A caesarean section is a surgical operation. Compared with a normal birth, caesarean sections are associated with a greater risk of complications for both the mother and the child, both immediately and in the longer term.
Caesarean sections must therefore only be performed when they are absolutely necessary and there is a medical reason behind the decision to carry out the procedure. This means that pregnant women cannot demand that they have a caesarean section unless there is a medical reason behind the procedure.
Planned caesarean section
Illustration: Phuchong Choksamai / Mostphotos
If it is decided that you should give birth via caesarean section, the child will be born a little before the due date determined during the ultrasound examination in week 18. The date on which the caesarean section is performed will be determined towards the end of your pregnancy, depending on the reason for the operation.
Once the date of the caesarean section has been decided, you will be told when to go to the hospital, the preparations that must be made before the operation and the general rules that you must follow after your operation.
You will normally be asked to go to the hospital on the day before or a few days before the operation in order for you to have blood samples taken and to speak to the obstetrician, anaesthesiologist and midwife. Some people go home after this and return to the hospital on the morning of the day on which the operation will be performed, while other people stay overnight at the hospital on the night before the operation.
Anaesthesia
In the case of planned caesarean sections, you will normally be given an epidural or spinal anaesthetic. You can be awake during the operation, but you will not be able to see what the doctors are doing and you will not feel any pain. You will hear the child’s first cry, you will be able to see and, whenever possible, hold your child immediately after it is born. Your companion will also be able to attend the operation and experience it with you.
Physical skin-to-skin contact between mother and child immediately after birth is important both for establishing breastfeeding and for bonding. In the case of caesarean sections, the hospital will arrange for this wherever possible.
As soon as your child is born, he or she will be cleaned up and placed on your chest if you are well enough. Skin-to-skin contact is good for both mother and child.
Illustration: Irina Schmidt / Mostphotos
Emergency caesarean section
In the event of complications during childbirth, it may be necessary to perform an emergency caesarean section. The obstetrician will be responsible for deciding whether a caesarean section should be performed and, if so, how urgent the procedure is.
The main difference between a planned and an emergency caesarean section for you and your companion is the time that the staff have to prepare for the operation and explain to you what is involved.
If the operation has to be performed immediately because of your child’s condition or your health, it will be important to act quickly. This will reduce the amount of time that is available to give you information and explain what is about to happen. This information can then be given once the operation is over.
After a caesarean section
After a caesarean section, you will need more time and support to recover. The support given in the maternity ward will be based on your individual needs. How long you have to stay in hospital can vary, although it will normally be a few days. Your return home will be agreed with you based on your needs and those of your baby.
Surgical wound following a caesarean section
It is important that you monitor your surgical wound for any signs of infection. Possible signs of infection are:
- Red and irritated skin around the wound
- Swelling
- Fluid leaking from the wound
- Fever or pain
If you notice any of these symptoms, you should consult a doctor. All women who give birth via caesarean section will receive a questionnaire about 4-6 weeks after their operation about the procedure, especially if there have been any signs of infection after the operation.
The first six weeks after the operation
The surgical wound should not be a burden for you during the first six weeks after your operation. It is therefore important that you:
- Avoid heavy housework, such as vacuuming and floor cleaning
- Avoid heavy lifting, such as lifting of older siblings, shopping bags, pushchairs in and out of the car, etc.
- You can do light exercises for your stomach, but you should wait at least 12 weeks before doing any sit-ups
- Hold your wound when you cough and sneeze.
Reactions after caesarean section
After giving birth, particularly if the birth did not happen as you expected, you will be left with many questions which make it difficult to understand what and why what happened actually happened in the way it did. Some people may also experience a mental and/or physical reaction.
If your birthing experience was negative, it may be a good idea to speak to someone who was present during the birth or other health professionals who can explain to you what happened and why. If you would like to discuss what happened, speak to the staff in the maternity ward or the midwife or doctor who looked after you during your pregnancy.
Activity and rest following a caesarean section
After you have given birth, it is important that you give your body time to recover after the pregnancy and childbirth. Rest is just as important as activity, and it is a good idea to have several fairly long rests every day. Feel free to ask a midwife or physiotherapist for tips for good resting positions.
It will be good for you to move around. Feel free to go for walks. Start with short walks and then gradually increase the length of your walks. You can push the pushchair yourself, but try to avoid steeper hills at first.
Your pelvic floor muscles will be stretched after your pregnancy. Exercising your pelvic floor muscles is just as important for mothers who have given birth via caesarean section as it is for those who have given birth in the normal way. You can start exercises straight away after the birth.