A surgical delivery method used when vaginal birth poses a risk to the mother or baby. The baby is delivered through abdominal and uterine incisions.
Indication
- Signs of fetal distress or fetal heart rhythm abnormalities
- Breech or transverse presentation when vaginal delivery is not appropriate
- Placenta previa (placenta covering the birth canal) or placental abruption
- Previous classical (vertical) cesarean section or history of multiple cesareans
- Failure to progress in labor, cephalopelvic disproportion
- Active genital herpes, HIV, and certain other infections with high risk of vertical transmission
- Method chosen based on situation in multiple pregnancies
Preparation
- Fasting for 6-8 hours before the procedure (in planned cesarean)
- Up-to-date blood type, complete blood count, coagulation tests, and necessary imaging
- Inform the anesthesiologist about medications used and allergies
- Cleansing of the abdominal area and shaving if needed
- Insertion of a urinary catheter and IV access
How it's performed
- Spinal/epidural (regional) anesthesia is generally administered by the anesthesiologist; general anesthesia may be chosen when needed
- Blood pressure, heart rhythm, oxygen levels, and fetal heart rate are continuously monitored
- The abdominal skin is sterilized and the operative field is covered with drapes
- A horizontal (Pfannenstiel) incision is made in the lower abdomen and tissues are passed layer by layer
- Through an appropriate uterine incision, the baby is delivered, the umbilical cord is cut, and the placenta is removed
- The uterus and abdominal layers are closed with absorbable sutures, and the skin is sutured or stapled
Post-procedure
- Generally a 2-4 day hospital stay
- In-bed movement during the first 24 hours; then assisted standing and walking
- Pain management with prescription medications; choices compatible with breastfeeding
- Keep the incision clean and dry; consult the physician for redness or discharge
- Avoid heavy lifting and intense exercise for up to 6 weeks
- Postpartum gynecological check and psychosocial assessment at week 6
Risks
- Infection (wound site or urinary tract)
- Bleeding, possibly requiring blood transfusion
- Bladder or bowel injury (rare)
- Clot formation (deep vein thrombosis, pulmonary embolism)
- Adhesions, placental implantation problems, and risk of uterine rupture in subsequent pregnancies
FAQ
How long does recovery take after a cesarean?
Hospital discharge is typically 2-4 days. Light daily activities can be gradually resumed within 1-2 weeks; pain at the incision site may persist for 2-3 weeks. Full recovery and return to heavy activities take about 6 weeks. The process is individual.
Does breastfeeding become more difficult after a cesarean?
No. Healthy breastfeeding is possible after a cesarean. Anesthesia effects, pain, or positioning difficulties may be experienced on the first day; these are usually overcome with breastfeeding counseling. A small delay in milk coming in may occur and is temporary.
Does a woman who has had one cesarean always have to have a cesarean?
No, this is not an absolute rule. If the type of previous incision, number of incisions, and the current pregnancy situation are appropriate, vaginal birth after cesarean (VBAC) can be considered. The decision is made together with the physician after detailed evaluation.
When can I become pregnant again after a cesarean?
It is generally recommended to wait at least 12-18 months for the next pregnancy. This period is important for full healing of the uterine incision and to reduce risks such as uterine rupture in subsequent pregnancies. Family planning options are evaluated at the postpartum check.
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