A Caesarean section, also known as C-section or a Caesarean delivery, is the surgical delivery of a baby, which is often necessary when a vaginal delivery may put the baby or mother at risk. While some Caesareans occur in critical situations, however, others are used to prevent critical situations, and some are elective.
What Are Some Reasons for Having a C-Section?
There's a multitude of reasons why you might need or want a C-section, which is why C-sections are quite common in the United States.
While only around 2.5 percent of C-sections occur at the mother's request without addressing a medical problem, according to the American College of Obstetricians and Gynecologists, research suggests that this number has increased over the last decade.
That said, here are some of the instances when a C-section is an ideal choice due to medical reasons.
- If the baby is large, which might make for a difficult vaginal delivery.
- If the baby is in the breech or transverse position and cannot align itself to move down through the birth canal.
- If the mother has a uterine condition or a fibroid obstructing the cervix.
- If the mother has previously given birth via C-section (though, just because you give birth via C-section once doesn't mean that you necessarily have to do it again).
- If the baby has an abnormal heart rate or there are any other signs that the baby is in distress.
- If there's a compressed or pinched umbilical cord that's endangering the life of the baby.
- If there are any issues with the placenta.
- If there are any maternal infections like herpes or human immunodeficiency virus (HIV) that could infect the baby during a vaginal delivery.
- If there are any maternal health problems like high blood pressure or diabetes that might make a vaginal delivery too stressful and, as such, endanger the mother or baby.
- If there are any complications for a woman carrying twins/multiples, such as the babies arriving too early.
- If labor does not progress as it should, such as if the contractions don’t lead to the cervix opening enough.
How Common Are C-Sections?
The United States has a 32 percent Caesarian rate that's continuously on the rise, according to the Centers for Disease Control and Prevention. While 2005 data suggests that one in four babies were born via C-sections, 2015 data puts the number at one in three. That's more than double what the World Health Organization (WHO) recommends. That's because C-sections can have some serious side effects on mothers, and they can often require longer recovery times than vaginal births.
In fact, the rise in C-sections is reportedly a major contributing reason behind the rise in maternal mortality. The United States saw a massive increase in maternal mortality in recent years, from 18.8 maternal deaths per 100,000 live births in 2000 to 23.8 maternal deaths per 100,000 live births in 2014, according to the United Nations. And maternal mortality rates are higher for C-sections than for vaginal deliveries, according to WHO, which reports that maternal mortality and morbidity from a C-section is five times that of a vaginal birth. This is because of the greater risk — complications like sepsis and hemorrhage are far more common with C-sections.
What Are the Side Effects of Cesarean Delivery?
Though it's a rather regular procedure, a C-section is major abdominal surgery — one that requires anesthesia ( general or local) to help numb the pain of the 10-to-20-centimeter-long, horizontal incisions made to your abdomen, just below your bikini line. Alternatively, your doctor may make a vertical incision from just below the navel to just above the pubic bone. And they'll make incisions, layer by layer, through the fatty and connective tissue and separate the abdominal muscle to access your abdominal cavity.
Then, they have to make a uterine incision, which means that you'll have to have a catheter to help you pass urine for the first 12 hours after your birth.
Your baby will be delivered through the incisions and, once the doctor also removes the placenta from your uterus, they'll close the incisions with sutures. You'll have to keep a dressing on your wounds for at least 24 hours, though sometimes much more.
None of that is a walk in the park.
As with most major surgeries, there are some lingering side effects. Here are some of the possible side effects that come with C-sections.
- As mentioned, sepsis and hemorrhaging are two possible complications that are more likely to occur with C-sections than with vaginal deliveries.
- Other side effects that may occur can put your future pregnancies at risk, such as uterine rupture, placenta previa (when the placenta covers your cervix), and placenta accreta.
- As with all major surgeries, you might react negatively to the anesthesia.
- A C-section might increase your risk of developing a blood clot inside a deep vein, which can be life-threatening if the blood clot travels.
- Some research supports that postpartum depression is more common in women who've had C-sections than women who delivered vaginally. This is because some research suggests that vaginal birth stimulates a more rapid release of the "love hormone" oxytocin. As such, C-section delivery is often linked with higher rates of postpartum depression because of the discrepancies in oxytocin release. Likewise, women who have unplanned emergency C-sections may be more likely to suffer from postpartum depression since they may feel traumatized or be left in physical and mental/emotional pain from the experience. That said, postnatal depression affects more than one in 10 women in the first year after giving birth.
- Research suggests that posttraumatic stress disorder (PTSD) affects more women who've had C-sections than women who've delivered vaginally. That said, it affects up to seven in 100 women after giving birth.
- You might be at risk of developing an infection of the lining of your uterus (endometritis) following a C-section.
How Long Does it Take to Recover From a C-Section?
You might be wondering, how long does it take for a cesarean to heal internally? The answer, in short, is: longer than it usually takes to heal from a vaginal birth, but up to you. Your childbirth is your journey, and every woman is different. There's no right amount of time that it takes to recover from a C-section. That said, you can likely expect to stay in the hospital for at least three to four days after your delivery (and longer if you experience any serious complications). When you return home from the hospital, you'll want to give your body about six weeks to fully heal from your C-section.
With any major surgery, you need to give your body time to heal and recover so that you can get back to your everyday routines and exercise. If you don't, your wound can become infected, and it'll take even more time to heal. This is why you need to keep a keen eye on any signs of infection like pus, a fever or unusually heavy bleeding that may occur following a surgery like a C-section.
So, how much bleeding is normal after C section? You will have some vaginal bleeding, which is called lochia, for two to six weeks after your birth. This bleeding is normal. But if you continue bleeding for much longer after about six weeks, you should absolutely consult your doctor.
Tips for Recovering from a C-Section
Again, your C-section recovery is your journey, and there's no one right way to do it. That said, it's important to take care of yourself during this healing time.
1. Get Rest and Take Care of Yourself
Abstain from any physical activities that are going to put strain on your body. Your body needs to rest, and you need to give it time to heal before you dive back in. Likewise, you'll want to make sure that you're hydrating and getting enough sleep, as well as tending to your wounds and cleaning them.
2. Spend Time Bonding with Your Baby
Bonding with your baby releases love hormones like oxytocin, which can help to relieve depression that may occur after birth. The more time you can spend with your baby, the more your baby will feel secure and calm enough to experience optimal development, as well.
3. Seek Professional Help When You Need It
Contact your health care provider if you think your recovery is taking too long, you may have an infection or you need someone to talk to because you're worried you may be experiencing any of the aforementioned side effects like postpartum depression or PTSD.
AnnaMarie Houlis is a feminist, a freelance journalist and an adventure aficionado with an affinity for impulsive solo travel. She spends her days writing about women’s empowerment from around the world. You can follow her work on her blog, HerReport.org, and follow her journeys on Instagram @her_report, Twitter @herreportand Facebook.