Cesarean birth

In a Cesarean birth, your baby is born through an incision (surgical cut) in your abdomen.

The surgery takes about 30 to 40 minutes. Your baby is born five to 10 minutes after the surgery begins. The rest of the time is needed to remove the placenta and repair the incisions.

A Cesarean birth can happen with any pregnancy.

Cesarean birth video series

Cesarean birth video transcripts

This series of five videos covers Cesarean birth preparation, pain relief, what to expect during Cesarean surgery, and  recovering from a Cesarean in the hospital and at home.

Read a transcript of each video below.

 

The birth of your baby is an exciting time. Although there is some discomfort involved in any childbirth, your health care team will be with you through each stage of your surgery, answering any questions you may have, and helping you feel as comfortable as possible.

However, there are still many things you can do to prepare for your surgery and hospital stay. This video will focus on the different ways you can take a more active role in your Cesarean birth, and help ease any discomforts you may feel after surgery. Mothers who take an active role in their surgery and recovery often heal more quickly.

Having a baby is not just about your body. Yes, your body changes during pregnancy, but pregnancy also affects your emotions, and how you feel and care for yourself. This is why preparing yourself physically and emotionally is so important. The birth of your baby is a journey of body, mind, and spirit.

Taking care of your body is the first step. This means making sure you get plenty of rest, which is sometimes difficult during pregnancy.

Sleeping on your side instead of your back is sometimes helpful.

You may also try supporting your stomach with pillows while you sleep.

Try to drink fluids earlier in the day instead of near bedtime.

Eating the right foods is also very important. Avoid foods that may give you heartburn, which makes sleeping difficult.

Make sure you keep all appointments with your doctor – who can also give you information about the best foods to eat while you are pregnant.

It is also important to get some exercise; talk to your doctor about what is right for you. Exercise helps to increase blood flow and supply oxygen to your baby. Getting regular exercise during the day also helps expectant mothers sleep better at night.

A busy mind is common during pregnancy, as expectant mothers often feel overwhelmed. Writing down any questions or concerns you have is a good way to communicate with your health care team during scheduled appointments. Having information about your upcoming Cesarean birth is a good way to put your mind at ease.

The mind and body are linked together. Sometimes your mind feels fear, and it affects your body – sometimes causing physical discomfort. But there are several relaxation techniques you can learn which will allow you to move past fear and put your mind and body at rest. These techniques will be very useful in easing anxiety before surgery, or helping to lessen pain as you recover.

Some forms of relaxation you may already know, such as reading, taking a bath, watching TV, listening to music, and talking with family and friends. These are all very helpful, and you may use these forms of relaxation as you prepare for surgery and recovery.

Some other forms of relaxation may be new to you, and you should become familiar with them. Just as an athlete trains for a race, you should prepare for your surgery and recovery by practicing these mind-body skills long before you ever go to the hospital.

The following are brief explanations of these techniques, but they are also explained in greater detail in print and audio files, which you can download by visiting the website mentioned at the end of this video.

We all breathe, but we are not always aware of it. Becoming aware of your breathing and learning different ways to breathe can help reduce your heart rate, increase your oxygen flow, calm your fears, and change how you feel pain. Focusing on your breathing can help you shift your concentration from discomfort to something more pleasant.

Guided imagery is the act of closing your eyes and imagining yourself in another positive place. Guided imagery can be done with words from another person or with music, but you can also imagine this positive place in silence. The relaxing effect of guided imagery is often a sense of calm and peacefulness, which can create a sense of comfort.

Sometimes the simple act of a soft touch can be very soothing, such as the stroking of hair or the forehead. Massaging the hands, feet, and shoulders are also good ways to relieve emotional tension and anxiety, and to create comfort. As you prepare for your baby’s birth, practice massage with your birthing partner or a family member. Massage can be a very good way to ease pain.

Every Allina Health hospital offers aromatherapy, which is the breathing of essential oils to help reduce pain and anxiety, and relax a busy mind. There are many different oils available, and each one offers a different calming effect.

All of these mind-body skills can be studied in much greater detail by downloading print material or MP3 audio files by visiting the website shown on the screen. If you do not have a computer, your local library can help you download this information.

