As you approach your due date, you’re probably wondering what it will be like when it’s finally time to welcome your baby into the world. And while hopes, dreams and anticipation swirl in your mind, another thought may be creeping in, too: What if I need to have a C-section?
The possibility of an unplanned or emergency C-section – or Cesarean section – can be a common source of concern. Many women write their birth plans with the assumption that they’ll have a vaginal birth. So if your care team recommends a C-section, it can be overwhelming and a little scary.
If the need for a C-section arises, your care team will be there to walk you through everything – and your support partner can usually be with you the whole time. But it can also be helpful for you to learn a little bit about this common delivery method in advance. This can help you feel more prepared and in control.
Below we walk you through the different types of C-sections, reasons why a C-section may be recommended, what you can expect during delivery, and much more.
What is a C-section?
A C-section is the surgical delivery of a baby through incisions in the abdomen and uterus. There are three different types of C-sections, which are generally separated by level of risk or urgency.
Scheduled vs. unplanned vs emergency C-section
Typically, a planned C-section will be scheduled to take place around week 39 of pregnancy, usually because there is a known medical reason to do so. For example, if you have certain medical conditions like high blood pressure or heart issues, a scheduled C-section may be recommended to help make sure the delivery process is as safe as possible. Another reason for a scheduled C-section may be to help prevent sexually transmitted infections that can be passed on to the baby during a vaginal birth.
But one of the most common reasons for a scheduled C-section is that a mother has delivered this way in the past. Although many mothers who’ve had a previous C-section try for a vaginal birth after a C-section (VBAC), many choose to schedule another C-section.
Most C-sections are unplanned because the need for one doesn’t present itself until much closer to labor, or during it.
In these cases, moms have been planning for a vaginal birth. But a few weeks, days or even hours before delivery, mom and their doctor decide that a C-section is the safest option. This kind of change can be disappointing and stressful, but rest assured that your care team will still do everything they can to make your birth experience match up to your birth plan.
As you might expect, the difference between an unplanned Cesarean and an emergency Cesarean is urgency. Generally, this means there is an immediate safety concern for you or your baby, and immediate intervention is needed to keep you both as healthy and safe as possible.
Reasons for an unplanned or emergency C-section
There are a number of reasons why an unplanned C-section, or in more serious cases an emergency C-section, may be recommended. But they all stem from one reason in particular: it’s in the best interests of you and your baby.
Your birth team will be working to ensure a healthy, safe delivery and may recommend a C-section as the best way to do so. Situations that can require a C-section include:
Your labor slows, stops or doesn’t start at all, despite strong contractions
Stalled labor can sometimes be restarted with things like oxytocin infusions, which can strengthen contractions. But a C-section may be recommended if these kinds of labor stimulation methods don’t work.
The difference in size between your baby and your pelvis puts both of you at risk
This is often referred to as cephalopelvic disproportion, and it happens when a baby’s head or body is too big relative to their mother’s pelvis to pass through safely.
The umbilical cord comes out first
This is referred to as a prolapsed cord. If the cord gets damaged or wrapped around the baby, this can interfere with their oxygen.
The position of your baby prevents a safe, head-first delivery
When a baby is positioned to come out feet or buttocks first, this is known as breech presentation. If they’re sideways, this is known as a transverse lie. Any position other than the standard, head-down position can increase the chance of complications such as an injury to the baby, a prolapsed umbilical cord or prolonged labor.
The placenta presents a problem
As you likely know already, the placenta is the organ that develops inside your uterus to deliver oxygen and nutrients to your baby through the umbilical cord. Sometimes issues can develop with the placenta to make a C-section necessary.
For example, the placenta can cover the opening of the cervix. This prevents the baby from exiting the birth canal, and is known as placenta previa.
As another example, sometimes the placenta can separate from the wall of the womb before the baby has been delivered. This is known as abruptio placentae, and it can deprive the baby of oxygen.
Your baby’s heart rate indicates distress
Your birth team will be monitoring your baby’s vitals to make sure they’re not experiencing any distress. If their heart rate is abnormally high or low, a C-section may be recommended to get them out as soon as possible.
You're having twins
Twins can often be safely delivered vaginally. But because there’s more than one baby sharing the same space, ensuring a safe delivery can be more complicated. For example, either one of the babies could be in a position that makes vaginal delivery impossible.
What happens during a C-section?
