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A cesarean section is major surgery and comes with risks, but it's generally a safe procedure for both mother and child.

Most pregnant women plan to give birth the old-fashioned way and, by and large, that's just what happens. But sometimes a vaginal delivery isn't possible, or it's deemed unsafe for mother or baby. In these cases, a doctor may recommend that the baby be delivered by a surgical procedure known as cesarean section or C-section.

While some C-sections are planned in advance, the decision to perform the procedure is usually made only after unexpected problems crop up during delivery, according to the Office on Women's Health (OWH).

Here's a look at what to expect if you need a C-section.

Preparation

Before the operation, your abdomen will be cleaned and your body hair may be clipped. A catheter will be put into your bladder to keep it empty during the procedure. An intravenous line will be inserted into your arm or hand so medicine and fluids can be given easily.

You'll also be given anesthesia so you'll feel no pain during the procedure.

Most women receive either a spinal block or an epidural, according to OWH. Both involve injections in the lower back to prevent pain in the lower half of the body. With a spinal block, there's no feeling below the chest. With an epidural, you may feel some pulling or pushing. With both, you're awake but pain-free during surgery.

Less often, general anesthesia is used. If you receive general anesthesia, you'll sleep during the operation.

The procedure

Cesarean delivery is done through two incisions in the abdomen. The first cut exposes the uterus. It's typically about 6 inches long and made from side to side, just above the pubic hairline, according to OWH. A second cut is then made to open the uterus.

After the second incision, the doctor carefully removes the baby, cuts the umbilical cord and removes the placenta. The uterus is then closed with special stitches that are absorbed into the body after healing. The abdominal cut is also closed.

The surgery takes about 45 to 60 minutes. Most of that time is spent closing the incisions after delivery, according to OWH.

After delivery

If you were awake for the C-section, you'll probably be able to hold and breastfeed your baby soon after the procedure, according to the American College of Obstetricians and Gynecologists. 

Expect to be monitored for a few hours in a recovery area before you are moved to your hospital room. The catheter will come out soon after surgery, but the IV will probably stay in until you are able to eat and drink normally.

Your abdomen will be sore, but you'll be given medication for the pain.

A typical hospital stay after a C-section is two to four days, according to the college. Once you get home, limit your activities until you're fully healed. That can take about six weeks.

Risks

Women who have C-sections often stay in the hospital longer, take longer to recover and have more pain than women who give birth vaginally. According to the college, other possible risks include:

• Infection, especially of the uterus, pelvic organs or incision site.
• Bleeding, which may require a blood transfusion.
• Blood clots in the legs, pelvic organs or lungs.
• Bladder or bowel injury.
• Adverse reaction to medications or anesthesia.

Babies delivered by C-section tend to have more breathing problems right after birth compared to other babies, according to OWH.

If you have heavy bleeding, fever, worsening pain or other problems after a C-section, tell your doctor.

Reviewed 11/21/2023