Allina Health is providing you with these materials to help support you during your pregnancy, your surgery, and your recovery. But you can actively prepare for your surgery and recovery by practicing these techniques by yourself or with a birthing partner or friend – using all of your body, mind, and spirit.

During your labor, you’ll have different pain relief options available to you. These options may change depending upon your medical condition.

During a normal vaginal delivery, one simple option is to administer pain medication through your IV. The IV pain medication may be enough to lessen the pain as you go through the first and second stages of labor.

There are times, however, when you will feel that more pain relief is needed than what you’re getting from the IV pain medication. In these cases, a procedural called an epidural can be done. An epidural is a procedure where a small tube will be placed through the skin of your back using a needle. The needle’s then removed, and special pain medicine’s given through that tube to provide you with a higher level of pain relief. This medicine’s typically delivered right up until the baby is delivered.

Even if you want to give birth vaginally, there are times when it may be necessary for your obstetrician to recommend delivery by Cesarean section. If you already have an epidural in place, this will most likely be used to give you additional medicine so you don’t feel any pain during the surgery.

If you’re scheduled for a Cesarean birth in advance, or a Cesarean birth is recommended while you’re in labor but you don’t have an epidural in, you’ll most likely receive spinal anesthesia. Spinal anesthesia’s an injection of medicine through the skin of your lower back. This medicine will make the lower part of your body numb, temporarily, so you don’t feel any pain during the surgery.

There are rare times when it might be necessary for you to receive general anesthesia for your Cesarean birth. General anesthesia’s where you’re given medicines through your IV, and these medicines will make you go off to sleep for the surgery. Anesthesia medicines will be continued that will keep you asleep until the surgery’s completely done.

Regardless of the kind of anesthesia that you have for your Cesarean birth, you will receive pain medication to help you to feel as comfortable as possible after the surgery.

We at Allina Health are fully committed to seeing you through the birth process as comfortably and safely as possible.

There is the possibility that some women who plan to give birth vaginally may need to give birth by Cesarean instead. It is recommended that all expectant mothers and their birthing partners watch the following video about Cesarean birth.

Before your surgery for Cesarean birth, you will need to sign a surgery consent form, and then your health care team will prepare you for surgery.

Your baby’s heart rate will be monitored.

Your vital signs will be checked.

An IV will be started, if you don’t already have one.

Blood will be drawn for routine lab work.

Your pubic hair will be clipped.

A small tube called a catheter will be placed in your bladder to drain urine.

You may be given an antacid to drink.

Once you are prepared for surgery, you will be moved to an operating room. You may be given either epidural or spinal anesthesia, depending on what you and your anesthesiologist agreed upon.

You will then be placed on a narrow bed, where more monitoring equipment will be attached to you.

As your health care team prepares you for surgery, you may feel anxious or nervous, which is very normal. This is a good time to practice some of the things you learned about in chapter one – especially breathing exercises and guided imagery, which will help you relax.

Be aware of your breathing, taking long, slow, peaceful breaths in, and then slowly breathing out all of the tension you are feeling. Continue this for a while – a cleansing breath in, a relaxing breath out.

Guided imagery may also help calm you before surgery. Allina Health hospitals provide MP3 audio players for guided imagery, or you may bring your own audio player from home. You can also guide yourself to your favorite place simply by closing your eyes and concentrating on the sounds, colors, scents, and textures of the place you are imagining. Stay in your favorite place for a few minutes, enjoying peace and comfort.

Your birthing partner is welcome at the birth, but he or she must wear scrub clothes and not touch any of the surgical drapes, gowns, or instruments, in order to protect you and your baby from infection.

The anesthesia staff will make sure that you are numb or asleep before starting surgery.

The surgery for your Cesarean birth will take about 30 to 40 minutes, and your baby will be born 5 to 10 minutes after the surgery begins.

When the baby is lifted out and the umbilical cord is cut, if you are awake you may feel pressure at the top of the uterus, but you will not feel any pain.

As long as neither you nor your baby need extra medical care, you and your birthing partner will probably be able to touch and hold your baby.

