There are situations where the safest option for either you or your baby, or both, is to have a caesarean section. As a caesarean section involves major surgery, it will only be performed where there is a real clinical need for this type of delivery.

The baby is delivered by cutting through the abdomen and then into the womb. The cut is usually done crossways and low down, just below the bikini line. It is usually hidden when your pubic hair grows back again.

A caesarean section may be ‘elective’ (that is, planned in advance) or ‘emergency’. An elective caesarean may be recommended if labour is judged to be dangerous for you or the baby. An emergency caesarean may be necessary if complications develop and delivery needs to be quick. This may be before or during labour.

Sometimes the cervix does not dilate fully during labour and an emergency caesarean will be suggested, but, providing you and the baby are well, there is no need to proceed with great haste.

Whenever a caesarean is suggested, your doctor should explain why it is necessary and any possible side effects. Do not hesitate to ask questions. Where possible, the operation is performed under epidural anaesthesia or the similar spinal anaesthetic.

A general anaesthetic is sometimes used, particularly when the baby needs to be delivered very quickly, or if it is not possible to use epidural anaesthesia, but this increases the risks for you and the baby. This is why epidural and spinal anaesthetics are recommended.

If you have an epidural, you will be awake throughout the operation, but you won’t feel pain, just some tugging and pulling and wetness when the waters break. A screen will be put across your chest so that you cannot see what is being done. The doctors will talk to you and let you know what is happening. The operation takes about 30–40 minutes.

One advantage of an epidural or spinal anaesthetic is that you are awake at the moment of delivery and can see and hold your baby immediately. Our units are usually happy to let your partner be present at a caesarean under epidural or spinal anaesthetic so that they can give you lots of support and welcome the baby at birth.

After a caesarean you will be uncomfortable for a few days, as you would expect to be after any major surgery. It will be difficult to sit up or stand up straight, and it will hurt to laugh. You will have to stay in hospital a bit longer, this will depend on your condition.

You will also have to take it easy once you are home, and you will need help. You shouldn’t lift anything heavy or drive a car for six weeks. Your maternity team will advise you on how much you can do.

Postnatal exercises are especially important after a caesarean to get your muscles working again, but take things at a gentle pace. The midwife or hospital physiotherapist will tell you when you should begin them.

You can also contact the Caesarean Support Network for information and support on 01624 661 269 (Monday-Friday 6-9pm and weekends).

• What to do after a Caesarean Birth (.pdf)

Vaginal Birth after Caesarean

Many women who have had a Caesarean section can safely have a vaginal birth in a subsequent labour. This is known as Vaginal Birth after Caesarean section (VBAC). As long as there are no reasons not to, you will be offered and encouraged to try for a vaginal delivery.

For more information on VBACs please click on the link below:

• Vaginal Birth after Caesarean Section (VBAC) (.pdf)