is a caesarean section?

A Caesarean section, (also C-section) is a surgical procedure in which an incision is made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies, or, rarely, to remove a dead foetus. A late-term abortion using Caesarean section procedures is termed a hysterotomy abortion and is very rarely performed.

Why is it done?

A Caesarean section is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk, although in recent times it has been also performed upon request for childbirths that could otherwise have been natural.

What to expect after surgery?

After a routine cesarean section, expect to be monitored closely for the next 24 hours to make sure that you don't develop any problems. You will receive pain medicine and will likely be encouraged to begin walking short distances within 24 hours of surgery.

Walking can help relieve gas buildup in the abdomen. It is usually very uncomfortable to begin walking, but the pain will decrease in the days after the delivery.

Avoid strenuous activities, such as bicycle riding, jogging, weightlifting, and aerobic exercise, for 6 weeks or until your doctor says it is okay.

The typical hospital stay after a cesarean delivery is about 3 days. You can feed and care for your newborn as you feel able. Before going home, you'll receive postsurgery instructions, including warning signs of complications. It can take 4 weeks or more for a cesarean incision to heal, and it isn't unusual to have occasional pains in the area during the first year after the surgery.

What are the risks of the surgery?

Cesarean risks for the mother include:

  • Infection.
  • Heavy blood loss.
  • A blood clot in the legs or lungs.
  • Nausea, vomiting, and severe headache after the delivery (related to anesthesia and the abdominal procedure).
  • Bowel problems, such as constipation or when the intestines stop moving waste material normally (ileus).
  • Maternal death (very rare). The risk of death for women who have a planned cesarean delivery is very low (about 6 in 100,000). For emergency cesarean deliveries, the rate is higher, though still very rare (about 18 in 100,000).

Cesarean risks for the infant include:

  • Injury during the delivery.
  • Need for special care in the neonatal intensive care unit (NICU).
  • Immature lungs and breathing problems, if the due date has been miscalculated or the infant is delivered before 39 weeks of gestation.
  • Higher infant mortality risk: in c-sections which are performed with no indicated risk (singleton at full term in a head-down position), the risk of death in the first 28 days of life has been cited as 1.77 per 1,000 live births among women who had c-sections, compared to 0.62 per 1,000 for women who delivered vaginally.

What are the alternatives to the surgery?

The other option is vaginal (normal) delivery.