The rest of the time in surgery is needed to remove the placenta and repair the incision in your abdomen.

After your incision is closed, you will then be taken to a recovery area.

After your Cesarean birth, you will be in a recovery room for about one to two hours.

You will still have an IV in your arm, and a urinary catheter. You will also be hooked up to monitoring equipment.

A nurse will regularly check your vital signs, the firmness of your uterus, your incision area, the amount of vaginal bleeding, and ask how you are feeling.

Your nurse or provider will press down on your belly to massage your uterus several times after your baby is born. This is to make sure your uterus is sealing off the blood vessels where the placenta was attached. This massage can be uncomfortable, but using the breathing and relaxation skills you learned in chapter one can help decrease discomfort.

Recovery from a Cesarean birth is often more uncomfortable and can take longer than a vaginal birth. But your health care team will be there for you during your recovery, helping you feel as comfortable as possible. When you are ready, you will be moved to a room for the rest of your hospital stay.

Whatever discomforts you may feel, your nurse will describe to you what is called a care map – a guide to help manage your pain, take care of yourself, and get to know your baby during your hospital stay.

You are the only person who can describe your pain, but your health care team will work with you on ways to rate your pain – so that your providers know how best to help you feel better. The important thing is to be consistent in how you rate your pain, so that your health care team will know how best to treat you.

Your health care team will tell you about different types of medicine that may be right for you. But there are many other ways you can control some of the discomforts you are feeling. Mothers who take an active role in their own healing often recover more quickly.

Your incision may still hurt a little, so gently press a pillow over it any time you move. Applying cold or heat to an area that hurts is also helpful, but wrap any cold or heat packs in a towel to protect your skin.

Muscle spasms and pain from gas are common after a Cesarean birth. A good way to help ease discomfort is to close your eyes and concentrate on breathing slowly and gently into the area that hurts. Focus on your breathing until the discomfort goes way. Soft music may also help you relax.

Within 8 hours of your surgery, your nurse will help you walk around the room. It may be uncomfortable at first, but it gets much easier. Walking is one of the best ways to help you recover faster.

As you learned in chapter one, breathing the essential oils in aromatherapy can also help reduce anxiety, ease your pain, and make you feel better.

Taking a warm shower can help soothe your muscles and make you feel refreshed.

Although there are many types of pain relief available to you, it is very important to tell your nurse if your pain relief is not working, or if you feel any new pain. Your health care team wants to help you feel better and recover as soon as possible.

One of the best ways to help ease your own discomfort is by rooming- in with your new baby – keeping your baby with you as much as possible while you recover at the hospital.

It is during this time that your health care team will help you with breastfeeding, as well as ways to help ease the discomfort that breastfeeding sometimes causes.

Rooming-in is safe for healthy babies and their mothers. Babies who room-in with mothers often: feed better, cry less, and lose less weight.

While you are awake, you can hold your baby while lying in bed or sitting in a chair. When you sleep, your partner can hold the baby, or the baby can sleep in a crib.

Mothers who room-in with their babies: sleep much better than mothers who do not room-in – and getting better rest helps them recover more quickly; feel less discomfort because their focus is on their babies; and develop greater confidence in their ability to care for their babies.

As you recover in the hospital, your health care providers want to be sure of several things, including:

  • You can walk around by yourself
  • You know how to take care of yourself and your baby
  • You are not bleeding too much, and your stitches have begun to heal
  • You do not have a fever, and you can manage your pain
  • Your baby has had at least two successful feedings, and has had both wet and soiled diapers
  • The time it takes for all of this to happen is different for each mother and baby. Your health care team will partner with you to follow your care map and meet all of these requirements. Once you do, you may return home with your baby.

The recovery time that follows the birth of your baby is called postpartum and means “after birth.”

Postpartum is a special time, as you get to know your baby. But it is also a time of adjustment; you may still feel some pain from giving birth.

As you recover at home with your baby, there are many ways for you to care for yourself as you continue to heal during this postpartum period.

The anesthesia and loss of blood from your Cesarean birth will probably make you feel tired, so it is very important to get plenty of rest. If possible, sleep when your baby sleeps. If your incision still hurts, use pillows to get comfortable.

