Types of Cesarean Births

Since April is Cesearean Awareness Month, we thought it would be a great time to talk about options for a Cesarean birth. Generally, there are two kinds of C-sections…planned an unplanned. Today’s blog will take a look at both kinds of belly births and what options look like in both scenarios.

Planned C-sections

Planned, or scheduled, C-sections are exactly what they sound like. You and your care provider are planning on your baby being born via a C-section. Reasons for planning a scheduled C-section might include baby’s positioning (breech or transverse babies are most often born via C-section in the US), giving birth to twins or triplets, having an active herpes outbreak, having had precious C-sections and you don’t want to have a VBAC, having a previous vaginal birth with severe tearing, or just because you want one. Your provider will recommend scheduling the surgery typically between weeks 38-40 of your pregnancy.

You can discuss your preferences for the Cesarean at your prenatal appointments with your provider. Typically you can play the music of your choosing in the OR, you can ask to have your arms unrestrained, you can have your support person with you in the OR, you can have a clear drape, and you can request immediate skin to skin once your baby is born.

In a scheduled C-section, you’ll be given a time to arrive at the hospital on the day of your baby’s birth. Once you arrive, your nurse will get you prepped for the OR. You’ll wear a monitor for your baby’s heartrate. Your nurse will give a small drink to help reduce stomach acid (pro tip, drink this as a shot as it does not have a great taste). The anesthesiologist and your care provider will stop by your room to see if you have any questions before you go into the OR. Once you are in the OR, the anesthesiologist will place your spinal block (if for some reason the spinal block doesn’t work, they may try a very dense epidural). Once that is in place, your team will help you lie down on the OR table and get everything ready to go. As soon as everything is ready to proceed, a nurse will bring your support person into the OR to sit on a chair that will be right beside the head of the bed. After your support person is seated, your OB will start the procedure. Typically your baby is born within a few minutes. When your baby is born your provider will either lift the baby up over the sterile drape, or , they wlll take down the drape and leave a clear drape so you can see your baby be born. This is absolutely your choice as to which way you prefer to see your baby for the first time. While there is a movement at some hospitals to do immediate skin to skin right after a C-section, it is more common for the baby to be quickly take to a warmer and dried and quickly assessed. If all is well, a nurse will bring the baby to you and help you do skin to skin time right there in the OR. If you aren’t feeling up to it, your partner can do skin to skin time with your baby. Usually after some time with your baby, your support person and baby will leave the OR with a nurse and go to the recovery area. You will join them right after your surgery is complete. Typically you would stay in the recovery area for a couple of hours before moving to your postpartum room.

Unplanned C-sections

Unplanned C-sections are C-sections that were not scheduled and can happen for several reasons. Unplanned C-sections can be the result of fetal distress during labor, lack of labor progression despite interventions, pushing for several hours with no fetal descent, cord prolapse, or severe pre-eclampsia when it is too dangerous to wait on a labor induction. In most cases, your medical team will move quickly to get the C-section underway and head to the OR. If you already have an epidural, the anesthesiologist will just dose it up higher to give you plenty of pain management during the surgery. If you don’t have an epidural, the anesthesiologost will likely place a spinal block. You can ask for your arms to be unrestrained during the birth and you can ask for a clear drape. Your OB may even be happy to play your playlist in the OR. In most cases, you should still be able to have your support person join you in the OR once your OB is ready to make an incision. Once your baby is born your OB can show you the baby via the clear drape. Once baby is checked out at the warmer, the baby will be brought to you for some skin to skin time. After your OB finishes your surgery, you’ll go to the recovery area (PACU) for a couple of hours. If you and your baby are doing well then you will move into your postpartum room.

Regardless of whether the Cesarean was scheduled or unplanned, if your anesthesiologist is unable to get you comfortable with a spinal or epidural, or if it is a true emergency like a cord prolapse, you may be given general anesthesia and will be asleep during the birth.

In most cases, you still stay in the hospital for about 3 days after a C-section. During this time your nurses will help you regain mobility, teach you how to care for your new baby, and help you manage your recovery with pain meds and movement. Be sure to have some support in place when you get home with your new baby.