There’s no doubt that caesarean sections in Ireland are on the rise. A study conducted by the Economic and Social Research Institute (ESRI), UCD and Trinity College Dublin, found that C-section births have increased from 7% in 1984 to 13% in 1993 and 30% by 2014.
Finding out what to expect during a C-section as well as the risk and benefits – both during the procedure and afterwards – can help you prepare.
What is a C-section?
A Caesarean section (C-section) is an operation that enables your baby to be born through an incision made on your pregnant abdomen. A C-section may be planned for medical reasons or you may experience an emergency Caesarean when labour does not go as planned. An emergency C-section usually occurs after labour has begun.
What if I have a general anaesthetic?
If you have a general anaesthetic, you will be asleep for the procedure. This is rare, but it may be needed if there is a reason why staying awake is not suitable. The doctor will give you oxygen to breathe before the general anaesthetic is started. If this type of anaesthetic is chosen, your partner will be asked to stay in the waiting room and he will be able to see and hold the baby after the birth.
“Five of my seven children were born by c-section. The first C-section was a little bit surreal. Unlike a vaginal birth, there is no pain at the time of delivery and this baby is just ‘lifted out’ of your tummy. The two tips I would give anyone who has a C-section is to stay on top of your pain medication afterwards, in the early days especially, and get moving as soon as you can – without overdoing it. I found my fifth C-section as easy to recover from as my first. I think it helped knowing what to expect and knowing how to help myself recover.”
What happens during a caesarean section?
- In theatre there will be a team to care for you and your baby.
- Equipment will be attached to you to measure your blood pressure, heart rate and the amount of oxygen in your blood.
- The anaesthetist will set up a drip to give you fluid through your veins prior to the anaesthetic.
- An epidural or spinal will be sited by the anaesthetist.
- When the anaesthetic has taken effect, a urinary catheter tube will be inserted into your bladder to keep it empty during the operation. This should not be uncomfortable.
- For the operation, you will be placed on your back, slightly tilted to your left side.
- You should mention if you feel sick to the anaesthetist. This may be caused by a drop in blood pressure and the anaesthetist will give you treatment to help you.
- A screen will be put up at the level of your chest to separate you and your partner from the site of the operation.
- Your abdomen will be washed with antiseptic and covered with sterile drapes. The anaesthetist will stay with you all the time.
- The staff will let you know what is happening as they go along.
- Once the operation is underway, you should tell the anaesthetist if you are uncomfortable at any time. The anaesthetist can give you more pain relief as required.
- Occasionally, it may be necessary to give a general anaesthetic, but this is very rare.
- Immediately after the birth, your baby is checked and skin-to-skin starts.
- It usually takes another 20- 30 minutes to complete your operation.
- If you are not feeling well or feeling sleepy, your partner can do skin-to-skin with baby.
A planned caesarean section
A planned Caesarean section will be scheduled before the onset of labour for a specific clinical indication. Other reasons for a C-section include a breech presentation, where it is not safe to turn a baby or turning a baby has been unsuccessful. Another reason is placenta previa, where the afterbirth is covering the vaginal opening. A repeat C-section will be planned if the woman has had two or more previous C-sections.
A request from the expectant mum is not, on its own, an indication for Caesarean section. Specific reasons for the request should be explored, discussed and recorded. When a woman requests a Caesarean in the absence of an identifiable reason, the overall benefits and risks of Caesarean section compared with vaginal birth should be discussed and recorded.
When a woman requests a C-section because of a fear of childbirth, she should be offered counselling, such as cognitive behavioural therapy, to help address her fears in a supportive manner. This results in reduced fear of pain in labour and shorter labour.
Emergency caesarean section
The decision to carry out an emergency C-section will be made if your baby’s wellbeing or your own health are at risk. Some examples of this would be antepartum haemorrhage (a bleed before delivery), abruption (when the afterbirth comes away from the wall of the uterus) or uterine rupture.
Q. Is it possible to give birth vaginally (VBAC) if your first baby’s birth was a C-section?
A. Having a vaginal birth after having a C-section can be a safe choice for most women. Whether it is right for you depends on several things, including why you had a C-section before and how many C-sections you’ve had. You and your doctor can talk about your risk for having problems during a VBAC trial of labour.
According to Rosaline O’Donovan, Assistant Director of Midwifery at CUMH: “If a woman goes into spontaneous labour by themselves, they have a 70% chance of a vaginal delivery next time. It is important to be assessed and monitored during the labour as each case is individual.” As with any labour, if the mother or baby shows signs of distress, an emergency Caesarean section is done.
The benefits of a VBAC compared to a C-section include:
- Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. The more scars you have on your uterus, the greater the chance of problems with a later pregnancy.
- Less pain after delivery.
- Fewer days in the hospital and a shorter recovery at home.
- A lower risk of infection.
More like this:
Outlining your birth preferences
The ultimate hospital bag checklist
Birth story: change of plan