Caesarean Delivery

A caesarean delivers your baby through a cut in the lower abdomen and a second cut in the lower part of the uterus. The abdominal cut is horizontal and sits low, just above the pubic hairline, so the scar is covered by underwear once it has settled. It is about fifteen to twenty centimetres long and fades over the first year to a thin pale line.

It may be planned weeks ahead or decided once labour is under way, and the operation itself is much the same in both cases. A planned caesarean is booked for a date your obstetrician chooses. One decided during labour is called an emergency caesarean whatever the level of urgency, and most are done with enough time to explain everything and answer your questions first.

A caesarean is major abdominal surgery and it is also a birth. You are normally awake, your partner can usually be in theatre with you, the baby is lifted out within the first few minutes, and skin-to-skin contact can often begin on the operating table once the team is satisfied that the baby is breathing well.

You are given a spinal anaesthetic, injected into the lower back while you sit leaning forward or lie curled on your side. It takes a few minutes to numb you from the chest down and you stay awake throughout. A drip goes into your arm, a catheter into the bladder, and a screen is placed at chest height so you do not see the operating field. A general anaesthetic is used only where a spinal is unsuitable or there is no time for one.

The operation takes about forty-five minutes to an hour. Your baby is usually delivered within the first ten minutes and the rest of the time is spent delivering the placenta and closing the uterus and the layers of the abdominal wall. You will feel pulling, pressure and rocking while that happens and no sharp pain; tell the anaesthetist at once if you feel anything more, because more can be given.

You are watched in a recovery area for a couple of hours and then moved to the ward, and you will be in hospital for about three to four nights. The catheter comes out the morning after, you will be helped to sit and then walk within about twelve hours, and feeding can usually start within the first hour.

The first two days are the sorest. Take the pain relief on schedule instead of waiting to need it, because being comfortable enough to move, feed and cough is what prevents most of the complications. Wind pain in the days after is common and walking shifts it faster than anything else. If your stitches or clips are the kind that need removing, that is done around day five to seven.

Bleeding from the vagina continues for two to six weeks and gradually lightens. Keep the wound clean and dry and look at it daily. Lift nothing heavier than your baby for six weeks, and expect to be able to walk comfortably for twenty minutes by about week three. Most women return to desk work at six to eight weeks and to heavier work later.

Driving is usually possible at four to six weeks, once you can perform an emergency stop and check your blind spot without hesitating because of the scar; confirm it with your insurer. Sex is generally advised after six weeks and once bleeding has stopped and you feel ready. Numbness in the skin above the scar is normal and takes months to a year to fade, and some of it may be permanent.