Caesarean birth: why it is done, how it goes and what recovery looks like

A caesarean is an operation in which your baby is born through a cut in the abdomen and womb wall. It can be planned, or it can come up as an emergency while labour is under way. Either way, the aim is the safety of you and your baby. Giving birth by caesarean is not a shortfall; it is a way of giving birth.

Why is a caesarean recommended?

The reason depends on the person and the situation. Some common ones are:

• The baby's position, such as breech
• Labour that is not progressing
• Changes in the baby's heartbeat during labour that cause concern
• The placenta covering the cervix or separating early
• Certain situations in multiple pregnancies
• A previous caesarean or womb surgery
• Some health conditions of the parent

Beyond this, some people choose a planned caesarean after talking through their own health and circumstances with their doctor. Your doctor should explain clearly what suits you.

How does the operation go?

Most caesareans use regional anaesthesia, which numbs you from the waist down while you stay awake. In an emergency, general anaesthesia is sometimes needed.

• A drip is placed before the operation and a catheter is put into the bladder.
• A cut is made in the lower abdomen; the baby is usually born within the first minutes.
• If you and your baby are well, your partner can often be with you in the theatre.
• If your baby is well, skin-to-skin contact can often start soon after.
• The rest of the operation is spent repairing the womb and the incision.

Hospitals do things differently; asking beforehand tells you what is possible for you.

What does recovery look like?

A caesarean is major abdominal surgery and healing takes time. A hospital stay of a few days is common.

• Your team will suggest suitable pain relief; you do not need to put up with pain.
• Getting up and moving as soon as you can supports circulation.
• Keep the wound clean and dry; ask your doctor for care instructions.
• Gas pains and cramps can occur.
• Follow your doctor's advice on lifting, strain and driving.
• If you wish to breastfeed, the team can help you find comfortable positions that protect the wound.

For more detail on healing, see the article on recovery after a caesarean.

Bonding and feeding

Bonding with your baby after a caesarean is entirely possible; a delay of a few hours or days does not stand in the way. Skin-to-skin contact, holding your baby and breastfeeding can often start once your condition allows. If you wish to breastfeed, side-lying or the underarm hold protects the wound. Until your baby can come to you, skin-to-skin contact with your partner is also very valuable.

When to contact your doctor

After you go home, contact your doctor or hospital if you notice:

• Increasing redness, swelling, warmth, discharge or a bad smell at the wound
• Fever
• Pain that keeps growing or does not ease with pain relief
• Bleeding heavy enough to fill a pad every hour, or large clots
• Swelling, redness or calf pain in one leg
• Burning when passing urine, or being unable to pass urine

For shortness of breath, chest pain, fainting or very heavy bleeding, call 112 (or your local emergency number) straight away.

What you can do

• Prepare a birth plan that also covers the possibility of a caesarean; the birth plan in the app can help.
• Ask your doctor about the procedure, the anaesthesia options and the chance of skin-to-skin contact.
• Add loose clothing that does not press on the wound, and thick pads, to your hospital bag.
• Arrange help in advance for when you get home.
• It is common to feel sad if the birth did not go as you hoped; share your feelings with loved ones or your team.

However your baby is born, their arrival matters. This article is for information only; your doctor's advice for your own situation comes first.