Caesarean, C-section, Caesar, sunroof birth, tummy birth - no matter what you call it 35% of Australian women will have a caesarean Birth. April is Caesarean awareness month, and we thought that it would be an excellent opportunity to give you the c-section low down with what you need to know prior to birth, in the hospital and at home to recover from a Mama who has had a couple of babies, here is what I know now and what I learnt along the journey (and some of my tips). By educating yourself about caesarean births, you can prepare yourself for the possibility of needing one and have a better understanding of what to expect during the procedure and recovery. You can choose to have a C-section; you don't need a reason (you don't need to justify your decision to anyone). Most importantly know that c-section is NOT the easy way out and you are a birthing champion.
Pre-birth checklist
- Buy recovery shorts for the hospital
- Buy high black undies that don't sit on the scar - Buy soft high wasted stretch pants for after the birth (so the waste is above your scar) - Cook for your freezer (it is major surgery, and you need to recover when you get home plus look after your baby, you need good food to recover)
- Learn some relaxation techniques to use in the operating theatre
- Talk to your doctor about the type of c-section you would like if that becomes the best way to birth your baby or if you choose to have a c-section.
What to expect before your c-section
Before the c-section operation, they will make you fast (a c-section is a major abdominal surgery). You will wear a surgical gown, your partner will wear scrubs, and you will both wear those cute blue canteen hairnet/hat things. You can't wear nail polish or jewellery in some hospitals
C-section Operation
- There is a pre-op admissions room (at least 2 hours before op for elective C-section) - You can ask the doctor and theatre staff not to talk about footy, and you can have music for birth - You will be awake (only a small number are under general anesthesia) - The spinal/epidural can be scary (they may ask you to lean over a pillow and may ask your partner to step out - you will be in safe hands)
- A catheter is inserted and it is a quick process - Some hospitals will shave the area they will cut - The operating room is cold and bright with lots of people (2x OBs, 2x Midwives, Theatre staff, Pediatrician, Anesthetist); if private, they send you a bill afterwards, separate to your OB - You will be given fluid via an IV and hooked up to monitors - Traditional c-section, they will place a big blue sheet underneath your chest to block the view of the c-section (some operating theatres have a monitor you can see the operation on) - It is possible to touch your baby during op; you don't need a sheet up (maternally assisted birth - please ask your OB about this amazing option)
- 7 layers of tissue are opened - They use forceps to pull the baby out - It is a weird pulling sensation (rummaging in your stomach, like rummaging in your handbag) but not painful - Your partner can still cut the cord
- In most cases, they will wipe down the baby, weigh the baby, check the baby, give immunizations, wrap the baby and allow you a little cuddle while they sew you up. - You will be taken to the recovery room before your room - Special care is something that may happen (your partner will go with the baby) - You can breastfeed in the recovery room. Your milk may take longer to come in as there are no natural birth hormones (if the blood sugar of the baby is low they may give formula if you haven't expressed colostrum prior - talk to your OB about your breastfeeding preferences)
- They give you a suppository for pain in your bottom at the end of the operation (you won't feel it go in as you have a spinal in) - It is very quick only about 5 mins from incision to baby being birthed - There are different stitches (dissolvable, staples - talk to your OB about their method and if you can have steroids injections in your incision to help with scare healing) - You will have a roughly 10cm horizontal cut where they pull your baby out (in very rare cases you could have a vertical cut in an emergency if they need to get the baby out quickly
- There are some complication risks ask your OB about these (A rare complication is that your spinal fluid can leak from the spinal tap, they can accidentally cut your bladder during the operation, you can hemorrhage, your baby can get 'wet lungs' transient tachypnea during birth and may need a short stay in special care).
- It can be beautiful and empowering
C-section recovery
What to expect after the operation in the hospital - Get up and move (so you don't get blood clots, just a slow shuffle around the ward) - Catheter first night (then removed)
- Daily clexane injections (usually for 3 days)
- You will have intense uterus contractions - You will wear compression stockings, legs and feet very swollen from fluid given for the birth - Place a pad over your scar, so it doesn't catch on your pants - Ice scar with a pad on top for the first 24 hours off and on to help with healing and pain. - Op slows bowls (get a softener for first poo) - Get on your recovery shorts as soon as you can. They support the pelvic floor and hold it all together (hard to take off to wee but worth it) - Get out of bed from the side, knees together - Hold the C-section scar if you need to cough - Be careful of toddlers jumping on your bed (place a pillow over your stomach for protection).
- You will be sore (take the pain medication you are given; you need it, and it won't affect your baby)
C-section recovery at home
- Invest in help for the first 6-8 weeks at home - Your stitches can come undone if you lift (no lifting until eight weeks, only your baby, no heavy washing)
- Wound care staples or sutures (sutures are dissolvable, midwife removes staples) - Lifting arms to hang washing pulls at scar (get someone else to do it). - Night sweats are real (getting rid of IV fluid/bed wet) - Leg cramps are real (getting rid of fluid) - Pain rising throughout shoulders (gas leaving body they fill the stomach up for a room with surgery) - No driving for 6-8 weeks (can't slam foot on brake) - Keep up meds (it can be very hard to manage pain from 0. You need a constant level of pain relief) - It's normal for the scar area to be numb for a while
- It is important to rest (you have had major surgery) - When your partner moves in bed, it will hurt (you will miss your hospital electric bed, which can help you sit up and get out) - You can massage your scar and apply cream after six weeks - Your vagina will shrink. It doesn't know you had a C-section - Everyone gets stomach separation to see a woman's physio for exercises - See a women's physio as your pelvic floor can still be impacted - You will look pregnant for a few weeks - You will vaginally bleed for 4-6 weeks
- 1 in 4 mothers in Australia are diagnosed with postnatal depression, and the leading cause is a traumatic birth
- 1 in 10 Australian mothers will be diagnosed with post-traumatic stress disorder following their birth, so if you had an emergency C-section, it is worth booking in to see a perinatal psychologist or a counsellor with that you can talk about your experience with
- The pain will eventually go away (the first two weeks are the worst)
- You can feel extremely disappointed and judged if you end up with a C-section and it wasn't your plan (know you are a birthing legend and C-sections can save both your and your baby's life) - You will get better, hang in there
- You can do this!
Although it can be painful, you should feel so proud to be a C-Section Mama. I have had four births, 2 of which were vaginal, and a C-Section is not the 'easy way out'. Know that you can choose a C-section birth if you like; if you know what to expect, it can be an absolutely positive, empowering experience. Please look up the video section of our @parentsyouvegotthis_au Instagram to watch a couple of Maternally Assisted Caesareans performed by our OB Expert, Dr Peter Jurcevic, to see how empowered your C-section birth can be.
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To learn about what to expect for any sort of birth book into our Virtual Birth or In-person Birth Masterclass.
If you have to have a C-section, you can do anything, be proud of your birth and know you have this!
