Emergency caesarean

A Caesarean section is a medical procedure that involves cutting the abdomen and womb in order to deliver a baby. The WHO recognises that around 15% of babies are born through caesarean section. It is also known as a C-section, Caesar or CS. An emergency caesarean section is a caesarean performed once labour has commenced, where a planned or elective caesarean is scheduled to take place before your labour begins.

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What makes an emergency caesarean necessary?

There are a few reasons why your doctor might suggest an emergency caesarean. Here are a couple of the most likely options:

Your baby’s heartbeat shows that he is not coping well with the birth, in other words, your baby is ‘distressed’.
Your cervix slows down dilating or stops altogether.
The placenta starts to come away from the wall of the womb and there is a risk of internal bleeding.
The baby does not move down into the pelvis, indicating that the pelvis is too small for the baby to get through.
You were planning a caesarean, but went into labour before the operation. Your caesarean can go ahead within a few hours of your labour starting, as long as you and your baby are well.
The labour process is going so slowly that it presents a risk to both mother and child.
Multiple babies, i.e. twins and triplets, are sometimes very difficult to deliver naturally and if multiple babies are not anticipated, an emergency caesarean might be the best option.
The baby is in the breech position, i.e. feet first, as opposed to the normal head-first positioning.

Emergency caesarean risks

An emergency caesarean is inherently riskier than vaginal delivery. Here are some of the risks that accompany it:

Infection of the womb or womb lining
Clots or thrombosis forming in the mother’s legs
Excessive bleeding
Damage to your womb, bladder or pelvic floor muscles
The baby may be more susceptible to breathing difficulties
Some babies are affected by the drugs given to the mother for anaesthesia during surgery

What to expect during an emergency caesarean

You may be given a pair of surgical stockings to wear, which will help prevent the formation of clots. Nail varnish and jewellery will be removed, and you will be shaved around your pubic area. In theatre, you’ll be given an anaesthetic or epidural.

The anaesthetist will ensure you cannot feel anything before the caesarean begins. A screen is clipped up so you can’t see what is going on, a catheter will be inserted to drain your bladder, and a cut made just above your bikini line, giving the surgeon access to your womb for the caesarean.

You may feel a tugging or rummaging sensation, but no pain. The baby will be delivered within around 3 - 5 minutes of the first cut, your new baby will be lifted out, checked, and the cord clamped and cut.

If everything is OK, you will be able to hold your baby on your chest while the placenta is delivered and you are stitched up. You may prefer your partner to hold the baby while this is done.

The whole caesarean takes around 30 minutes. You will then be moved to a recovery bay or room, and then onto a ward. A midwife will encourage you to breastfeed your baby as soon as possible.

After the caesarean

Your catheter will usually be left in place until the morning after the operation. You will also have an IV attached to a drip, administering medications, and if you are wearing surgical stockings they will be left on to prevent any clotting. You will be given painkillers, but your doctor, a nurse or midwife will encourage you to get out of bed to walk around as soon as possible to promote circulation and help prevent clots.

Expect to stay in hospital for around 3 days and arrange to have extra help at home as you may find getting around difficult at first. This period after the caesarean is called the postpartum period and it can be really difficult for you and your family. During this period you are most vulnerable to any complications arising from the c-section and you really need to take it easy.

Before leaving the hospital, talk to your doctor about pain medications that you can take at home; what doses, what frequencies, and any side effects of the drugs should be discussed. Your womb will start contracting shortly after the caesarean and this will entail a fair bit of vaginal bleeding, so make sure you have plenty of pads before you go home.

You should be as inactive as possible, don’t lift anything heavier than your new baby. You should ensure you have a healthy diet, full of fibre, fresh fruit and vegetables. Hydration is also key, so try to have a water bottle with you for most of the day as this will encourage drinking.

Set up your ‘baby station’ as close as possible to where you will be resting, so that you don’t have to get up that often. Notify your doctor immediately if you feel sore or feverish, as this can be a sign of infection, which needs to be treated. An emergency caesarean may also leave emotional scars, especially if you were expecting a nice, regular normal birth. Spend some time de-stressing and relaxing; you may also want to consider seeing a psychologist or psychiatrist if you have a really bad case of the blues.

When to call your doctor

There are a couple of instances after your caesarean where you should call your doctor immediately. What follows are a few things to keep an eye out for:

You have a very high temperature that persists
You develop a headache after the c-section and its severity doesn’t decrease
Pain that develops in the stomach or abdominal area
Vaginal discharge that has an unusual smell
Swollen and red areas on your legs
You find that passing urine (peeing) is painful or there is blood in your urine
Your breasts become very sensitive and red blotches appear

If you notice any of these changes to your body occurring, especially if they happen together, then it’s time to give a medical professional a call.