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Pregnancy

      C Sections - your guide to Caesarean births

      Hospital

      Preparing for the birth of your baby is an exciting time. There’s a lot to think about, and your head’s probably swimming with questions. What do you need to pack in your hospital bag? Who will be your birth partner? What are your pain relief options? And of course, how would you like your baby to be born?

      You might have a good idea of the kind of birthing experience you’re hoping for. However, as with anything in life, it’s never a bad thing to understand all of the potential possibilities. And when it comes to giving birth, a C section is one of those possibilities.

      In this article, we’ll do our best to tell you everything you need to know about C sections. From an elective C section and what’s involved, to C section recovery and those all important do’s and don'ts.

      Did you know?
      It’s been suggested that the origins of Caesarean birth go as far back as ancient Roman times1!

      Midwife scan

      What if I need a C section?

      Well, that’s OK. There are a number of reasons why a C section could be the right birth journey for you.

      Your instincts may have led you to choose a Caesarean birth. This is known as an elective C section, or planned C section (more about this later). Or it might be that together with your doctor and/or midwife, you’ve agreed that the best and safest way for your baby to be born is by C section2.  

      Sometimes, the decision to deliver a baby by C section is taken during labour, which can be a little daunting for mums and their birth partners. But don’t worry, here you’ll find everything you need to know about C sections. We’ll give you the peace of mind you need so that when the time comes to meet your baby, you’ll be fully prepared. 

      Why might I need a C section?

      You might be offered a C section if3

      • Your baby is breech (bum first!) or in another awkward position.
      • Your placenta is low in your uterus or blocking your baby’s exit (placenta previa). 
      • The umbilical cord falls forwards, making a vaginal delivery tricky (cord prolapse). 
      • Your baby is bigger than anticipated and may struggle to fit  through your pelvis. 
      • You’re expecting three or more babies. Or, if you’re carrying twins and the first baby isn’t head down.
      • Your baby’s health is at risk during labour and your doctor needs to speed up their arrival. 
      • You have a pregnancy related health condition (for example, pre-eclampsia).  
      • You have an outbreak of genital herpes that you could pass onto your baby. 

      Rest assured.
      Birth is birth. Whichever way your baby comes into the world, what matters is that they do so safely, happily and ready to start their life journey.

      What is an elective C section?

      A Caesarean birth involves your baby being delivered through the lower part of your tummy (the abdomen), just below your bikini line4. A Caesarean birth may leave you with a mark known as a C section scar, which in most cases fades over time5

      An elective C section is one which is planned in advance, before you go into labour6, and your doctor and midwife should talk you through what’s going to happen and answer any questions you have.

      Can I request a C section?

      Yes. Some women opt for a Caesarean birth for non-health related reasons. If you’re feeling anxious or worried about having a vaginal birth, make sure that you talk about this with your midwife or doctor. They’ll be able to talk you through the pros and cons of a C section and together, you can make a choice that’s right for you and your baby.

      Did you know?
      Around one in four women expecting a baby in the UK have a C section7.

      Are there any C section risks?

      Rest assured that in the main, a C section is a very safe procedure8. However, if you’re considering a C section, then it’s only sensible to be aware of the risks involved,  no matter how small.

      What are the C section risks9 for you?

      • It’s quite common for your C section scar or the lining of your womb to become infected.
      • Another common problem is an infection in the lining of your womb. Signs to look out for are tummy pain, heavy vaginal bleeding, abnormal discharge and fever.
      • You may develop a blood clot in your leg, a condition known as deep vein thrombosis (DVT). This can be quite painful and cause swelling. It’s very important that you seek medical help if this occurs as, if left untreated, the blood clot can travel to your lungs.
      • While very uncommon, you may experience excessive bleeding during or following the operation. In some cases, a blood transfusion may be required.
      • On rare occasions, a C section can cause damage to your kidneys and bladder which may require another operation. 

      What are the C section risks for your baby?

      As an expectant mum, you want to do everything you can to minimise risks to your baby. Whilst minimal, it’s good to be in the know about the risks a C section carries for your baby. Then you can make an informed decision about the way your baby is born.

      After a C section, you may notice that your baby has a small cut in their skin. This sometimes happens when your tummy is opened, and usually heals very quickly. In addition, it’s not uncommon for your baby to experience some breathing difficulties following a C section, but this usually improves very quickly and rarely something to worry about10.

      If you have any questions about C section risks, you can always ask for further advice from your midwife or doctor.

      How long do you stay in hospital after a C section?