Your incision may itch, feel numb, or be sore when you touch it. This may last a few months, but you can continue to apply heat or cold to distract you from any discomfort, which will eventually go away.

New mothers often feel some pain in their breasts during the postpartum period, including sore nipples. Keeping your breasts dry, changing your breast pads often, and applying non-petroleum and non-alcohol ointment to your nipples usually helps.

Your breasts may also become engorged – swelling with extra fluid. To help ease the discomfort of engorgement, feed your baby often – eight to twelve times every twenty-four hours. You may also want to gently massage your breasts before and during feedings. Try different nursing positions that make you comfortable. And let your baby drain the first breast before offering the second breast.

Your breasts may become engorged even if you are formula feeding. If so, hand express or pump milk for relief, which you can also do if you are breast feeding.

Breastfeeding should not hurt. You should call your Lactation Support Resources if you have pain in your breasts that won’t go away after your baby starts feeding; your nipples are cracked, blistered, red, or bleeding; you are unsure if your baby is feeding effectively, or if your breasts are not draining enough.

You may continue to feel some aches and pains from birth, including some cramping. If heat or cold packs do not offer relief, physical movement may help – but make sure you follow your health care provider’s instructions on exercise.

It is also common to be constipated after giving birth, especially if you are taking pain medicine. Make sure you follow the directions in your After Visit Summary about what to eat and drink. Talk to your health care provider before using any stool softener or laxative.

More than half of all new mothers feel depressed after giving birth, usually within three or four days. There are a number of reasons for this, including lack of sleep, feeling overwhelmed, and hormonal changes in your body.

You may feel sad, anxious, or have trouble sleeping or eating. You may have low energy and feel like doing nothing – followed by periods of high energy where you are overly excited and want to do too much.

Although these feelings may be scary at times, just remember that postpartum depression is common, and that it eventually goes away. It is important to get enough rest if you are too anxious, and to try to move your body if you feel tired much of the time.

Talking about your feelings with your partner, family member, or a close friend is very helpful during this time.

It is also very helpful to use some of the alternative therapies you learned about in chapter one. Aromatherapy, guided imagery, massage, and other mind-body skills are excellent ways to help you feel grounded, so you can continue to care for your baby and yourself.

If your feelings of depression seem to be too overwhelming and will not go away, call your health care provider. Help is always available.

During your postpartum recovery at home, it is very important to keep all your follow-up appointments with your health care team – who can address any questions or concerns you may have about how to care for yourself and your baby as you recover at home.

Your health care provider is always available and prepared to help you deal with what may seem like a difficult time in your life – but which can also be a time of great joy. Just remember that you and your baby are not alone. Allina Health will be there for both of you.

Planned Cesarean birth

You may have a planned Cesarean birth. This means that you and your health care provider know before your labor begins that this is the way your baby will be born. A Cesarean birth might be planned if:

  • you've previously had a Cesarean
  • you've had complications in a previous birth
  • your baby is breech (your baby's buttocks, feet or both are closest to the cervix)
  • you have placenta previa (the placenta is covering some or all of the cervix)

If you know you will be having a Cesarean, talk with your health care provider about the reason. Ask all of your questions and raise all of the concerns you have. Consider asking your partner, family member, or a friend to come to that visit.

Unplanned Cesarean birth

You may have an unplanned, emergency Cesarean. This might happen because of your baby's position, size or health, or because of your own health. A decision for an unplanned Cesarean birth can occur over several hours or happen quickly.

If it happens quickly, you may not feel that you've had enough time to ask questions or adjust to this new idea. In an emergency, you may be prepped for surgery quickly and be unconscious during the birth. It is important to talk with your health care provider after the surgery so that your questions can be answered and your feelings addressed.

