A Caesarean section is a type of surgery used to deliver a baby. The baby is removed from the mother's abdomen and uterus through two separate procedures.
According to the most recent birth statistics from the Centers for Disease Control and Prevention, nearly one third of pregnant women in the United States gave birth by Caesarean section in 2020. The World Health Organization says that 21 percent of babies are born by C-section, but only 7 percent were delivered this way in 1990.
The increased rates of Caesarean deliveries have been linked to a variety of factors, from rising rates of diabetes to multiple births and increased maternal age.
Other reasons for high C-section rates include the use of epidurals and techniques that induce labor, which may cause complications that could result in the need to perform a surgical delivery.
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Although Caesarean births can be life saving for both mother and baby, the American College of Obstetricians and Gynecologists has expressed concern that C-section deliveries might be overused, and they have recommended ways to reduce the national rate.
The new guidelines call for women with low-risk pregnancies to spend more time in the first-stage of labor, as well as encouraging them to avoid excessive weight gain during their pregnancies.
Dr. Allison Bryant is a maternal fetal medicine specialist at Massachusetts General Hospital.
She said that most women who deliver their first baby by C-section will end up having a repeat C-section somewhere down the road.
If a woman has already had a C section for a previous birth, she may be advised to do it again if she has another baby. Women who have had C-sections and attempt to deliver their next children vaginally, which is called a VBAC, may have a relatively low rate of hospital stays, such as needing blood transfusions or hysterectomies.
Bryant said it was important to understand why one-third of American babies are delivered by Caesarean. She explained that we need to figure out which babies need to be delivered by C-section to protect their health and which surgeries may be unnecessary.
Bryant said that educating women about the benefits of vaginal delivery is one way to possibly reduce C-section rates.
The following information will explain what a C-section is and how a woman may feel after it.
An IV will be placed in a woman's arm or hand to give her the fluids and medications she will need during surgery. Her pubic hair may be clipped or trimmed.
A catheter is placed into a woman's bladder to remove urine, and it will stay there for up to 18 hours.
Regional anesthesia, which numbs the lower half of the woman's body, will allow her to be awake when her baby is born. Bryant said that this tends to be safer than general anesthesia, where a woman would be asleep during the delivery.
The doctor will use a knife to make a horizontal incision in the skin and the abdominal wall, which will be covered up by underwear or a bikini bottom, Bryant said. She said that some women may get an up-and-down cut.
The uterus is opened after the abdomen is opened. Bryant said that a side-to-side cut is usually made, which causes the amniotic sac to be torn open. The baby is removed from the uterus, the cord is cut, and the placenta is removed after the protective membrane is torn. The baby is given back to the mother after being examined.
Bryant explained that the cut made to the uterus is important because it affects the ability to have a vaginal birth in the future.
Once the delivery and afterbirth are completed, the cuts made to the mother's uterus are repaired with stitches, which will eventually disappear under the skin, according to the Research Journal of Pharmaceutical Dosage Forms and Technology. Before a woman leaves the hospital, the abdominal skin is closed with stitches or a stapler.
Bryant said that a woman spends 60 to 120 minutes in the operating room for a C-section. A woman will be taken to the maternity ward after the surgery.
A woman may spend up to 4 days in the hospital after a C-section, but it may take up to 6 weeks to feel like herself again.
The skin and nerves in her abdomen will need time to heal after the surgery. Bryant said that most women use pain medications for about 2 weeks after surgery.
A woman may experience bleeding for up to 6 weeks after a surgical birth. She is advised to not have sex for a few weeks after her C-section and to avoid strenuous activities, such as lifting heavy objects, according to the Victoria State Government Department of Health.
The National Library of Medicine website has information about C-sections and related studies. The Royal College of Obstetricians and Gynaecologist has a document that can answer questions about C-sections.
Epidurals: Do They or Don't Increase Cesareans? The Journal of Perinatal Education was published in 2015.
The safe prevention of the primary Cesarean delivery is important. The American College of Obstetricians and Gynecologists.
A brief review on vaginal and Cesarean delivery. The Research Journal of Pharmaceutical Dosage Forms and Technology was published in 2020.
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