Info Every Preggo Should Know (Yes, Even You!)
Sometimes C-sections are planned, often because the baby is breech -- the case for 3 to 4 percent of all births. You may also be sent to the OR, without having so much as a single contraction, if your doctor suspects your baby is large (which can happen if you have diabetes), if he's transverse (lying sideways), if he has certain birth defects or you're carrying multiples, or if there are umbilical cord problems. A C may be nonnegotiable if you've had previous uterine surgery, if there's a problem with the placenta's position (such as placenta previa, where it covers the cervix), if you have an active genital herpes outbreak or HIV, or if you have severe high blood pressure, usually from preeclampsia.
Unplanned cesareans are different. They occur when something starts to go wrong once you're in labor. Most first-time C-sections happen this way, notes Carol Livoti, M.D., an ob-gyn in New York City and author of Vaginas: An Owner's Manual.
Numerous things can go awry. Changes in your baby's heart rate can suggest fetal distress. She may be too large to squeeze though the pelvic opening (a condition called arrested descent). Robert F. Katz, M.D., an OB in Beverly Hills, says that doctors also head to surgery if the umbilical cord blocks the baby's exit, the placenta separates from the uterine wall, the cervix won't dilate enough, or the baby changes position at the last minute.
The good news is this: As far as surgeries go, C-sections are considered safe. But, as with any operation, there are some small but real risks, says Daniela Carusi, M.D., director of Surgical Obstetrics at Brigham and Women's Hospital, in Boston. These include bleeding, blood clots, infection, often around the incision (but IV antibiotics before surgery can help fend off bacteria), and reactions to anesthesia.
Most C-sections will involve a horizontal incision, both in your uterus and in the muscles, fat, and skin above it. It's called a "bikini cut" because the line is about two finger-widths above the pubic bone, Dr. Carusi says, right at the top of where your pubic hair ends. Unless your bikini bottom is teensy-weensy (in which case, go you!), it's easy to hide the scar, so don't stress about the beach.
Your surgeon will use dissolvable stitches deep inside and close the wound with either staples or dissolvable stitches at skin level, Dr. Carusi says. After stitching, your doctor will cover the incision with surgical tape to keep the wound clean and foster healing.
In the moments after Baby is born, a pediatrician will examine him, bundle him up, and hand him to your partner. While the surgeons sew you up, you can nuzzle your newborn briefly. It's usually not until about 30 minutes later, once you're in the recovery room, that you can hold your cutie close and begin nursing.