During the procedure
While the process can vary, depending on why the procedure is being done, most C-sections involve these steps:
- At home. While research suggests the benefit is unclear, you might be asked to bathe with an antiseptic soap before your C-section to reduce the risk of infection. Don't shave your pubic hair. This can increase the risk of surgical site infection. If your pubic hair needs to be removed, it will be trimmed just before surgery.
- At the hospital. Before your C-section, your abdomen will be cleansed. A tube (catheter) will likely be placed into your bladder to collect urine. Intravenous (IV) lines will be placed in a vein in your hand or arm to provide fluid and medication. You might be given an antacid to reduce the risk of an upset stomach during the procedure.
- Anesthesia. Most C-sections are done under regional anesthesia, which numbs only the lower part of your body — allowing you to remain awake during the procedure. A common choice is a spinal block, in which pain medication is injected directly into the sac surrounding your spinal cord. In an emergency, general anesthesia is sometimes needed. With general anesthesia, you won't be able to see, feel or hear anything during the birth.
- Abdominal incision. The doctor will make an incision through your abdominal wall. It's usually done horizontally near the pubic hairline (bikini incision). If a large incision is needed or your baby must be delivered very quickly, the doctor might make a vertical incision from just below the navel to just above the pubic bone. Your doctor will then make incisions – layer by layer – through your fatty tissue and connective tissue and separate the abdominal muscle to access your abdominal cavity.
- Uterine incision. The uterine incision is then made — usually horizontally across the lower part of the uterus (low transverse incision). Other types of uterine incisions might be used depending on the baby's position within your uterus and whether you have complications, such as placenta previa — when the placenta partially or completely blocks the uterus.
- Delivery. The baby will be delivered through the incisions. The doctor will clear your baby's mouth and nose of fluids, then clamp and cut the umbilical cord. The placenta will be removed from your uterus, and the incisions will be closed with sutures.
If you have regional anesthesia, you'll be able to hear and see the baby right after delivery.
After the procedure
After a C-section, most mothers and babies stay in the hospital for two to three days. To control pain as the anesthesia wears off, you might use a pump that allows you to adjust the dose of intravenous (IV) pain medication.
Soon after your C-section, you'll be encouraged to get up and walk. Moving around can speed your recovery and help prevent constipation and potentially dangerous blood clots.
While you're in the hospital, your health care team will monitor your incision for signs of infection. They'll also monitor your movement, how much fluid you're drinking, and bladder and bowel function.
You will be able to start breast-feeding as soon as you feel up to it. Ask your nurse or a lactation consultant to teach you how to position yourself and support your baby so that you're comfortable. Your health care team will select medications for your post-surgical pain with breast-feeding in mind. Continuing to take the medication shouldn't interfere with breast-feeding. Pain control is important since pain interferes with the release of oxytocin, a hormone that helps your milk flow.
Before you leave the hospital, talk with your health care provider about any preventive care you might need, including vaccinations. Making sure your vaccinations are current can help protect your health and your baby's health.
When you go home
While you're recovering:
- Take it easy. Rest when possible. Try to keep everything that you and your baby might need within reach. For the first few weeks, avoid lifting from a squatting position or lifting anything heavier than your baby.
- Support your abdomen. Use pillows for extra support while breast-feeding. A pregnancy belt might provide additional support.
- Drink plenty of fluids. Drinking water and other fluids can help replace the fluid lost during delivery and breast-feeding, as well as prevent constipation.
- Take medication as needed. Your health care provider might recommend acetaminophen (Tylenol, others) or other medications to relieve pain. Most pain relief medications are safe for women who are breast-feeding.
- Avoid sex. Don't have sex until your health care provider gives you the green light — often four to six weeks after surgery. You don't have to give up on intimacy in the meantime, though. Spend time with your partner, even if it's just a few minutes in the morning or after the baby goes to sleep at night.
Contact your health care provider if you experience:
- Any signs of infection — such as a fever higher than 100.4 F (38 C), severe pain in your abdomen, or redness, swelling and discharge at your incision site
- Breast pain accompanied by redness or fever
- Foul-smelling vaginal discharge
- Painful urination
- Heavy bleeding that soaks a sanitary napkin within an hour or bleeding that continues longer than eight weeks after delivery
Postpartum depression — which can cause severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life — is sometimes a concern as well. Contact your health care provider if you suspect that you're depressed. It's especially important to seek help if your signs and symptoms don't fade on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
Aug. 04, 2015
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