      The $64,000 question after the birth of any baby! And there’s no one size fits all answer. It all depends on the kind of birth you’ve had, how much recovery time you need and who you’ve got on hand to help.  

      As a ballpark, your stay in hospital following a C section could be anywhere between 24 hours and four days11. If you’re worried or anxious about returning home after your C section, talk to your midwife who should be able to provide you with the peace of mind you need. 

      Take care of you!
      Remember, a C section is a major operation. It’s very important to follow all of the medical advice you’re given to help your C section recovery go smoothly.

      C Section Scars and Recovery: Do’s and Don’ts

      Now you know the reasons why you might need a C section, what’s involved and the potential risks, it’s time to start focusing on how to recover once your baby arrives.

      Following your C section, you’ll have a horizontal incision mark that’s around 10-20cm long, and that sits just below your bikini line12. As time passes, this will fade and develop into a scar. It’s not uncommon for some women to worry about their C section scar. However, it’s likely to be very faint and will spend most of its time covered by your underwear!

      All in all, it takes around six weeks to fully recover from a C section13. Here’s a general idea of what to expect as life returns to a new normal!

      In your own time...
      Everybody is different. Your recovery time after your C section may not be the same as the other mums you know. And that’s OK. Take things at your own pace and listen to your body.

      This is a very common question. The answer is that it’s going to take a little while before you can get back behind the wheel. Ideally, you should wait until your C section scar has fully healed and you feel well enough drive without discomfort. This may take up to six weeks, and in some cases longer14.

      If you’re a gym bunny, the thought of not being able to go for your morning run might be a difficult one. But you need to give yourself some time before you jump back on the treadmill.

      If you feel up to it, you can start increasing your physical activity after approximately six weeks. Your doctor may advise you to avoid high impact and strenuous exercise for as long as 12 weeks15.

      Top Tip!
      Whilst you won’t be running any marathons immediately after your C section, there are some things you can do to stay active. Once you feel up to it and the pain has subsided, try some pelvic floor exercises and perhaps a gentle stroll.

      As exciting as it is to bring a new baby home, ready to start your new life as a family, it’s important for you and your partner to take time for yourselves and take care of your relationship.

      As a general rule, you should wait at least six weeks before having sex after having a C section16. Your six week postnatal check is the perfect opportunity to ask your GP about this, and any other questions you may have.

      If you’re craving a relaxing bath after the birth of your baby, who could blame you?! You’ll be happy to know that it’s absolutely fine to bathe and shower after having a C section, as long as you feel up to it17.

      In some cases, you may be advised to wait up to four weeks before you relax into the tub, depending on how your C section scar is healing.

      Here are our top tips to help you enjoy your post-baby bubbles:

      • Make the water lukewarm.
      • Use only very gentle bath products so as not to aggravate your incision.
      • Always pat your C section scar dry - never rub it with a towel.

      Whilst sleep doesn’t spring immediately to mind when you think of newborn babies, trust us when we say, it’s important that you get your fair share of those 40 winks.

      Getting in and out of bed, finding a comfortable position - these are all things that can prove tricky when thinking about how to sleep after a C section. Try laying flat on your back, or on a slight incline. You may even find it comfortable to sleep in an upright position. Try using cushions and pillows for some comfy, cosy support. Some women find it more comfortable to sleep on their side, so see if that works for you.

      Did you know?
      Sleeping on your left side is better for blood flow and digestion18.

      C section scar problems

      If you follow all of the advice you’re given to help your C section recovery, there’s no reason why you would have any problems with your C section scar.

      However, C section scar problems do sometimes pop up, and it’s best to be prepared just in case they do.

      Infected C section scar

      If you notice any redness, swelling or oozing from your C section incision, this could be a sign of infection19. Always consult your midwife or GP if you experience any of the above. 

      To avoid your C section scar becoming infected:

      • Gently wash the incision with water every day and dry it gently.
      • Wear clothing that’s loose, comfortable and breathable, and avoid anything with an elasticated waistband.

      Internal pain after C section 

      It’s perfectly normal to have some pain and discomfort following your C section. After all, you’ve just been through a major operation. In most cases, this is nothing to worry about. In fact, for some women, this can last for several weeks. You’ll probably be advised by your midwife to take regular pain relief such as paracetamol or ibuprofen. 

      If you start to experience more severe internal pain and/or heavy vaginal bleeding, seek medical advice as soon as possible20.

      C section scar itching

      In the first few weeks, your C section scar may cause you some irritation and discomfort. Whilst unpleasant, it’s rarely anything to worry about and is often a sign of the healing process21.