What to expect during your Cesarean birth

  • You will need to sign a surgery consent form.
  • Your nurse and other staff will prepare you for surgery.
  • Your heart rate, blood pressure and temperature will be checked.
  • An IV will be started if you don't already have one.
  • Blood will be drawn to check for anemia and to type your blood. Blood typing is done in case you need a transfusion.
  • Your pubic hair will be clipped.
  • A small tube, called a catheter, will be placed in your bladder to drain urine.
  • You may be given an antacid to drink.
  • An anesthesia department staff member will discuss the best anesthesia choice for you and your baby. The type of anesthesia depends on the reason for the Cesarean birth. For more information, see the chart "Anesthesia medicine for Cesarean birth" at the bottom of this page (also available as a PDF).
  • You will be moved to an operating room.
  • You will be placed on a narrow bed with a safety strap placed across your legs.
  • A blood pressure cuff will be put on one arm.
  • A clip will be placed on your finger to monitor the amount of oxygen in your blood.
  • Patches will be placed on your chest to monitor your breathing and heart rate.
  • You will breathe oxygen through a mask.
  • Sterile drapes will be placed on your abdomen and legs.
  • The anesthesia staff and your health care provider will make sure that you are numb or unconscious before starting surgery.
  • Your partner, family member or labor companion is welcome at the birth. He or she will change into scrub clothes and must not touch any of the surgical drapes, gowns or any of the instruments. This is to protect you and your baby from infection.

    Your labor companion can sit on a stool behind your head. There will be a cloth screen across your abdomen to help keep the surgery area sterile. Although some operating rooms have mirrors, neither you nor your labor companion will see the actual surgery.
  • The incision on your skin will probably be a low transverse, or bikini, incision. It is horizontal and across the upper edge of your pubic hairline.
  • The incision on your uterus will probably also be low-transverse. If not, it will be a vertical, or midline, incision. Your health care provider will tell you which type of incision was made on your uterus. This is important to know for future pregnancies.
  • When your baby is lifted out and the umbilical cord cut, you may feel pressure at the top of your uterus. Your doctor may lift your baby over the cloth screen so that you can see, or may place your baby directly in a heated warmer. If your baby is doing well she may be possible to have skin-to-skin contact right after birth. A nurse will examine your baby.
  • Your baby's Apgar score will be assessed.
  • If your baby is premature or has special needs, she may go to a special nursery.
    • If your baby is in a special care nursery or a newborn intensive care unit, you may be taken there to see your baby before you are settled into your room.
    • If your baby has to be moved to another hospital for special care, you may be able to see and touch your baby before she is transported. This depends on whether you are awake and well enough before she leaves. You will be kept informed of your baby's progress. (Talk with your doctor to see if you will be discharged from the hospital early to go to the other hospital to see your baby.)
  • Identification bracelets will be placed on your baby's ankle, wrist or both, your wrist and your labor companion's wrist.
  • You and your labor companion may be able to touch and hold your baby and take pictures while still in the operating room.
  • Your baby may stay with you in the operating room or go to the nursery.
  • After your incisions are closed, you will stay in recovery for one to two hours. Later, you will go to your room.
Anesthesia medicine for Cesarean birth
Medicine   Purpose  Method  Effects
 Epidural Blocks pain and allows you to be awake for the birth; you may feel pressure and tugging.
An anesthesiologist places a small catheter in your back, and medicine flows through it into the epidural space; takes effect within five to 10 minutes; lasts as long as needed; more anesthesia is used than is used for a vaginal birth so you will not feel pain during surgery.
Oxygen will be given through a mask; you may feel nauseated.
 
 Spinal Blocks pain and allows you to be awake for the birth; numbs you from below the breasts to the toes; you'll be unable to move your legs.
Similar to epidural above, except medicine is injected directly into the spinal fluid; usually a one-time dose rather than a continuous infusion; lasts one to three hours.
 
You will be given oxygen through a mask; you may feel nauseated; you have a small chance of headache later; you may need to lie flat for a time.
 General You are unconscious during surgery; used in an emergency to allow a quick birth.
An injection through an IV makes you unconscious; then a tube in your throat gives you inhaled medicine; given by an anesthesiologist.
 
Your baby is born quickly, minimizing side effects; your baby may be a little sleepy; after the birth, you may feel groggy and have a sore throat.

Source: Allina Health's Patient Education Department, Beginnings: Pregnancy, Birth and Beyond, seventh edition, ob-ah-90026
First Published: 10/04/2002
Last Reviewed: 12/02/2015