Birth Blog

Your Guide to C Sections

Stephanie Martin

Your Guide to C Sections

Written by
Stephanie Martin

Around one in four women who give birth in the UK have a c-section. Find out everything you need to know about a caesarean section including the difference between an elective versus emergency c section, and the best postnatal remedies to help you recover after birth.

A caesarean section, or C-section, is an operation to deliver your baby through a cut made in your tummy and womb.

The cut is usually made across your tummy, just below your bikini line.

A caesarean is a major operation that carries a number of risks, so it's usually only done if it's the safest option for you and your baby

Why might I need a c section?

A caesarean may be recommended as a planned (elective) procedure or done in an emergency if it's thought a vaginal birth is too risky.

Planned caesareans are usually done from the 39th week of pregnancy.

A caesarean may be carried out because:

  • your baby is in the breech position (feet first) and your doctor or midwife has been unable to turn them by applying gentle pressure to your tummy, or you'd prefer they did not try this
  • you have a low-lying placenta (placenta praevia)
  • you have pregnancy-related high blood pressure (pre-eclampsia)
  • you have certain infections, such as a first genital herpes infection occurring late in pregnancy
  • your baby is not getting enough oxygen and nutrients – sometimes this may mean the baby needs to be delivered immediately
  • your labour is not progressing or there's excessive vaginal bleeding

If there's time to plan the procedure, your midwife or doctor will discuss the benefits and risks of a caesarean compared with a vaginal birth

Can I request a Caesarean?

Some women choose to have a caesarean for non-medical reasons.

If you ask your midwife or doctor for a caesarean when there are not medical reasons, they'll explain the overall benefits and risks of a caesarean to you and your baby compared with a vaginal birth.

If you're anxious about giving birth, you should be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour.

If after discussing all the risks and hearing about all the support on offer you still feel that a vaginal birth is not an acceptable option, you should be offered a planned caesarean. If your doctor is unwilling to perform the operation, they should refer you to a doctor who will.

Risks of a caesarean

A caesarean is generally a very safe procedure, but like any type of surgery it carries a certain amount of risk.

It's important to be aware of the possible complications, particularly if you're considering having a caesarean for non-medical reasons.

Possible complications include:

  • infection of the wound or womb lining
  • blood clots
  • excessive bleeding
  • damage to nearby areas, such as the bladder or the tubes that connect the kidneys and bladder
  • temporary breathing difficulties in your baby
  • accidentally cutting your baby when your womb is opened

What happens during a caesarean

Most caesareans are carried out under spinal or epidural anaesthetic.

This mean you'll be awake, but the lower part of your body is numbed so you will not feel any pain.

During the procedure:

  • a screen is placed across your body so you cannot see what's being done – the doctors and nurses will let you know what's happening
  • a cut about 10 to 20cm long will usually be made across your lower tummy and womb so your baby can be delivered
  • you may feel some tugging and pulling during the procedure
  • you and your birth partner will be able to see and hold your baby as soon as they have been delivered if they're well – a baby born by emergency caesarean because of foetal distress may be taken straight to a paediatrician for resuscitation

The whole operation normally takes about 40 to 50 minutes.

Find out more about how a caesarean is carried out

Types of Stitches Used in C-Sections

  1. Subcutaneous Stitches: These stitches are placed beneath the surface of the skin, typically in the fatty layer below the skin. They provide support to the deeper tissues and help to approximate the wound edges.
  2. Dermal Stitches: Dermal stitches are used to close the deeper layer of the skin, known as the dermis. They are typically absorbable and may be made of materials such as polyglycolic acid or poliglecaprone.
  3. Skin Staples: In some cases, skin staples may be used instead of stitches to close the outer layer of the skin. Staples are metallic devices that are applied externally and can be removed at a later stage.
  4. Dissolvable Stitches: These stitches are designed to dissolve over time as the wound heals. They are commonly used in both the subcutaneous and dermal layers and eliminate the need for removal.

Removal vs. Dissolution of Stitches

  1. Non-dissolvable Stitches: If non-absorbable stitches or skin staples are used, they will typically require removal by a healthcare provider. This procedure is usually performed during a follow-up visit, typically 7 to 14 days after the C-section, depending on the type of stitches used and the individual's healing progress.
  2. Dissolvable Stitches: Absorbable stitches, such as those made of polyglycolic acid or poliglecaprone, will gradually dissolve on their own over time. There is no need for manual removal, as the body naturally absorbs the material as part of the healing process.

Recovering from a caesarean

Recovering from a caesarean usually takes longer than recovering from a vaginal delivery.

The average stay in hospital after a caesarean is around 3 or 4 days, compared with an average of 1 or 2 days for a vaginal birth. You may be able to go home sooner than this if both you and your baby are well.

You may experience some discomfort in your tummy for the first few days. You'll be offered painkillers to reduce any discomfort.

When you go home, you'll need to take things easy at first. You may need to avoid some activities, such as driving, until you have had your postnatal check-up with the doctor at 6 weeks.

The wound in your tummy will eventually form a scar. This may be obvious at first, but it should fade with time and will often be hidden in your pubic hair.