      If your C section scar becomes itchy, try not to scratch it as that could lead to an infection.

      It takes a village!
      If you’ve had a C section, or are planning one, think about the people you have around you who can help. Don’t be shy of accepting help when offered.

      Breastfeeding after C sections - all the advice you need

      Following a C section, you might be wondering how you’re going to breastfeed your baby. But try not to worry. Having a C section doesn’t mean that you won't be able to breastfeed your baby, it just may take a little longer for you and your baby to get the hang of it! 

      Whilst in hospital, midwives will be on hand to help you with your first few feeds until you find a position and technique that works for you. In addition, there are a number of things you can do in order to give you and you baby the best possible start:

      • Be sure to have plenty of skin to skin time and close cuddles with your baby. 
      • Have someone else pass your baby to you when it’s time for a feed. This will reduce the amount of moving you have to do, helping your C section recovery. 
      • If you’re struggling to feed because of the discomfort, discuss the possibility of expressing your breast milk with your midwife22

      What are the best positions for breastfeeding after a C section?

      As with all breastfeeding journeys, you’ll probably try a number of different positions before you find the most comfortable way for you to breastfeed your baby. Here are a few of our tried and tested favourites:

      • Try laying back on a cushion (or a willing partner!) and lay your baby across your tummy. This will encourage your baby to naturally latch onto your breast with minimal movement from you. 
      • Also known as the ‘rugby ball’ hold, holding your baby underarm and guiding them to your breast is good for keeping tiny wriggles away from your C section scar. 
      • You could lay on your side supported by pillows. Place your baby on their side facing you and draw their little legs into your body and put them to your breast. 

      How many C sections can a woman have?

      There’s no hard and fast rule here, but doctors tend to agree that repeat Caesareans are more complex and carry increased risks23. For example:

      • Scar-like tissue can make Caesareans more difficult and increase the risk of damage to the bladder or bowel.
      • Problems with the placenta such as placenta previa are more likely to occur the more C sections you have.
      • You may also experience more incision related problems, such as the development of a hernia.

      It’s always best to discuss this with your doctor, to ensure that you’re following the right medical advice for your situation.

      Can I have a natural birth after having a C section?

      Yes! If you’ve had a Caesarean section this time around, this doesn’t mean that you can’t have a vaginal delivery in the future.

      Did you know?
      About 75% of women go on to have a vaginal delivery after a C section24. This is known as a VBAC (vaginal birth after Caesarean).

      1. https://www.britannica.com/science/cesarean-section
      2. https://www.nhs.uk/conditions/caesarean-section/
      3. https://www.nhs.uk/conditions/caesarean-section/
      4. https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/c-sections-everything-you-need-know
      5. https://www.nct.org.uk/labour-birth/different-types-birth/caesarean-birth/caesarean-birth-c-section-recovery-tips
      6. https://www.nhs.uk/conditions/caesarean-section/
      7. https://www.nhs.uk/conditions/caesarean-section/
      8. https://www.nhs.uk/conditions/caesarean-section/risks/
      9. https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
      10.  https://www.nhs.uk/conditions/caesarean-section/risks/
      11. https://www.nice.org.uk/guidance/cg132/chapter/1-Guidance#recovery-following-cs
      12. https://www.nhs.uk/conditions/caesarean-section/recovery/
      13. https://www.nhs.uk/conditions/caesarean-section/recovery/
      14. https://www.nct.org.uk/labour-birth/different-types-birth/caesarean-birth/caesarean-birth-c-section-recovery-tips
      15. https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/when-and-how-exercise-after-c-section#:~:text=Try%20to%20build%20up%20your,and%20low%20resistance%20gym%20work.
      16. https://www.nhs.uk/conditions/caesarean-section/recovery/
      17. https://www.babycentre.co.uk/a539020/recovery-after-a-caesarean-birth
      18. https://www.healthline.com/health/healthy-sleep/how-to-sleep-after-c-section
      19. https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/recovering-home-after-c-section
      20.  https://www.nhs.uk/conditions/caesarean-section/recovery/
      21.  https://www.healthline.com/health/skin/itchy-scar#causes
      22.  https://www.tommys.org/pregnancy-information/giving-birth/caesarean-section/breastfeeding-after-c-section
      23.  https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-birth-options-after-previous-caesarean-section.pdf 
      24.  https://www.nbt.nhs.uk/maternity-services/pregnancy/birth-after-a-previous-caesarean/vaginal-birth-after-caesarean-vbac#:~:text=Having%20a%20successful%20VBAC,%25)%20have%20a%20vaginal%20birth.
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