About a third of all the births in the USA are cesarean sections. We give you here a detailed step-by-step photo essay on a c-section birth.
The decision to have a cesarean can arise before labor, often called a planned or scheduled cesarean. Common reasons to schedule a cesarean before labor may include a breech presentation, a previous cesarean where vaginal birth after cesarean (VBAC) is not advised or desired, and placenta previa.
The decision might also happen in labor – if the labor is taking too long, the mother or baby is not tolerating the labor well, or other issues arise, such as the baby being in a malposition. This is typically called an unplanned cesarean.
In a few cases, it can be a true emergency, like in the case of a placental abruption or severe bleeding.
1. The Process Begins
After you have received your anesthesia, usually a spinal or epidural and all that entails, you will be ready for surgery. The anesthesia can take a while to take effect, even 20–30 minutes. The powerful numbing will happen quickly and effectively.
In this photo you will see that the mother has been draped with sterile drapes and is in the operating room as they make the initial incision into her abdomen.
While you receive your anesthesia, the room will be quite busy as the other nurses and doctors prepare the room with instruments and prepare the warmer for the baby.
2. Multiple Layers of Incisions
There are multiple layers that your surgeon must go through before reaching the baby. All in all, it takes about 5–10 minutes from the start of the surgery until the birth of your baby.
The doctor will use a combination of sharp instruments and blunt dissection as s/he goes through each layer. You may also hear whirring noises as a machine is used to cauterize or burn small blood vessels to prevent bleeding. Sometimes, there are strange smells, too.
Suctioning Amniotic Fluids
When the doctor reaches the uterus, the suctioning begins. After cutting through the uterus, the amniotic fluid will be suctioned away to make a bit more room in the uterus for the doctor’s hands or instruments such as forceps or a vacuum extractor.
4. The Baby’s Head Is Born
Your baby is usually engaged in the pelvis, generally head down, but perhaps rear first or breech. Whatever part has entered the pelvis will be lifted out by the doctors. You may feel pressure at this point and some women report feeling nauseated during this intense, but brief, moment.
The baby’s head is born! Once the head is out, your doctor will suction the baby’s nose and mouth for fluids. In a vaginal birth, these are normally squeezed out by the process of labor and birth.
In a cesarean birth, the baby needs some extra help getting rid of these fluids. If meconium is present, extra suctioning may be required.
5. Dislodging The Baby’s Head And Shoulders
At this stage, the surgeon will need to maneuver the baby back and forth to help with the birth. You may feel a wiggling sensation.
Once your baby has been well suctioned, the doctor will start to help the birth of the rest of the body. The doctor will check for umbilical cord entanglement or other complications as the body is born. You may also have the assistant surgeon pressing on the upper part of your abdomen of the fundus to assist in the birth.
6. The Birth Of The Baby’s Body
Your baby will usually be briefly held over the drape to be shown to you and then taken away by a nurse or neonatologist to a nearby warmer, depending on the set up of the operating room. With some prior planning, you can request to be skin-to-skin with your baby immediately while they finish the surgery.
Your baby’s warmer will be in the same room as your surgery. Here, the baby will be suctioned again to ensure that the amniotic fluid is cleared. Your baby may also have some basic care like weighing, measuring, vitamin K, etc.
The repair of the uterus and the layers that were cut during the surgery need to be completed before the end of the surgery. During this, the placenta will also be removed and examined by your doctor. This is the longest part of the cesarean section, which takes about 45–60 minutes to complete.
During this time, you can usually have your baby with you to breastfeed or hold. It can also be possible for your support person to hold the baby close to your face if you are unable to manage the weight.
Wound Care After The Surgery
After the surgical bit is finished, your surgeon will suture (sew) or staple your incision shut. It will be covered with a bandage.
You will be watched in the post-op area for at least an hour to ensure that your vital signs are stable and that you aren’t bleeding too heavily, though everyone will bleed vaginally from the healing uterus.
You will then be taken to your postpartum room. There you will spend the remainder of your stay, which is usually about 4 days.