C-section Expectations
The expectation of having a surgical birth may cause some anxiety due to the unknown. We hope this walk-through of what you may encounter during a c-section will allow you to stay calm and trust the process.
On birthday, to help you stay confident and relaxed as you await surgery:
Realize that you will be meeting your baby soon!
If you become uncomfortable about anything at all, SAY it. Your care providers are there to provide info and assist you.
Stay relaxed by controlling your breath. Do this exercise together: breathe in to a count of 4 and exhale to a count of 8. Release the tension in your face, neck, and shoulders. Focus on relaxing your eyes, tongue, jaw, and hands. Sometimes it helps to do this by squeezing first the face/hands, etc. while breathing in and then exhaling to relax the body part. In addition, try this meditation exercise that is specific to c-sections and can be used in the pre-operative room and even the OR, if permitted.
This is a sweet time to cherish forever. If you want keepsake photos, typically you can begin taking photos as soon as baby is born. Be sure to take plenty more photos in the recovery area too since mom may be woozy or a bit out of it. The photos will memorialize the first meeting, feeding, and skin-to-skin bonding time.
Questions to ask your medical care team:
What is the preferred anesthesia options (epidural, combined spinal-epidural, general)?
Who can be with you at the birth? Your partner? Your doula? Both? If not, ask WHY.
Can you have the baby placed on you in the OR while the surgery is finishing?
Can you have a mirror to watch the birth?
Can a clear drape be used so you can see your baby’s birth?
Is photo taking permitted?
What postpartum pain management options are available?
When can you begin breastfeeding (if desired) after the procedure is completed?
The baby is born in the first few minutes of a c-section. The rest of the nearly hour-long procedure is the repair. If your partner is busy with the baby or in the nursery, you will be alone during this period. Having a doula present for this can prevent you from becoming emotionally overwhelmed or frightened.
Surgical Birth
PRE-OPERATIVE: After you arrive at the hospital, you will be given many documents to review and sign. About an hour later, you will go into a room or recovery / triage area. You will have blood work done and be given medications to neutralize the acid in your stomach. An IV will be placed in your arm. You may also have part of your pubic hair trimmed, not shaved.
INSIDE THE OPERATING ROOM: Your abdomen will be scrubbed and the surgical instruments prepared. Drapes and curtains will be placed to prevent infection. Your arms will usually be placed on boards that stick out, away from your body.
SURGERY BEGINS: The surgery starts by checking to ensure that you're completely numb in the area where the incision will be made. The layers are cut and dissected. These include your skin, muscle, fascia (fat), peritoneum, uterus, and amniotic sac. This part of the surgery is usually fairly quick 5-10 minutes compared to the overall length of surgery.
ACTUAL BIRTH: You may feel pressure and tugging. Some people may feel briefly nauseated from the pressure or feel pain in their shoulder - this is referred pain. There isn’t much that can be done to alleviate this but it’s still important to tell the anesthesiologist what you’re feeling.
If you want to witness the moment your baby is born, ask that the drape is lowered for the moment your baby is lifted from your abdomen. (Some facilities have clear drapes - just ask.) Your partner and/or doula are usually by your head and can take photos if permitted.
POST DELIVERY: If your baby is healthy, you can request to have your baby placed skin to skin on your chest with warm blankets covering both of you. Your partner, doula, nurse and/or anesthesiologist can help facilitate this for you. Some babies will latch on in the operating room and others will require some nursing assistance during their first few minutes following their birth. Your partner can go to the warmer while your baby is evaluated. When possible, they will bring the baby back to you after the evaluation.
After the surgery is complete, your doctor will leave the OR and your nurses will move you from the table to a bed. Most people continue holding their baby during this shift, if not, the baby is placed in a rolling bassinet.
RECOVERY: Your team moves down the hall into the recovery area. Your nurse will monitor you closely and may assist you with breastfeeding if a lactation counselor isn’t present. After 1-2 hours you, your baby and partner will move to the postpartum area where you all will stay the remainder of your time at the hospital.
To avoid blood clots from inactivity, you will be given special braces to wear that will squeeze your legs post-delivery. Your incision will be sore and most women experience great discomfort when first walking post-delivery. While uncomfortable, walking around will accelerate your healing process by increasing circulation and moving the muscles. C-section recovery is usually longer than that of a vaginal birth.
Incision
It will take about 6 weeks for your incision to heal. You will probably have some pain, but you’ll be given pain medication to take at home. The incision scar is usually about 4 inches and located just above your pubic hairline.
Ask your nurse how to care for the incision. Oozing from your c-section scar should never smell foul, nor should you have red streaks. Find underwear that won’t rub your incision. Try UpSpring or C-Panties, which are designed with a high waist so nothing irritates the incision site.
Bleeding
Women typically bleed vaginally for about 6 weeks after birth. The bleeding will start heavy and taper off over the course of a few weeks. Get some big pads (cloth or conventional) or disposable underwear.
Home Recovery
If you experience any of the below points, call your doctor or midwife right away (even if it’s 2am).
Multiple blood clots, or a clot that is the size of a golf ball or bigger
Heavy bleeding that fills a pad in an hour
Fever
Lower belly tenderness
Redness or drainage at your incision site
Foul-smelling or green/yellow vaginal discharge
Blurry or spotty vision
Severe headache
Feeling faint or dizzy
Sharp pain in an area of your leg or anywhere on your body that is accompanied by redness, warmth and hardness (ie: a blood clot)
Sharp or shooting breast pain, especially if accompanied by a hard spot, redness and/or a fever
Feeling very sad or anxious, excessively worrying about things, disconnected from your baby
If you feel like you want to hurt yourself or the baby, call 911, or go to the nearest emergency room.
Reminders
Be sure to schedule your postnatal appointment to be held about 6 weeks post delivery. Don’t have before sex then and only do so if cleared by your OB. If you do have any type of sex, you’ll likely spray breastmilk if you’re breastfeeding. Your breasts may be tender so be sure to protect and cover them.
It may take longer for your milk to come in compared to when there is a vaginal delivery. Put the baby to breast as soon as possible post surgery and breastfeed often to stimulate milk production. After you’ve returned home, if you need help breastfeeding look online for a lactation consultation, support group, or arrange an in-home visit from an IBCLC.
For additional postpartum expectations, please visit this page in the portal.
