Having a C-Section? What to Expect and How to Recover

Updated: 18 Dec 2024

Regardless of the kind of birth experience you’re hoping for, there’s a decent possibility you may end up delivering your baby via cesarean section (a.k.a., C-section). In the United States, the C-section delivery rate is almost 32%. For many women, anxiety about the both surgery itself and the longer recovery time may feel overwhelming. Taking a little time to educate yourself about the procedure can help you feel more mentally and emotionally prepared to handle it if you need one. Here’s what to expect with a C-section, including why you may need one and what happens after.

What Is a C-Section? 

A C-section is the surgical delivery of a baby through incisions in the mother's uterus and abdominal wall. C-sections can be lifesavers for women in emergency situations and those who may be at risk of experiencing a dangerous delivery-room situation. These may be performed with general anesthesia (the parent is completely unconscious) or with regional anesthesia (the parent is numbed from the rib cage down). C-sections are performed by obstetricians and occasionally family doctors. Midwives are not able to perform cesarian deliveries. There are two basic types of C-sections.

Emergency C-Section

Emergency C-sections are performed in instances where there is a direct threat to the health of the mother or baby. An emergency C-section may be performed for several reasons: 

• Labor isn’t progressing or stops (even with the use of medicines)
• Fetal distress, marked by shifts in the baby’s heart rate indicating a possible lack of oxygen
• The baby is too large to pass through the birth canal
• Placental abruption, in which the placenta actually detaches from the uterus too soon
• Umbilical cord prolapse, in which the umbilical cord descends into the birth canal ahead of the baby, squeezing the cord and limiting the baby’s oxygen
• Uterine rupture

Scheduled C-Section

Sometimes a C-section is scheduled in advance if the doctor anticipates a serious complication may arise during vaginal birth. C-sections may be scheduled due to several possible risk factors:

• Certain chronic conditions like heart disease, diabetes, high blood pressure, or kidney disease which make vaginal delivery dangerous 
• Medical issues with the mother that may pose a risk for the baby if delivered vaginally (e.g., high viral load HIV or an active genital herpes outbreak)
• Baby has particular birth defects, like severe hydrocephalus
• Baby is in a position other than head down in the womb and can’t be turned
• Placenta previa (in which the placenta covers the cervix) or other issues with the placenta
• Multiple babies
• Previous C-section delivery
• Large fibroids that block the birth canal or a past pelvic injury, making it difficult for the baby to  pass easily out of the birth canal
• Mother has developed pre-eclampsia

What Happens During a C-section?

Whether scheduled or a last-minute decision, hospitals try to make a C-section delivery as comfortable and normal as possible, with the mother conscious (but numb), her partner present, and the opportunity to welcome, snuggle, and possibly nurse the baby immediately following delivery. The delivery is fairly quick (only about 15 minutes in some cases) with another half hour or so for stitches.

The average C-section follows a pretty strict order of operations whether it’s an emergency or planned. Here’s what you can expect:

1. Prep and Anesthesia

At the beginning of the operation, you’ll be given a routine IV and anesthesia, typically a spinal block or an epidural that will numb only your lower half. During an emergency C-section, time may be limited, in which case you may be given general anesthesia that will put you to sleep for the entire procedure. 

The surgical staff will then shave and scrub your abdomen with antiseptic. You’ll also be fitted with an oxygen mask and have a catheter inserted into your bladder. Your partner or coach will put on scrubs and be permitted to sit next to you. A screen will block the view of your abdomen so that you don’t see the cut. Some women opt for a “gentle C-section,” in which case the drape will be clear. You can also ask for a mirror to watch.

2. Surgery and Birth

After you are completely numb or fully unconscious, the physician will make a small cut in the lower part of your belly, just above your pubic area. Next, the doctor will make a second incision in the bottom part of your uterus. Your doctor may use one of two incision types:

• • A vertical incision down the middle of the uterus. This type of cut is rarely used these days and typically only if the baby is oddly positioned or lodged low in the uterus.
  • A low-transverse cut across the bottom of the uterus is the most commonly used incision. This type of incision produces less bleeding and makes a VBAC (vaginal birth after cesarean) much more possible in the future. 

3. After Delivery

Once the umbilical cord has been severed, the doctor will remove the placenta and check over your reproductive organs. Your uterus will then be closed with absorbable stitches and your abdomen closed with either staples or stitches. You may have a dose of antibiotics added to your IV (to reduce the risk of infection), along with some oxytocin (to minimize bleeding and tighten the uterus). Your breathing, pulse, and blood pressure will be continually monitored. Then you’ll probably get to see your new baby.

If the baby is healthy, you may be able to hold and/or nurse your infant in the recovery room. You may need assistance holding the baby to your breast if you have to stay lying down flat. If your newborn is taken to the NICU nursery, don’t worry. This is simply a routine precautionary measure at many hospitals after a cesarean delivery, not necessarily an indication that anything is wrong.

Once the anesthesia wears off, you will probably feel the pain from the incisions. You may also feel gas pains and have difficulty taking deep breaths. As your uterine lining sheds after the surgery, you will also have a vaginal discharge, called lochia, that’s red at first and then gradually changes to yellow. 

Recovery Tips and Side Effects of C-Section Delivery

C-sections require a longer recovery time than a vaginal birth, about three to four days in the hospital and six to eight weeks at home. During recovery, it’s important to scale back your activities to avoid putting undue strain on your incisions. Here are a few strategies to keep in mind:

• Go easy on yourself. Besides the pain from your incision, you’ll be dealing with all the same recovery issues that come with a vaginal delivery: fatigue, cramps, bleeding, perineal pain, and breast engorgement. Give yourself time to heal. 
• Be careful. You’ll be sore for a while so don’t hold or carry anything heavier than your baby.  
• Watch that wound. Keep the incision area clean to avoid infection. Wear loose-fitting clothing. Use a nursing pillow to protect your scar while breastfeeding or snuggling your baby.
• Take your medications. The pain-relieving drugs prescribed after surgery will help. If you’re breastfeeding, let your practitioner know so they prescribe something safe for the baby.
• Move around. Walking, even just strolling around the house, can relieve uncomfortable gas build-up and boost circulation. 
• Feed yourself. Keep lots of water and healthy snacks on hand to keep up your energy. Fiber-rich fruits are especially helpful since constipation after pregnancy is common.

The Bottom Line on C-Sections

Though it may be a challenge to keep yourself from taking the reigns again at home after surgery, be gentle with yourself and try to relax when possible. In just a few short weeks, you’ll be back in the game full force.