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What happens during a C-section

Even if you’re currently planning to have a vaginal birth, everyone has a chance of having a cesarean birth. And it is natural to have questions about what happens during a C-section. Here are the basics of what to expect so you’ll feel more confident and prepared on delivery day. 

Unplanned but not unprepared

A C-section may be planned ahead of time if you’ve had one previously or develop certain pregnancy complications. But sometimes, people find out they will need one once labor is already underway. In those cases, things can move quickly, and the sense of urgency may feel overwhelming and scary. Having an understanding of what a C-section entails — before, during, and after — can help you feel more in control. 

Rest assured, your medical team is highly experienced in delivering babies this way. They know every step they have to take to keep you and your baby as safe as possible. While they may look very busy and hurried, you should also know that it is always within your rights to ask questions. You aren’t inconveniencing them. This is your body and your baby and you deserve to understand your provider’s decisions.

In most cases, your partner or support person can be by your side for a cesarean birth. While they may have to wait outside as you’re getting situated in the operating room, as long as you’re awake for the procedure, they should be there right by the head of your bed with you.

Know that It’s completely normal to have some difficulty letting go of the birth you had envisioned. It may take time — like any grief process — to work through everything you feel afterwards. 

What will happen?

A C-section is a surgical procedure. This means that you’ll be moved into the operating room. It’s a very bright, sterile environment that can be intimidating and it’s often a little chilly in the operating room. You can ask for a warm blanket across your arms if that feels comforting. Because you’re having surgery, you will be given fluid and medication through your intravenous (IV) line. You’ll lay down on the operating table and your abdomen will be washed. Then, you’ll have a blood pressure cuff and a pulse oximeter (clip on your finger to measure your oxygen levels) placed for monitoring. If you don’t already have one, a nurse will likely insert a catheter to collect urine as well. 

Regional anesthesia vs. general anesthesia

In most cases, you’ll receive regional anesthesia — typically a spinal or epidural block — so you’ll remain awake during the procedure but you won’t feel any pain. This means you’ll still be able to experience the birth and be ready to greet your baby immediately after delivery. In rare situations or emergencies, general anesthesia may be required, which would mean you’d be in a sleep-like state for the delivery. Again, this is reserved for rare cases when there isn’t time to place the regional anesthesia and is only done when it’s in your and your baby’s best interests.

What will it feel like?

Before surgery, a curtain is drawn between your upper and lower body to help you stay relaxed. Your partner can sit behind this curtain at the head of your bed while you await your little one’s arrival. You’ll also have an anesthesia provider right there with you whose sole purpose is to make sure you are okay. They can answer your questions and help treat uncomfortable symptoms (like nausea) should they arise. Once your surgeon has made sure you’re completely numb, they’ll make a horizontal or vertical incision in your lower abdomen and then another in your uterus to deliver your baby. Next, they’ll cut the umbilical cord and remove the placenta. Then your medical team will stitch you back up. The entire process is usually done in about an hour. 

Will I really feel nothing?

The anesthesia will ensure there’s no pain at all. However, there may be other sensations. Some women report feeling tugging, pressure, or shortness of breath as their doctor presses on their uterus and eases the baby out. It’s also possible to experience light shaking or shivering, which can be a side effect of a spinal block and is no cause to worry. 

None of these sensations should hurt; however, they might feel strange or even frightening. Using a breath technique or relaxation practice can help you through it, as can leaning on your support person. Keep your doctor and anesthesiologist informed about how you feel so they can ensure you remain as comfortable as possible. 

What happens with my baby?

Just like with vaginal delivery, unless there is an immediate medical need, you’ll be able to see your baby right away. As long as you’re feeling well enough, after the umbilical cord is cut and your baby is dried gently, they can be placed on your bare chest for skin-to-skin contact. Depending on your hospital and how you’re feeling, you may even be able to try breastfeeding in the operating room or recovery area. If you’re not up for having baby on your chest, you can have your partner hold baby cheek to cheek with you to get that skin to skin contact and feel the soothing presence of your baby near to you.

How will I feel after?

After birth of any type, you’ll probably feel sore, elated, and exhausted. However, a C-section is a major surgery, so the healing timeline may be longer than with vaginal birth, and you will likely be in the hospital for an extra day or two. 

In the hours after birth, you will receive pain medication to help you remain comfortable as the anesthesia wears off. You can spend time skin to skin with baby, start to breastfeed, and check out all their little fingers and toes. You may also feel really sleepy so this might be a good time for your partner to do some bonding while you rest.

When can I eat?

At this point you’ll be able to slowly start to eat some ice chips and drink some fluids. Once you’re feeling well enough, you’ll be encouraged to drink plenty of fluids and eat your first meal. Usually the day of your C-section or the morning after (depending on what time of day your surgery was), you’ll get up to walk around with the help of your nurse. You’ll gradually get better at this and will be encouraged to get up several times a day, which will help prevent constipation and reduce the risk of blood clots in your lower extremities.

In the days following the birth, your care team will keep a close eye on your incision to watch for bleeding or any signs of infection. During this time, you’ll most likely experience cramping in your uterus and vaginal bleeding as you would after a vaginal birth.

The first weeks

Over the first few weeks of recovery, it’s important to rest as much as possible and avoid lifting anything heavier than your baby. So get ready for plenty of snuggling and cuddling as you heal. Expect that movement may be uncomfortable and deep bending is off the table until usually four to six weeks after delivery. It is still important to continue doing several short walks a day, which over time you’ll be able to slowly increase in length. The physical limitations can be extremely challenging and frustrating as a new parent, so lean on your support system wherever possible. Full recovery typically takes about six weeks, so it may make sense to consider how you would handle this recovery period now, just in case. 

You’ve got this

(And we’ve got you.) Ovia’s goal is to help you have your healthiest pregnancy and most empowered birth experience. Part of that is feeling ready to make decisions with your healthcare provider that prioritize your and your baby’s safety and wellbeing. This information is meant to help you feel prepared and reassure you that birth can still be beautiful, even when it doesn’t go exactly as planned. 

Reviewed by the Ovia Health Clinical Team

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