Tips for C-Section Scar Care

  1. Keep the Incision Clean: Follow your healthcare provider's instructions for cleaning the incision area. Gently wash it with mild soap and water, then pat dry with a clean towel. Avoid harsh scrubbing, as it can irritate the wound.
  2. Monitor for Signs of Infection: Watch out for any signs of infection, such as increased redness, swelling, warmth, or discharge from the incision site. Contact your healthcare provider immediately if you notice any concerning symptoms.
  3. Protect the Incision: Keep the incision site dry and avoid exposing it to excessive moisture. Wear loose-fitting clothing to prevent rubbing and irritation. Additionally, refrain from lifting heavy objects or engaging in strenuous activities that could strain the wound.
  4. Support Your Healing Process: Prioritise rest and proper nutrition to support your body's healing process. Stay hydrated, eat a balanced diet rich in vitamins and minerals, and consider incorporating foods known for their anti-inflammatory properties, such as fruits, vegetables, and omega-3 fatty acids.

Products to Aid in C-Section Scar Healing

  1. Silicone Scar Sheets: Silicone sheets are designed to flatten and soften scars while reducing redness and discolouration. They provide a protective barrier over the incision site and can be worn comfortably under clothing.
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C section Silicone Scar Sheets
  1. Scar Massage Gel: Specialised scar massage gels contain ingredients like vitamin E and onion extract, which promote collagen production and improve scar appearance. Gently massage the gel onto the scarred area to enhance circulation and tissue regeneration.
  2. Topical Creams and Ointments: Look for over-the-counter creams or ointments formulated with ingredients like aloe vera, cocoa butter, or shea butter. These moisturising agents can soothe dry, itchy skin and aid in scar healing.
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C Section Scar Silicone Gel
  1. Scar Healing Oil: Natural oils such as rosehip oil or argan oil are known for their skin-nourishing properties. Apply a few drops of scar healing oil to the incision site and massage gently to improve elasticity and fade scars over time.
  2. Compression Garments: Compression garments or abdominal binders provide gentle support to the abdominal muscles and incision area, reducing swelling and discomfort. Choose a breathable, adjustable garment for maximum comfort during the recovery process.

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47,000 reviews on Amazon - Postpartum Compression Garment

How big will my C-Section scar be?

A standard c-section scar will be around 10-12cm long, and sits where the bikini line is at the bottom of your abdomen (tummy). This is the same for a planned or unplanned operation. In some extreme circumstances, it may be necessary to perform what’s known as a classical incision, a vertical cut from your belly button downwards. Even rarer still, when they have tried the horizontal way and then go on to the vertical, leaving you with an inverted T shape scar. I have only seen this once in my 14 years experience and it was an exceptional case.

c section scar picture
3 weeks post c-section with first baby, courtesy of Lycrawidow.com

General Recovery Tips For C-Section Mums

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Be kind to yourself – you’ve had major abdominal surgery! Whilst most people recovering from surgery are encouraged to rest and recuperate, you’re handed a baby, expected to feed and be responsible for it, often straight after the surgery. Make sure you ask for help picking up the baby, for suitable positions for breastfeeding and pain relief when you need it. Some hospitals allow partners or close relatives to stay with you, which will help. When you go home, don’t be tempted to get back into your routine, particularly housework and childcare. Learn to delegate! Here are some general tips which may have some effect on your wound healing:

  1. Keep hydrated
  2. Eat fibre rich and iron rich foods, like fruit, leafy green vegetables and wholegrain foods
  3. Keep mobile – rest where possible but don’t sit or lie too much, keep the circulation going
  4. Wear supportive clothing and/or support garment.
  5. Avoid anything perfumed or containing alcohol on your skin
  6. Keep the wound clean and dry
  7. Pat dry rather than rub dry

Understanding the Impact of a Previous C-Section

A C-section involves the surgical delivery of a baby through an incision in the abdomen and uterus. While it is a safe procedure, it does come with potential implications for future pregnancies:

  1. Uterine Scar: The scar tissue from a previous C-section may increase the risk of uterine rupture in subsequent pregnancies, particularly if the incision was made vertically (classical incision) rather than horizontally (low transverse incision).
  2. Placenta Previa: Women who have had a C-section may have a slightly higher risk of developing placenta previa in subsequent pregnancies, where the placenta partially or completely covers the cervix.
  3. Placenta Accreta: In some cases, the placenta may implant too deeply into the uterine wall, leading to a condition called placenta accreta. This complication is more common in women with a history of C-sections.

Factors to Consider for Future Pregnancies

  1. Type of Incision: The location and type of uterine incision from the previous C-section can influence the management of future pregnancies. A low transverse incision is less likely to cause complications than a vertical incision.
  2. Interval Between Pregnancies: It is generally recommended to wait at least 18 to 24 months after a C-section before conceiving again. This allows the body time to heal and reduces the risk of complications in subsequent pregnancies.
  3. Consultation with Healthcare Provider: Before attempting another pregnancy, it's essential to discuss your medical history, including details of your previous C-section, with your healthcare provider. They can provide personalized guidance and recommendations based on your individual circumstances.
  4. Mode of Delivery: Depending on various factors, including the type of uterine scar and any pregnancy complications, your healthcare provider may recommend either a vaginal birth after cesarean (VBAC) or a repeat C-section for subsequent deliveries.

VBAC vs. Repeat C-Section

  1. Vaginal Birth After Cesarean (VBAC): VBAC is a safe option for many women who have had a previous C-section, especially if the incision was low transverse and there are no other complicating factors. However, it carries a small risk of uterine rupture, which can be a life-threatening emergency.
  2. Repeat C-Section: In some cases, a repeat C-section may be recommended, particularly if there are concerns about uterine integrity or other medical indications. While it is a surgical procedure, advances in surgical techniques have made C-sections safer than ever before.

For more information, the Royal College of Obstetricians and Gynaecologists has a leaflet on birth options after previous caesarean section (PDF, 357kb).

Reference nhs.uk

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