Mother and Baby

Having a caesarean: all your questions answered

Section: Labour & Birth

Around 25% of mums have a c-section birth 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.

In this article:

Medical considerations

For most women, 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.

‘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.’

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. 

The 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. 

Can you choose a c-section?

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

What happens during a c-section?

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.

Read more: 10 tips for a faster recovery after a c-section

11 surprising things that happen during a c-section 

Whether a C-section is in your birth plan, or it happens as an emergency because of complications during your labour, here are a few things to remember and hopefully to alleviate any fears you have, based on real experiences of M&B mums. 


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1) It might come as a surprise 

Having a C-section might have been the last thing on your birth plan, but sometimes nature doesn't take its course and you have to bow to the expertise of the doctors and midwives around you.

My birth plan was to have a water birth, I had studied hypnobirthing, it was going to be a calm affair and I had refused to even listen to anything about a C-section as I was so determined.

However, you'll find out once baby arrives that you have to work to his timescale, not yours, and you'll be out of control for a long time once he's in charge - and that might be the same for your labour. In the end my waters broke at 35 weeks and 29 hours later I had to have an emergency C-section as the risk of infection was too high so many hours after my waters had broken. So despite my best efforts, nature didnt work with my meticulous plan.

Sometimes you have to relinquish control, listen to the doctors and let them help your baby arrive. 
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2. You'll probably have contractions while they're giving you anaesthetic

This could be the hardest part, mentally and physically. If you have an emergency C-section, you might be continuing to have contractions right up to the point of being given anaesthetic - and this can be really hard to cope with.

The pain might be really strong, but you know that it's unnecessary pain as the contractions won't ultimately lead to birth. But keep breathing through - keep concentrating on the thought that your baby will soon be with yo
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3) You'll feel a lot

The process of cutting you open and getting your baby out is weird - that's the one word that every C-section mum I know has used to describe how the anaesthetic works.
You can't feel anything but at the same time can feel it all - you're completely numb and yet can feel the tugging and moving. Weird. There really is no better way to describe it. 
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4) You might get the shakes 

One side effect of the anaesthetic might be the shakes. This can last all during the surgery and for an hour or so afterwards. It's like severe shivering and you won't be able to stop it, but it's completely normal and nothing to worry about. 
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5) The surgeons are super efficient

Your baby will pop out quite quickly, and you'll be sewn back up within an hour normally. There's no hanging around - which can be strange if it's an emergency C-section and you've been trying to get baby out for hours on end. 
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6) You'll be very wobbly

Obviously afterwards you won't be able to move your legs for a while. And once the anaesthetic wears off you'll still be wobbly for ages.
Don't try too much too soon - if the nurses suggest a shower, take up their offer of going with you, and then sit on the chair in the shower. This is a whole different type of 'being swept off your feet' to when you met your other half. 
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7) You'll be very emotional

This really should go without saying. You've been emotional for the past 9 months and it doesn't stop once baby arrives.

Having a C-section might not have been your plan, but remember what's important is that baby is safe and healthy. Acknowledge how you feel and talk about it to anyone who'll listen - your family, the midwives, or other mums on the ward. 

Some mums say that having a C-section makes you more emotional after birth, and prone to crying more than normal. There might not be any scientific proof behind this, but if you do find yourself feeling emotional, make sure to talk to someone. Whether it's your partner, mum, friends, or support network at the hospital or otherwise, there will be a shoulder for you to cry on somewhere. 
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8) Skin to skin is possible

One of my biggest concerns over having a C-section was whether I'd get skin to skin with my new baby. Thankfully, after being whipped off to cut the cord and be checked over, my baby boy came straight back to me to lay on my chest while they sewed me up.

Obviously this depends on how much immediate care your baby needs after birth, but that's the same whether you have a C-section or vaginal birth. 
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9) You'll need massive granny pants 

I'm talking massive knickers that you thought only very old ladies wore. You'll want them to go right over your belly. Huge. I've never seen such big pants - nor have I ever been so grateful for such big pants.

Not only do you want the support for your suddenly empty but still pregnancy-sized belly, but your normal knickers will probably sit right on your wound and so be really uncomfortable or painful. So invest in some enormous pants. Those lovely lacy ones can wait a few weeks to return. 
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10) You'll be numb for a while

Every woman's recovery will be different, but expect to be numb around your wound for quite a while. It's a strange feeling and will take some getting used to - now that your pregnancy bump has gone, you might find you still take comfort in rubbing your numb belly where once a wriggly baby was. 
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11) Do not do too much once baby arrives

Seriously. Do not try to do everything. Do not try to be superwoman. Do not attempt to go back to normal straight away doing the washing, cleaning, tidying, cooking, or whatever you used to as well as looking after your new baby AND recovering from your C-section.

You've had a big surgical procedure and you need to rest and recuperate. Take up everyone's offer of help and sleep as much as you can. Rest up - your body needs to heal. Pregnancy takes a lot out of your body without the massive strain of surgery. Do not underestimate how much healing this will take. 

Read more:

What is a natural c-section? 

‘I Was Happy To Have An Emergency C-Section’ Read This Mum’s Birth Story

How to enjoy sex after a c-section

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