While your C-section may not be planned, your doctor and care team are highly trained and experienced in delivering babies this way. Also, your partner or support person can usually be with you through it all. And it won’t take long for you to meet your baby.
To get you ready for surgery, you’ll be given fluids – usually through a vein in your arm – and your vitals will be checked and set up for monitoring. Then, to make sure you’re as comfortable as possible during surgery, you’ll receive medications to help you relax and to numb your belly and legs so you won’t be in pain.
Typically, you’re awake for a C-section. General anesthesia, which puts you in a sleep-like state, is usually only used during emergency C-sections. So, while you may feel a little sleepy from the pain medications, you should be relaxed and ready to see your beautiful baby as soon as they make their arrival.
Before the surgery begins, a curtain will be drawn between your upper and lower body. This helps keep you calm and relaxed while your surgical team works to deliver your little one.
When surgery begins, an incision is made across the lower abdomen where the lowest part of the uterus lies underneath. Once your baby has been delivered and the umbilical cord has been cut, your surgeon will remove the placenta, do a routine check of your reproductive organs, and then start stitching you up.
How long does an unplanned or emergency C-section take?
C-sections generally don’t take very long. Delivery of your baby can be done in minutes, and the whole thing is usually done in less than an hour. To put that into perspective, the pushing process to deliver a baby vaginally can last anywhere from just minutes to up to three or four hours.
Your care team will be looking after you the whole time, and your support partner will usually be able to stay with you too. Barring any immediate medical needs, you’ll be able to meet and feel your baby next to you – and maybe even try breastfeeding for the first time – almost immediately.
What are the potential risks of a C-section?
C-sections are an incredibly common method for delivering babies, accounting for about 1 in every 3 births in the United States. While C-sections are generally considered safe, like any major surgery, they still carry some risks.
While rare, infection is always a possibility with any surgery. Your surgical team and your postpartum care team will follow rigorous health and safety protocols from start to finish to help minimize any risk. But it will also be important for you to closely follow wound care instructions while you heal at home.
Other risks can include allergic or other negative reactions to anesthesia, blood loss, blood clots and accidental injury of you or your baby.
What to expect from unplanned or emergency C-section recovery
Whether you give birth vaginally or by Cesarean section, your body will have done an incredible thing. You’re going to be tired, sore and maybe even a little anxious. But it’s going to be okay.
When it comes to C-section recovery, the healing timeline is a bit longer than a vaginal birth because you just had a major surgery. This usually means a couple more days in the hospital and a couple more weeks at home before returning to normal activities, when compared to an average vaginal delivery.
While you heal, a lot of bending and lifting will be off the table, as you will need to avoid straining your lower belly. Don’t worry – you can pick up your baby, but you should ask for help with anything heavier or more involved. You can expect pain in your abdominal area too, for which medication may be prescribed. You may also experience some vaginal bleeding throughout the weeks of your postpartum recovery.
Getting enough sleep and doing some light walking every day will help your recovery progress and help prevent post-C-section complications. Be gentle with yourself, and plan to take things slow. You’ll be given plenty of instructions and tips for recovering from your C-section before you go home.
But if you find yourself unsure about what to do or not do, we’re available 24/7 and just a phone call away. HealthPartners patients can call 800-551-0859. Park Nicollet patients can call their clinic directly during regular business hours, or 952-993-4665 if it’s after hours. For questions and advice on new baby care, you can also call our 24/7 BabyLine at 612-333-2229.
But most importantly, take this time to adjust to your new life. You’ve earned it! Kick back (gently), try to relax and bond with your baby.
Unplanned doesn’t have to mean unprepared
The thought of having an unplanned C-section can be overwhelming. But unplanned doesn’t have to mean unprepared.
Know that C-sections are common – and that you didn’t do anything wrong if one is recommended. Your care team has just one thing in mind when recommending a C-section: the health, safety and well-being of you and your baby.
When the time comes to bring your baby into the world, we want you to feel ready. So, if you have any questions, talk with the doctor or midwife who’s providing your pregnancy care. Also, choose a hospital-based birth center that’s prepared for every possibility.
We want to help you have the safest, most comfortable birth experience possible. Our birth centers are designed with flexibility in mind and supported by expert care professionals. We’re ready to help you through every step of the birthing process, planned and unplanned.
Find a hospital-based birth center that’s ready for everything