If you're getting ready to deliver your baby by caesarean section, or if you've already had one, you're certainly not alone. Did you know that about 25% of Canadian babies today are born by C-section? Older and overweight moms are among those more likely to deliver their babies by caesarean. But women from all walks of life can and do have caesareans.

A caesarean is a surgical operation to deliver a baby safely when the doctor believes it will be a better option than a vaginal birth. A doctor makes an incision through the woman's abdominal wall and uterus to reach the baby. The mom is usually awake to welcome her baby, but medication keeps her from feeling any pain during the procedure.

In some cases, the C-section is scheduled in advance. The doctor may already be aware of certain risks, and may have recommended the procedure. Most of the time, though, the decision to have a caesarean is made only after labour has started and a problem unexpectedly crops up.

Why is a caesarean done?

There are many reasons why a baby might be delivered by C-section:

  • The baby is too big or isn't positioned properly. What this means: a vaginal delivery may be difficult, may cause injury, or may even be impossible.
  • Labour is taking too long or stops. What this means: a caesarean section may be needed to speed up the delivery.
  • The baby is in distress and the heart rate is no longer normal. What this means: the baby needs to be delivered quickly.
  • The placenta is in the wrong place, or it separates suddenly from the uterine wall. What this means: the placenta could block the path of the baby or cause heavy bleeding.
  • The umbilical cord has slipped down into the vagina. What this means: the cord could block or strangle the baby.
  • The mom has a medical condition like diabetes, high blood pressure, or HIV. What this means: she or the baby might get very sick from a regular delivery.
  • The baby has a medical problem. What this means: the baby may do better if delivered by caesarean.
  • The mom is having twins, triplets, or even more babies. What this means: one or more of the babies might not be positioned properly, or they may be at risk with a vaginal delivery.

Very often women have a caesarean section simply because they've had one in the past, even if there are no problems with their current pregnancy. But doctors now believe that well over half of all women who've had C-sections can have a vaginal birth later.

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What are the risks?

Although a caesarean section, also called C-section, is a common procedure and is considered safe, it is not free of the risk of complications. C-sections have more risks than vaginal births and it takes longer for the mother to recover from them. There is no way to predict exactly how a woman will go through the experience of a caesarean.

What women can expect:

  • With an intravenous (IV) in your arm and a sore tummy from surgery, you may find it uncomfortable or awkward to breast-feed your new baby. Working with a lactation consultant will help you find a breast-feeding position that works.
  • If you have had a C-section, you can expect a longer hospital stay than if you gave birth vaginally.
  • Pain and fatigue are common after a caesarean, even after returning home from the hospital. This can make it more difficult for you to look after your new baby. Caesarean moms should take it easy, rest, and get help around the house if possible.
  • Sudden movements like coughing or sneezing can hurt the tummy. Driving a car may be out of the question until you're feeling better.
  • You should avoid any heavy lifting for a few weeks. This may make caring for a toddler at home more challenging. Support from family and friends in these first few weeks will help.
  • Often, after a woman has had one C-section, a vaginal birth will be too risky to try in later pregnancies. However, many women who have had a C-section can go on to have safe vaginal deliveries with future pregnancies.
  • There may be a permanent scar from the surgery, although it will fade.
  • If the procedure was unexpected, caesarean moms may feel disappointed or disheartened because they were unable to have the vaginal birth they had planned. These feelings are normal. Keep in mind what really matters is that you and the baby are safe and healthy.

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What else can happen?

Although serious complications from caesarean sections are rare, as with any surgery, they are possible. Women who have had C-sections are more likely than other new moms to be readmitted to the hospital soon after their babies are born.

Risks to mom include:

  • blood clots
  • death - although very rare, it is more likely with a C-section than with a vaginal delivery
  • heavy bleeding, sometimes requiring a blood transfusion
  • heavy bleeding in later pregnancies (because of placenta problems)
  • infection, either around the incision or of internal organs
  • injury to the bladder, bowel, or other internal organs during surgery
  • reaction to medications

Risks to baby:

  • very rarely, injury to the baby during incision
  • breathing problems in the baby, which are usually temporary

A caesarean section is still the best choice if a vaginal birth poses greater risks to the mom or the baby. Their health and safety is top priority. And there are ways to reduce some of the risks associated with C-sections, such as taking daily walks to prevent blood clots. If you have questions or concerns about caesareans, speak with your doctor.

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Lisa Bendall, 
in association with the MediResource Clinical Team