What you can expect
Before the procedure
While the process can vary, depending on why the procedure is being done, most C-sections involve these steps:
- At home. Your health care provider might ask you to shower with an antiseptic soap the night before and the morning of your C-section. Don't shave your pubic hair within 24 hours of your C-section. This can increase the risk of a surgical site infection. If your pubic hair needs to be removed, it will be trimmed by the surgical staff just before surgery.
- At the hospital. Your abdomen will be cleansed. A tube (catheter) will likely be placed into your bladder to collect urine. Intravenous (IV) lines will be placed in a vein in your hand or arm to provide fluid and medication.
- Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body — allowing you to remain awake during the procedure. Common choices include a spinal block and an epidural block. In an emergency, general anesthesia is sometimes needed. With general anesthesia, you won't be able to see, feel or hear anything during the birth.
During the procedure
Your doctor will use an abdominal incision and a uterine incision to delivery your baby.
- Abdominal incision. The doctor will make an incision through your abdominal wall. It's usually done horizontally near the pubic hairline. Alternatively, the doctor might make a vertical incision from just below the navel to just above the pubic bone. Your doctor will then make incisions — layer by layer — through your fatty tissue and connective tissue and separate the abdominal muscle to access your abdominal cavity.
- Uterine incision. The uterine incision is then made — usually horizontally across the lower part of the uterus (low transverse incision). Other types of uterine incisions might be used depending on the baby's position within your uterus and whether you have complications, such as placenta previa.
- Delivery. The baby will be delivered through the incisions. The doctor will clear your baby's mouth and nose of fluids, then clamp and cut the umbilical cord. The placenta will be removed from your uterus, and the incisions will be closed with sutures.
If you have regional anesthesia, you'll be able to hear and see the baby right after delivery.
After the procedure
After a C-section, you'll probably stay in the hospital for a few days. Your health care provider will discuss pain relief options with you.
Once the effects of your anesthesia begin to fade, you'll be encouraged to drink plenty of fluids and walk. This helps prevent constipation and deep vein thrombosis. Your health care team will monitor your incision for signs of infection. If you had a bladder catheter, it will likely be removed as soon as possible.
You will be able to start breast-feeding as soon as you feel up to it. Ask your nurse or a lactation consultant to teach you how to position yourself and support your baby so that you're comfortable. Your health care team will select medications for your post-surgical pain with breast-feeding in mind.
Before you leave the hospital, talk with your health care provider about any preventive care you might need. Making sure your vaccinations are current can help protect your health and your baby's health.
When you go home
During the C-section recovery process, discomfort and fatigue are common. To promote healing:
- Take it easy. Rest when possible. Try to keep everything that you and your baby might need within reach. For the first few weeks, avoid lifting anything heavier than your baby. Also, avoid lifting from a squatting position.
- Seek pain relief. To soothe incision soreness, your health care provider might recommend a heating pad, ibuprofen (Advil, Motrin, others), acetaminophen (Tylenol, others) or other medications to relieve pain. Most pain relief medications are safe for women who are breast-feeding.
- Avoid sex. To prevent infection, avoid sex for six weeks after your C-section.
You might also consider not driving until you are able to comfortably apply brakes and twist to check blind spots without the help of pain medication. This might take one to two weeks.
Check your C-section incision for signs of infection. Pay attention to any signs or symptoms you experience. Contact your health care provider if:
- Your incision is red, swollen or leaking discharge
- You have a fever
- You have heavy bleeding
- You have worsening pain
If you experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life shortly after childbirth, you might have postpartum depression. Contact your health care provider if you think you might be depressed, especially if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
The American College of Obstetricians and Gynecologists recommends that postpartum care be an ongoing process rather than just a single visit after your delivery. Have contact with your health care provider within the first three weeks after delivery. Within 12 weeks after delivery, see your health care provider for a comprehensive postpartum evaluation. During this appointment your health care provider will check your mood and emotional well-being, discuss contraception and birth spacing, review information about infant care and feeding, talk about your sleep habits and issues related to fatigue and do a physical exam. This might include a check of your abdomen, vagina, cervix and uterus to make sure you're healing well. In some cases, you might have the checkup earlier so that your health care provider can examine your C-section incision. Use this visit to ask questions about your recovery and caring for your baby.