Having a c-section

What is a c-section?

A c-section (short for Cesarean birth) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). Most babies are born through vaginal birth. But if there are problems with your pregnancy or with your baby’s health, you may need to have your baby by c-section.

A c-section can be planned (or scheduled), meaning you and your healthcare provider decide on a date based on your health and your baby’s health. In some cases, it may be an emergency c-section, which is performed immediately if there’s a risk to you or your baby’s health. C-sections should only be done for medical reasons.

What are the risks of having a c-section?

A c-section is major surgery and may lead to more complications than a vaginal birth, including:

• Infection in the incision (cut), uterus, or nearby areas, like your belly and bladder.
• Heavy blood loss that might require a transfusion.
• Injury to organs near the uterus, such as the bladder and intestines.
• Blood clots in the legs, pelvic area, or lungs, which can block blood flow. A blood clot is a solid mass or clump of blood that can block blood flow to parts of your body.
• Reactions to medications, including anesthesia, which numbs pain during surgery.
• Amniotic fluid embolism, which is a rare condition when baby cells, hair, or amniotic fluid enter the bloodstream during or after labor, which can cause a fast or irregular heartbeat, heart attack, or even death.

Although rare, there is a higher risk of death during a c-section than with a vaginal birth.

A c-section can cause other complications for you after giving birth, too. For example:

• You may have trouble breastfeeding. Women who have a c-section may be less likely to breastfeed than women who have a vaginal birth. Talk to your provider about what you can do to start breastfeeding as soon as possible after your c-section.
• You may need to stay in the hospital longer if you have a c-section instead of a vaginal birth.
• It may cause problems in future pregnancies. Once you have a c-section, you may be more likely in future pregnancies to have a c-section. The more c-sections you have, the more problems you and your baby may have, including problems with the placenta. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord. 
• A c-section also increases the risk of the uterus tearing along the scar line (uterine rupture) for women who try to have a vaginal birth for a future pregnancy. Some women who’ve had a c-section may be able to have a vaginal birth after c-section (also called VBAC). VBAC isn’t safe for all women, though. If your pregnancy is healthy and you’re planning to have more children later, it’s best to have your baby through vaginal birth unless there are medical reasons to have a c-section.

A c-section also can cause problems for your baby, including:

• Your baby may be born before 39 weeks. Babies need at least 39 weeks in the womb to grow and develop before they’re born. If you have your c-section too early, your baby may be born preterm (before 37 weeks of pregnancy). This can cause health problems for your baby at birth and later in life.
• Your baby may have breathing problems and other health problems.
• Your baby may be affected by anesthesia you get during your c-section. This may cause them to be inactive or sluggish.
• Your baby may be injured during the surgery.

What happens during a c-section?

Here’s what you can expect when you have a c-section:

Anesthesia: Most likely you can have regional anesthesia (like an epidural or a spinal block) that lets you stay awake for your baby’s birth. With a spinal block, you’re numb from below your breasts all the way down to your toes and it provides complete pain relief. With an epidural you won’t feel pain but you may be aware of tugging and pushing. If you have an emergency c-section, you may need general anesthesia. General anesthesia makes you go to sleep during surgery.

Before surgery:

1. The nurse washes and may shave your belly so the area is clean for surgery.
2. You get a catheter (tube) in your bladder to drain urine.
3. You get an IV (needle) in your hand or arm to give you fluids and medicine.
4. Massaging sleeves may be put around your legs to reduce the risk of blood clots during surgery .

During surgery:

1. When you’re numb, the doctor makes the first cut in your belly. In most cases, it’s a low transverse cut (also called a bikini cut) that goes across your belly, just above your pubic bone.
2. The doctor makes the next cut in the uterus. A horizontal (across) cut is best because it doesn’t bleed too much and heals well. Sometimes the doctor has to make a vertical (up and down) cut because of your baby’s size or position.
3. The doctor opens the amniotic sac and takes out the baby. You may feel some tugging, pulling and pressure.
4. Your health care team clears your baby’s mouth and nose of fluids. 
5. The doctor cuts the umbilical cord and removes the placenta.
6. The doctor closes the incisions with stitches or staples.

What’s recovery like after a c-section?

It usually takes longer to recover from a c-section than vaginal birth. You can expect to stay 2 to 4 days in the hospital after a c-section. Full recovery usually takes 4 to 6 weeks.

Here’s what you can do to feel better faster:

• Talk to your health care provider about pain medicine. They can recommend one that won’t hurt the baby while you’re breastfeeding. A heating pad may also help with pain.
• If your provider says it’s OK, get out of bed and walk around within 24 hours after surgery.  This can help you have a bowel movement and prevent blood clots. Make sure a nurse or another adult is there to help you the first few times you get out of bed.
• Call your provider if you have a fever or if your incision swells, is painful or gets more and more red. These could be signs of infection.
• Call your provider if you have leg pain, leaking from your cut, heavy bleeding or shortness of breath.
• To prevent infection, don’t have sex or put anything (including tampons) in your vagina for a few weeks after your c-section. Ask your health care provider when it’s safe to do these things again.
• Take it easy. Avoid hard activities, like lifting heavy things, for a few weeks. Try to sleep when your baby does. Try to keep everything you and your baby need within reach. 

How can you get ready for a c-section?

Here’s what you can do to prepare for your c-section:

• Learn as much as you can about c-sections. Ask your provider about what to expect and about different kinds of anesthesia. Talk to friends and family members who have had a c-section.
• Get help at home. Ask friends or family to be there after your baby’s born to help take care of the baby, other children and household tasks.
• Ask if your partner can be with you in the operating room.
• If you think you want to watch your baby’s birth, tell your provider and the nurses at the hospital.
• Tell your provider and the nurses that you want to hold the baby right after birth. This should be OK unless your baby needs medical attention. You can breastfeed right after birth, too.

What if you feel badly about needing to have a c-section?

Some women who have a c-section may feel disappointed that they didn’t have a vaginal birth. Their partners may feel this way, too. If you feel disappointed, angry or depressed after having a c-section, here’s what you can do:

• Remember that having a healthy baby is more important than how the baby is born.
• Ask your provider to explain why you needed a c-section. This can help you understand why it was best for you and your baby.
• Remember that you can’t control everything. Sometimes unexpected events make a c-section the safest choice.
• Don’t worry if you get emotional after your baby’s birth. Some of your feelings may be caused by hormonal changes that many women experience after having a baby.
• Share your feelings with your partner, family, friends or provider.
• If you have feelings of sadness or anger that don’t go away after 2 weeks, tell your provider.

Last reviewed: November 2024

See also: 39 weeks infographic