By (and with) Alexandra Smith
What is a caesarean section?
A caesarean section or c-section is where an incision is made in a pregnant woman's uterus in order to remove her baby. The incision is usually horizontal and the scar left on the abdomen would normally be hidden by your bikini briefs. The opening has to be opened wide enough to fit a baby's head through so it is usually around 4 inches or more in length depending on the surgeon, your baby (or babies) and your body. It is uncommon to have a vertical incision. In my experience, it took around 20 minutes to be prepared for surgery, 10 minutes to get the baby out and 30 minutes to be stitched back up.
Do you have to be awake when they operate?
You're usually awake for the c-section because you can witness the birth of your baby and it is easier to monitor you when you're not under anaesthetic. Most surgeons say it's actually safer and will not hear of having you 'knocked out.'
How do they stop you feeling the operation?
Being awake means you need to be numbed from below your arms down. An anaesthetist will make this numbness happen by putting a needle in your spine which should normally be quick and stress-free. I found this part the scariest as the anaesthetist struggled to get the needle in position for quite a while because I have a small sideways curve in a section of my spine that neither of us knew about. The affect was tested by using a cold spray down my front and I was horrified that I could still feel the spray below my ribcage. I was informed that I wouldn't feel sharpness or pain but I would feel a soft brushing sensation when something touched me (a bit like the feeling in your mouth if you've ever had a local anaesthetic at the dentist).
How do you keep calm?
Trying not to think about it at the same time as being aware of what is going on is a big thing to ask of anyone in this situation but it is possible. A blue sheet was clamped up so I couldn't see the operation happening but the anaesthetic was making my arms shake and the two anaesthetists were panicking over reading monitors and bags of fluid running in to my hands so what I could see wasn't particularly pleasant either. There were a lot of student doctors watching my cesarean birth because I thought I'd be doing the medical profession a good turn by agreeing to help students in their case-studies. This meant that the surgeon was explaining what he was doing so my husband talked to me about the plot of a book he was reading to drown out what was happening. Thankfully, once my daughter was born I was more fixated on getting a glimpse of her than what was happening around me.
Does it feel like a birth?
Yes and it's important to view it as equal to a natural birth. After being pregnant for so long and growing a little life inside your body, it's easy to get caught up in wanting to complete the task of birthing the baby yourself so it can be disappointing to end up in surgery. One thing I noticed in my c-section was that they pushed on my chest to force the baby out and I felt lighter immediately even though I couldn't really feel my lower half. Once I knew my daughter was out and alive, I felt a wave of relief which I think must be a normal feeling in most live births.
Did you get to have skin-to-skin contact with your baby?
Not immediately. There's a big deal made about first contact between mother and baby because it is good for bonding but this contact doesn't have to be straight after delivery. I say this because I've heard stories about babies born by c-section where the screen has been down so the mother can see, music has been playing, the father cut the cord and the baby lay on the mother's chest but I asked about having these things and the medical team looked at me like I was mad. I think you have to be quite open-minded and prepare to abandon parts of your birth plan without feeling disappointed. Try to be proud of yourself and know that the baby is yours so you will get to spend time with him or her eventually.
Did you expect to have a c-section?
I knew it was a possibility because there are many reasons for women to have a cesarean birth and I have a family history of high blood pressure in pregnancy which is a complication that may (and did) necessitate a c-section. Mine was called an 'emergency' but emergency and planned sections are both performed to avoid serious problems such as the baby getting stuck or hurt during labour so neither are more or less serious than the other.
How can you avoid having a c-section?
I don't think you should avoid a cesarean if you may need one. If you have a known risk factor or complication in pregnancy then you should be assigned a consultant. Take their advice and ask for a second consultant's opinion if you want it (as professionals, they shouldn't be offended). I was lucky that I saw many consultants and they all agreed on the same course of action so I trusted their judgement.
How do you feel after a c-section?
I was told that once the feeling in my legs returned and the catheter has been removed (having a catheter isn't as painful as it sounds), I should try to walk to the shower within 24 hours of the operation and peel off the wound dressing. Unfortunately, this was said around 36 hours later so, by the time I got to the shower, the dressing had blistered my skin. Initially I thought my operation scar must be very long because I could feel these sharp painful blisters but actually the scar was more of a dull pain and much smaller than I expected. I used lanolin on the blisters and, once the incision wound healed, I used scar oil on it (you should only use clean water on it while its healing). I would advise anyone who is pregnant to use a body moisturiser during and after pregnancy because an incision scar can be less problematic than stretch marks and an appropriate moisturiser will help to keep skin happier while its under stress. Physically, bending down is a bit difficult and you need to avoid lifting heavy things for about six months or more so you don't open your stitches or create a hernia. I felt a weakness in myself for about a year and this seemed to remind me to take more care than I usually would.
What advice would you give to someone who is expecting to have a c-section?
In advance of the occasion, picture meeting your baby rather than dwelling on the technical side of the c-section itself. Try to enjoy the experience: have a giggle at your birth partner wearing scrubs, listen to your baby's first sounds and think about how special and honoured the people attending to you and your baby are because they are part of such a big event in your life. Remember that the medical team will have done the operation before and try to trust that they want the best for you and your baby otherwise you'll do more worrying than enjoying. Finally, after it's over, congratulate yourself and remember that you've had a major operation as well as having made a baby so don't put pressure on yourself or let anyone make you feel inferior because you didn't push the baby out naturally- you just did more than that!
Have you had a c-section? What was your experience?
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Disclaimer: These tips are created from lessons I have learnt during my own experience. With regard to the content and advice on this blog, Alexandra Smith makes no representations or warranties about its accuracy, reliability or suitability for anyone. Any reliance you place on the blog or its content is at your own discretion and in no event will Alexandra be liable for any loss, damage or injury in connection with your use.