When it comes to giving birth, the end goal is the delivery of a healthy baby by a healthy mom.  How we get there will be one of two ways:  vaginal birth or surgical delivery by caesarean section (c-section). 

Elective and emergency c-sections, what’s the difference?

The majority of deliveries in hospitals are vaginal deliveries but there are also several babies delivered by c-section. It could be an elective surgery where it is preplanned for whatever reason, you have a date and a time that you come to the hospital for and that is when your baby is born! 

Of course, there are also emergency c-sections done at any time!  A mom who is scheduled for an elective surgery may come in early or any mom in labour runs the risk of her labour ending in surgery.

Can I ask for a c-section?

Pregnant women have a right to choose a c-section for non-medical reasons however health care providers usually recommend that c-sections only be done for medical reasons.

Not too long ago, I did a prenatal class with a couple and a few weeks after the class they emailed me to tell me that they did some more research and decided a vaginal delivery was not for them and they wanted a c-section.  The couple asked me how to navigate this.  I recommended she talk to her doctor and advised that her doctor would go over the risk to having a c-section and if her doctor wasn’t able to do the surgery then they would have to make a referral to another doctor who could.  After talking with her doctor, she chose an elective c-section with no medical indication.  After weighing the pros and cons, this was the right decision for this family.

Risks and what to expect

C-sections are major abdominal surgery and therefore come with more risks than a vaginal delivery.  Typically, c-sections result in a slightly longer hospital stay, higher infection rates and longer recovery times.  Ideally, patients that are going for a c-section have not had anything to eat or drink for several hours.  They would have an IV placed and prepped for surgery.  The nurses will start with a checklist to review their health history and their wishes.  The doctor will come and sign a consent and at that time they will review the risks of the surgery such as blood loss, infections, blood clots and injury to other organs. 

After the surgery is over, mom will move to the recovery room for the next couple hours.  Even though a c-section is major abdominal surgery mom’s bounce back pretty well.  We are lucky that c-sections are done on pregnant women who are younger, often healthier population of women and pregnancy is the one time in your life where you have extra blood circulating.  So…a younger, healthier person with extra blood – that’s an ideal person to undergo surgery! In the recovery room, mom’s will often have some sips of water, be able to tolerate sitting up and hold/feed their baby.  If a mom has had more blood loss then these things are hard to do, so she may need some medications for nausea and need to stay lying down a little flatter.

After a c-section, moms will have a dressing (large Band-Aid) over the incision.  C-section incisions are horizontal lower bikini line and only big enough to get a baby out, about 10cms.  That dressing will be advised to stay on for the first 24 hours.  After that it can come off and you can care for the area the same as the rest of the body, just with warm soapy water.  You may notice some bruising and tenderness around where the cut was made.  The incision is usually closed with stitches and these stiches dissolve as your body heals.  

It does take 4-6 weeks to fully recover from a c-section.  Similar to other major abdominal surgeries, there are a few rules to follow.  You don’t want to lift anything heavier than 10lbs during the 4-6 weeks, so this might mean the baby in the car seat is to heavy for you to lift. You also have to be really cautious with stairs, the up and down motion can be hard on the lower abdomen.  Finally, no pushing and pulling motions, such as vacuuming for 4-6 weeks.  Even though your baby didn’t deliver vaginally you can still expect the vaginal bleeding to occur postpartum.  Usually, it is a little lighter and doesn’t last for as long compared to a vaginal delivery but it can still be present and continue for the 4-6 weeks postpartum.

The hospital stay isn’t hugely extended, after a vaginal delivery patients stay in the hospital usually around 24-48 hours and after a c-section about 1 extra day, so more like 2-3 days.  

Pain management postpartum looks similar as a vaginal delivery where narcotics are usually not prescribed.  Pain is managed with Tylenol and NSAID’s such as Naproxen and Toradol.  C-section moms just need to take these medications around the clock to stay on top of the pain whereas vaginal delivery moms can just take medications as needed.

An important thing to consider if you are going back and forth over whether a vaginal delivery or a c-section is right for you might be how big of a family you want.  Once you have had one c-section there is usually an option for a vaginal delivery after caesarean (VBAC), your healthcare provider would go over this with a future pregnancy.  However, once you have more than two c-sections the recommendations are often only c-sections from there on. The more surgeries you have on your uterus the higher the risk the pregnancies become.  There is a risk that the uterus has thinned out where it has been cut and could rupture.

If you are unsure about delivery, do what the couple I described above did and take a prenatal class to get educated on all of it!  If you have done your research and feel strongly about your baby delivering by an elective c-section then talk to your doctor about it.  After you have all the information, make the decision that feels right for you for now as well as for your future.  You got this!

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