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Having A Caesarean - everything you need to know

Around 25% of mums have a c-section birth – not because we’re too posh to push, but because sometimes it’s the safest option

C-sections are undoubtedly a necessary option for every woman going into labour. With any luck, you’ll have a vaginal birth. But with one in four babies delivered by caesarean, it really is worth being prepared for the process should you need one

Medical considerations

For most women, a vaginal birth is the ideal way to bring your baby into the world but, for some, medical reasons mean a c-section is the better option. These include placenta praevia, where a low-lying placenta blocks the neck of the womb and your baby’s exit route, or a breech presentation, where she’s lying feet or bottom first.

These conditions can lead to an elective caesarean, where you’re booked in because it’s necessary. A vaginal birth could still be possible, but it’s best to discuss your options with the consultant. 

C-section categories

  • Category 4 The fully elective procedure. 
  • Category 3 The semi-elective procedure takes place when labour isn’t progressing, and there’s time for discussion.
  • Category 2 An emergency c-section because your baby’s distressed but the threat to life is not imminent. The aim is to deliver the baby within 40 minutes.
  • Category 1 An emergency procedure where there’s an immediate threat to life. The team aim to deliver the baby within 30 minutes of making the decision. 

Your baby, your choice

New guidelines mean pregnant women can now request a c-section on the NHS for a reason that isn’t necessarily medical, such as a fear of birth. Counselling should be offered, as well as medical advice on the pros and cons of a caesarean versus vaginal birth. But, if you do still want a c-section, that’s your right.

‘If your hospital or obstetrician can’t or won’t proceed, you should ask to be referred to an alternative caregiver who can provide you with your preferred birth option,’ says Siobhan.

Giving birth doesn’t always go to plan and, occasionally, an emergency c-section may be your only option

Urgent attention

Giving birth doesn’t always go to plan and, occasionally, an emergency c-section may be your only option. Knowing what to expect will help you through it.

‘It’s rarely as rushed and stressful as it sounds. It’s simply that it’s unplanned and carried out when complications occur after natural labour has started,’ says Siobhan Quenby from the charity Wellbeing of Women. ‘It’s usually that things aren’t progressing as they should or your baby has become distressed.’

How it’s done

You’ll be given an epidural or spinal block, which allows you to stay awake during the procedure. A fabric screen is placed over your abdomen, so you and your partner can’t see the incision that’s being made just above your pubic hairline.

‘All you’ll feel is some tugging as your baby is pulled out. In all, it takes around 10 minutes,’ says Siobhan. Once you’ve enjoyed your first cuddle with your baby, you will be stitched up – scars are usually discreet, between four to six inches long – then you’ll be taken to recovery for monitoring.

Who can come in with me? 

You can be accompanied by one person. They’ll be asked to sit close to your head if the operation is difficult or there are a lot of staff present. If you have a general anaesthetic, they won’t be allowed to accompany you.

Who else will be present? 

Generally an anaesthetist and their assistant (known as an OPD); a surgeon and their assistant – both doctors; a nurse; probably your midwife and a runner (usually a healthcare assistant), who makes sure the surgeon has all the equipment needed. The neonatal team may well be present if the baby’s likely to need help after delivery.

How long will I need to stay in hospital?

Many hospitals believe in ‘enhanced recovery’ which means, providing there are no problems, you can go home the day after surgery. This reduces the risk of blood clots because you will be moving about more, and many women are keen to recuperate at home. Otherwise, a three- to four-day stay is usual.

How long will my recovery take?

It typically takes six weeks for your tissue to heal. During this time, you will be able to look after yourself and your baby, but you will need to take it easy. 

It’s common sense to avoid strenuous exercise, heavy lifting and tasks that are painful – for example, some mums who have had a c-section find vacuuming impossible for a few weeks post surgery.

Many mums choose not to drive in this six-week period. It’s important to check that your motoring insurance isn’t affected if you do otherwise. 

You will need to clean and dry the wound daily, wear loose clothing for comfort, and you may need painkillers to cope with discomfort.


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