Originally written by Roseanne Hickey, RN, BN, MSc(N), IBCLC

About 21 percent, or one in five Canadian women will give birth by caesarean section (or what is often referred to as a C-section).

The caesarean birth rate has gone up steadily since 1995. This is partly due to the later age of many expectant mothers, as well as changes in obstetrical practices. For example, all babies who are in the breech position near the end of the pregnancy (in which the baby would be born feet or buttocks first, instead of the typical head first) are now born by caesarean section.

Quick C-section facts:

  • Women experiencing labour for the first time have a 15 percent chance of having a caesarean birth.
  • Seventy percent of women who have had a caesarean birth before choose to deliver vaginally for the births of later babies (this is often referred to by the acronym VBAC, or Vaginal Birth After Caesarean).

Factors considered in C-section births: 

  • Fetal distress (physical distress experienced by the fetus, such as an abnormal heart rate)
  • The mother's health
  • The progression of labour

What happens during a C-section:

A caesarean birth is a surgical procedure in which your baby is born through an incision in your abdomen, rather than vaginally.

Some women know ahead of time that their baby will be delivered by C-section, while others have an unplanned caesarean for medical issues that arise when they are in labour. In an emergency, however, you may not be able to choose the type of anesthetic that is used.

If you're undergoing a scheduled C-section, you will be required to fast for several hours. You'll be admitted to the hospital, prepped for surgery and introduced to the surgical team and then, when the time arrives, you'll be moved to the operating room (eek! Your babe is moments away!). It will likely be a little less controlled if you are undergoing an emergency C-section, as you'll already have been labouring, but once you're in the operating room, the procedure is generally the same.

You will probably be awake during the birth of your baby. Sensation and pain will likely be blocked with a regional anesthetic (spinal or epidural). In rare cases (usually only in emergencies) a general anesthetic is needed, in which case you will be unconscious during the surgery.

Your belly is wiped with a cleaning solution and a curtain is placed above and around your tummy. The drapes keep your tummy area germ-free, and they block your view and your labour partner's view of the surgery. (No one likes to see their own intestines, amirite?)

The surgery begins when surgical staff are certain the anesthetic has taken effect. During the operation, you may feel a sensation of pulling or tugging, but you should not feel pain. If you do, speak up immediately.

It takes only about 10 minutes before you see your baby. The doctor will usually hold the baby up immediately, to show you your new bundle of joy. Then, usually, the baby is rubbed dry and placed in your arms within minutes. When your incision is closed and the operation is complete (usually inside of an hour), you are moved to a recovery room. You will be monitored closely for a couple of hours; your baby will be with you and you can begin to breastfeed him. Your nurse will show you some comfortable positions for nursing.

What you need to know before a C-section:

  • Ask your health care professional about the options at your hospital in the event of a caesarean birth, so you're prepared and can ask all of the questions you have.
  • Ask if your partner can be there during the surgery.
  • Try to plan before the birth for help at home after the baby is born. (You'll have just had major abdominal surgery, lady!)

Recovering after surgery:

You usually stay in the hospital for three or four days after the surgery. You will be given medicine to relieve pain as you need it. (The medication is not harmful to you or your baby, even if you breastfeed.) You will feel a little better every day.

You'll get back to your normal activities gradually, but go slowly and be patient with yourself. You shouldn't lift anything that weighs more than 10 lbs, do major housekeeping or major exercise until you see your doctor for your follow-up visit at about six weeks.

Roseanne Hickey, RN, works at Sunnybrook and Women's College Health Sciences Centre in Toronto as a nurse in labour and delivery. She has taught prenatal classes for many years.