McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is a cesarean section?

A cesarean section is an abdominal operation performed to deliver a baby when delivery through the birth canal (vagina) is not possible or safe. The doctor makes a cut in the mother's abdomen and uterus to remove the baby. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

This procedure is also called a C-section. In the U.S. 15% to 25% of all births are by cesarean section.

You and your health care provider should discuss C-section delivery during your pregnancy so you are prepared if it becomes necessary.

When is it used?

A cesarean section may be performed before labor begins if there are medical reasons for not having labor or a vaginal delivery. For example, the health of the mother or the baby may be in danger if the pregnancy continues or vaginal delivery might be impossible or unsafe.

A cesarean section may also be done when labor begins or during labor if certain problems occur. For example, if at the time of delivery the lowest part of the baby is the face, brow, shoulder, or buttocks (breech), instead of the head, a cesarean section is usually necessary.

For many women in labor, the cervix begins to dilate and then stops before it is fully dilated. Oxytocin may be given to make the contractions stronger. Despite this drug, however, many women do not dilate fully and cannot deliver vaginally. Other women may dilate fully but may not be able to push their babies far enough down the birth canal for a safe vaginal birth. This may happen because the baby is too large for the woman's birth canal. A cesarean section may be performed in these situations.

At any time during labor a baby may develop problems that cause the baby's heartbeat to slow down. These problems may indicate that the baby cannot tolerate further labor and a cesarean section may be necessary.

How do I prepare for a cesarean section?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your health care provider. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

If you go into labor, call your health care provider.

What happens during the procedure?

You are given a regional or general anesthetic. A regional anesthetic numbs part of your body, preventing you from feeling pain while you remain awake. A general anesthetic relaxes your muscles, puts you to sleep, and also prevents you from feeling pain.

The doctor makes a cut below your belly button and into the lower part of the uterus to remove the baby. The doctor removes the baby, placenta, and birth sac. The doctor then sews the uterus and abdomen closed.

What happens after the procedure?

You may stay in the hospital about 2 to 4 days, depending on your condition.

Avoid heavy lifting for 6 weeks. After 6 weeks you may begin an exercise program to regain abdominal muscle tone. Ask your health care provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

Cesarean sections can save the lives of newborns and their mothers or prevent the potential complications of a delayed vaginal birth. Delivering the baby by cesarean section may be safer for you or the baby when:

• Labor is abnormal or ineffective.
• You have herpes virus infection in the genital area.
• The baby is in an abnormal position.
• The baby is having abnormal fetal heart rate patterns.
• You have severe preeclampsia (high blood pressure caused by pregnancy).
• You have a vertical scar on your uterus from a previous operation.
• You have a growth in the uterus (fibroid) that is blocking the birth canal.

In addition, some of the pain of labor may be avoided, and it may be possible to schedule the time of the delivery.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your health care provider.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. In most cases, regional anesthesia is considered safer than general anesthesia.
• A blood vessel may rupture or be cut and bleed internally.
• A piece of blood clot may break off, enter the bloodstream, and damage the lungs.
• The cut in the wall of the uterus may leave a weak part in the wall.
• Any future children may need to be delivered by cesarean section, depending on how this cesarean section was done.
• You may develop an infection or bleeding.

You should ask your health care provider how these risks apply to you.

When should I call my health care provider?

If you have just had a cesarean section, call your health care provider immediately if:

• You develop a fever.
• You have drainage from, or separation of, the incision.
• You have heavy bleeding from the vagina.
• You become dizzy or faint.
• You have leg pain, especially if you also have swelling and redness.
• You experience nausea and vomiting.
• You have chest pain.
• You become short of breath.

Call your health care provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.