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. But another thought may be creeping in too: What if I need to have a C-section?
The possibility of an unplanned or emergency Cesarean section (C-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 you’re close to delivery and 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. It can help you feel more prepared and in control to learn a little bit about this common delivery method in advance.
Below, we walk you through the different types of C-sections, reasons why a C-section may be recommended, how long they take, 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
Scheduled 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, including:
- A prior C-section – Scheduled C-sections are very common for those who’ve had a previous C-section and decide not to try for a vaginal delivery or they’re not a candidate for one. Though it’s important to note that a vaginal birth after a cesarean (VBAC) is often a safe option for many women.
- Baby’s position prevents a safe, head-down 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.
- A procedure called an external cephalic version (ECV) can be performed to get baby into a head-down position, but isn’t always successful or a mother may decline it.
Other common reasons for a scheduled C-section are complications, such as placenta previa or placenta accreta, twins who aren’t candidates for vaginal delivery or a mother expecting a big baby requests one.
Unplanned 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 for most of their pregnancy. But during labor or even in the last weeks or days of their pregnancy, 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.
Emergency C-section
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 quick 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 labor doesn’t progress after trying all other methods to safely help move labor along and give your body time to respond.
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 the mother’s pelvis to pass through safely.
It's not always possible to know before labor how your baby's size and position will fit with your body. During labor, your care team will try different positions and techniques to help your baby move through the birth canal safely before recommending a C-section.
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 placenta presents a problem
As you likely know, 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 during delivery that can make a C-section necessary.
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.
What happens during a C-section?
While a C-section may not be planned, your doctor and care team are highly trained and experienced in delivering babies this way. If you do end up needing a C-section, your partner or support person can usually be with you 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 baby as soon as they make their arrival.
Before the surgery begins, a curtain will be drawn between your upper and lower body. When surgery begins, an incision is made across the lower abdomen where the lowest part of the uterus is in your body. Occasionally a vertical incision on your skin or a vertical incision on your uterus is needed to safely deliver your baby, but these types of incisions are not as common.
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 a C-section take?
C-sections generally don’t take very long. Delivery of your baby typically happens 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 a few 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 for you or your baby, you’ll be able to meet and feel your baby next to you almost immediately.
How long does a planned C-section take?
When a C-section is scheduled in advance, the procedure itself usually takes around 45 minutes. It typically takes 10-15 minutes for your doctor to deliver your baby, and the rest of the time is spent closing your uterus and the incision in your abdomen.
How long does an unplanned or emergency C-section take?
Unplanned or emergency C-sections follow the same steps as planned C-sections. The main difference is how quickly your baby is delivered. Every situation is unique, but generally the goal is to have the baby delivered as soon as possible. After your baby is delivered safely, the time to close your incision should be about the same as a planned C-section.
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.
Your surgical team and your postpartum care team will follow rigorous health and safety protocols from start to finish to help minimize any risk. While rare, infection is always a possibility with any surgery. Other risks can include allergic or other negative reactions to anesthesia, blood loss, blood clots, and unintentional injury of you or your baby.
It will also be important for you to closely follow wound care instructions throughout the C-section recovery timeline to help with the healing process.
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. Often, the circumstances leading to a C-section are beyond your control. 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.