Cesarean birth: What you need to know

A caesarean delivery is a major surgical procedure and you will need longer to recover then a vaginal birth.

Almost one third of women in the United States have cesarean deliveries, a surgical method of childbirth. Here are the answers to the most commonly asked questions.

There are many reasons why a cesarean birth may be used to deliver your baby. Cesarean delivery is the birth of a baby through a surgical incision made in the mother's abdomen and uterus.

A cesarean delivery may be the best approach for both you and your baby. It may be planned in advance when certain conditons are known. In some cases, if problems arise, the decision is made during labor. Some women may request a cesarean delivery. This is a complex decision that should be carefully considered and discussed with the doctor.

Most cesarean deliveries are done when the doctor determines that labor isn't progressing as it should and there is some risk to the baby's or mother's health. Some other reasons for having a cesarean delivery include:

• The baby is in a breech position (buttocks or feet first)
• You are having two or more babies
• You have a health condition such as diabetes, high blood pressure or heart disease
• You are having a large baby

Q What happens during a cesarean delivery?
A During cesarean delivery, you are usually awake but your abdominal area will be numbed with anesthesia–either an epidural or spinal anesthesia.

The doctor will first make an incision through the abdomen, right above the pubic area, and then another incision through the uterus. These incisions are usually made horizontally (known as transverse), but in some cases, your doctor will make a vertical incision. The baby then is delivered through the incisions, the umbilical cord is cut, and the placenta is removed. If you are awake during the birth, you'll probably be able to hold your baby right away.

Like any major surgery, cesarean birth involves risks, such as bleeding, infection, reactions to the anesthesia, or injury to the bowel or bladder. These problems occur in a small number of women and usually are easily treated.

Q Will I be able to bounce and play with my baby afterwards?
A You'll be able to hold and breastfeed your baby right away, but keep in mind that a cesarean birth is major surgery. You ll need some time to recover–longer than if you had a vaginal birth–and the incision in your abdomen will be sore for the first few days. Most new mothers stay in the hospital about two to four days after having a cesarean birth. Your doctor may want you to try to take a few steps the very next day to help speed up your recovery time.

Once at home, you may feel soreness for another four to six weeks and may need to take a pain medication for a few days. You'll be able to take care of your baby, but will need to avoid any strenuous activity. Also, to prevent infection, you should not put anything into your vagina or have sex for the first few weeks.

Q If I have a cesarean birth, can I have a vaginal birth the next time?
A Many women who have cesarean deliveries can often have a vaginal delivery with their later pregnancies. It depends on the type of delivery that was done and why it was needed. Talk it over with your obstetrician, and ask about the risks, one being the chance the uterus could rupture during a vaginal birth.