You will be taken to a recovery room or directly to your room. If a general anesthesia was used during the delivery, you may not wake up for a few hours. When you do, you may feel groggy and confused. Don’t be surprised if your baby is still being affected by the anesthesia for six to 12 hours after delivery and appears a little sleepy. If you’re going to breastfeed, try to nurse her as soon as you feel well enough. Even if she’s drowsy, her first feeding will provide a reason for her to wake up and meet her new world and you. You’ll probably experience some pain where the incision was made. But you’ll soon be able to hold your baby, and you’ll quickly make up for the lost time. You may need to stay in bed for awhile. A hospital stay after cesarean birth is usually four days. The length of your stay depends on the reason for the cesarean birth. After You Go Home it will take a few weeks for your abdomen to heal. It’s important to help yourself heal. For a few weeks after the cesarean birth, you should not place anything in your vagina or do any strenuous activity. There are many reasons why a cesarean birth may be needed to deliver your baby. Many maternity centers have childbirth classes and support groups for couples who may need cesarean birth. If you have questions or concerns about cesarean birth, ask your doctor or nurse.

Previous surgery on the uterus, such as removal of fibroids from deep in the muscle wall of the upper part of the uterus, or cesarean section with a high (classical) incision. – Infectious conditions of the mom that could infect the baby in the birth canal — HIV, large vaginal warts, acute herpes outbreak at the onset of labor. – Medical conditions of the mom that make labor too great a risk for her, such as extremely high blood pressure or severe diabetes. – The baby is too big for the size of the mom’s pelvis (“cephalopelvic disproportion”). Sometimes this is so obvious that a cesarean delivery is scheduled from the outset; sometimes the decision is made to do a “trial of labor” and see what happens and only resort to a cesarean delivery when the baby appears to be stuck (“failure to progress in labor”). – More than one baby. Risks are greatly elevated, especially for the second or third baby, because the placenta may detach from the wall of the uterus before all the babies are out. – The exit is blocked. If a large tumor is located in the lower part of the uterus, it may block passage of the baby through the birth canal. The placenta can cover the cervix and block the exit. This is called placenta praevia. – The baby is breech. Even though many babies can be delivered in the breech position (bottom first), the risk of complications is greatly increased because the head and shoulders are the largest parts of a newborn. Once they have stretched the birth canal and are out the rest follows automatically. When the smaller bottom end comes out first, the head may get trapped, and the umbilical cord compressed between the baby’s skull and the mom’s pelvic bones. The baby then does not get any oxygen because the placental blood is cut off and the head is not yet out in the air. The American College of Obstetricians and Gynecologists now recommends that an attempt should be made to turn breech babies in late pregnancy and only deliver them by cesarean section if turning them fails. – The mom wants a cesarean section. A woman can choose to have a cesarean. She may choose this because she had one before and feels since she already has a scar, she does not want to subject her pelvis and vagina to the trauma of labor. Or she may just decide that labor is not for her (she may have problems to get her insurance company to pay in that case). Even with a previous cesarean women and their doctors have been pressured by the insurance companies to do a “trial of labor” (see section on VBAC). Sometimes the need for a cesarean section becomes apparent only during labor on a more or less emergency basis. In this case it is irrelevant if the baby is premature or not, as labor is already underway. Here are some examples of when a cesarean delivery becomes medically advised once labor has started: – Baby problems, possible fetal distress: During labor the baby’s heart rate, including how it responds to contractions, is followed either with a monitor or by auscultation. A non-reassuring fetal heart rate pattern can be a sign that the baby is not receiving enough oxygen. This can occur because the cord is tightly wrapped around the baby’s neck or shoulder, the placenta is separating from the uterine wall, or the baby is at risk for some other reason. – Mom problems: Rarely, laboring women develop medical problems, such as seizures, that make it unsafe for them to continue with labor. – Placental problems: This usually involves the placenta beginning to separate from the uterine wall (abruption placentae). Signs of this are excessive bleeding and fetal distress. – Labor problems (“Failure to progress”): About 30% of cesarean deliveries are done for this reason. The most common reason the baby stops advancing down the birth canal is that the baby does not fit (“cephalo-pelvic disproportion”). If labor is allowed to continue indefinitely, something will eventually give—either the baby will develop fetal distress or the uterus will rupture.

An elective cesarean section increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial costs. Even mature babies, the absences of labor increases the risk of breathing problems and other complications.

What is a Cesarean section?
A cesarean section is the surgical delivery of the baby through an abdominal incision. Supposedly, Julius Caesar was delivered in this manner, hence the name. After the skin is thoroughly cleansed with an aseptic solution and sterile drapes spread over the surgical field, the abdomen is entered by making an incision through all layers of the abdominal wall: the skin, the fat, and then several muscle layers and muscle sheaths (fascia). This incision can be made either vertically below the umbilicus like a zipper, or horizontally right above the pubic bone, a “bikini cut.” Usually all the intestines have been pushed up into the upper abdomen by the enlarged uterus and the uterus lies directly against the abdominal wall. Next, the incision through the muscle wall of the uterus is made and stopped just short of the amniotic sac that contains the baby. At this point, everybody gets ready for the arrival of the baby, including dad with the camera. The amniotic sac is ruptured carefully, so as not to hurt the baby, and the baby is delivered much as if she were coming out through the vagina. After the baby is dried and wrapped in soft cloths, the mom can often hold her baby, or at least touch while dad holds the baby. The time from the incision of the skin to the delivery of the baby can be less than three minutes if an emergency requires it, but usually takes about 10 minutes. If the incision into the uterus is made horizontally in the lower part of the uterus (low transverse incision), the woman is eligible for a trial of labor in a later pregnancy. Rarely, the incision has to be made, or extended, vertically into the upper part of the uterus (“classical” incision) in order to get the baby out. After a classical incision, future labor is too much of a stress for the uterine scar — it will burst and all subsequent pregnancies will have to be delivered by cesarean section. Rupture of the uterus during labor can occur even without a previous cesarean section but it is rare. It is life threatening to both mom and baby. Immediate surgery, however, can save both their lives (another reason not to have a home birth!). After the baby is delivered, the placenta is removed through the same uterine incision as the baby, and the uterus and abdomen are closed layer by layer in reverse order. This takes about 15 to 20 minutes.