Caesarean Births

By Roseanne Hickey, RN, BN, MSc(N), IBCLC on December 17, 2013
About 21 percent, or one in five Canadian women will give birth by caesarean section.

The caesarean birth rate has gone up steadily since 1995. This is partly due to the later age of many expectant mothers and changes in obstetrical practice. For example, all babies who are in the breech position near the end of the pregnancy (in which the baby would be born feet or buttocks first instead of the typical head first) are now born by caesarean section.

Other Factors For Caesarean Births:

  • Women experiencing labour for the first time have a 15 percent chance of having a caesarean birth.
  • Seventy percent of women who have had a caesarean birth before, choose to deliver vaginally for the births of later babies (this is called VBAC vaginal birth after caesarean).
  • Fetal distress (physical distress experienced by the fetus - such as an abnormal heart rate - because of a lack of oxygen).
  • The mother's health (such as excessive bleeding).
  • Labour which does not progress.

What Happens During A Caesarean Birth?

A caesarean birth is a surgical procedure in which your baby is born through an incision in your abdomen, rather than naturally through the vagina or birth canal.

Some women know ahead of time that their baby will be delivered by caesarean. Some women have an unplanned caesarean for medical reasons that come up when they are in labour. The procedure is generally the same in both situations. In an emergency, however, you may not be able to choose the type of anesthetic (painkiller) that is used.

As with any type of surgery, you must fast for several hours. Then you will be moved to an operating room. There will be several medical staff in the room. You will be given medications intravenously (through a blood vein). A catheter (small tube) will be used to drain urine from your bladder during the surgery.

You will probably be awake during the birth of your baby. Sensation and pain will likely be blocked with a regional anesthetic (spinal or epidural). In rare cases - usually only in emergencies - a general anesthetic is needed, in which you will be unconscious during the surgery.

Your belly is wiped with a cleaning solution and drapes or curtains are placed around your tummy. The drapes keep your tummy area germ-free, and they block your view and your labour partner's view of the surgery.

The surgery begins when surgical staff are certain the anesthetic has taken effect. During the operation, you may feel a sensation of pulling or tugging, but you should not feel pain.

It takes only about 10 minutes before you see your baby. Usually, the baby is dried and wrapped by a nurse and placed in your arms within minutes. When the operation is over (in about an hour), you are moved to a recovery room. You will be monitored closely for two hours. Your baby will be with you and you can begin to breastfeed him. Your nurse will show you some comfortable positions for breast-feeding your baby.

What You Need To Know Before A Caesarean Birth

If you have a caesarean birth, you can still make decisions about the birth of your baby:
  • Ask your health care professional about the options at your hospital if you need to have a caesarean birth, such as choices for the anesthetic.
  • Ask if your partner can be there during the surgery.
  • Try to plan before the birth for help at home after the baby is born.

Recovering After Surgery

You usually stay in the hospital for three or four days after the surgery. You will be given medicine to relieve pain as you need it. (The medication is not harmful to you or your baby, even if you breastfeed.) You will feel a little better every day.

You will need some extra help at home for the first few weeks, and you can go back to your normal activities gradually. You should not lift anything that weighs more than 10 lbs, do major housekeeping or major exercise until you see your doctor for your follow-up visit at about six weeks.

Roseanne Hickey, RN, works at Sunnybrook and Women's College Health Sciences Centre in Toronto as a nurse in labour and delivery. She has taught prenatal classes for many years.

By Roseanne Hickey, RN, BN, MSc(N), IBCLC| December 17, 2013

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