What you need to know about caesarean section births

Rates of caesarean births are on the rise. Whether you’re expecting, or planning to start a family, here’s what you need to know about this major abdominal surgery.

The rate of babies born via caesarean in Australia is on the rise.

In 2021, 38 per cent of women giving birth had a caesarean section — an increase from 25 per cent in 2004.

Australian Institute of Health and Welfare statistics show caesarean-section delivery was also higher in private hospitals (43 per cent) than in public (29 per cent), with elective — or planned — caesareans driving some of the trend.

Whether you are expecting, planning for the future, or simply curious about childbirth practices, understanding the factors contributing to the increasing rates of caesarean births is essential.

So, grab your cuppa and let’s chat about caesareans, because knowledge is power — especially when it comes to your own birthing journey.

What is a caesarean and why might you need one?

A caesarean section, also known as a C-section, is the birth of your baby via major abdominal surgery.

Royal Women’s Hospital Women’s Birth Centre director and obstetrician Associate Professor Julia Unterscheider explains there are two types of caesarean sections — planned (elective) and unplanned (emergency).

She says some of the main medical reasons for a planned caesarean birth can be a repeat caesarean, having a very small or very big baby, placenta previa, or if the baby is in an abnormal position such as breech.

An unplanned caesarean may be required if there are complications during a natural labour.

“It could be because the baby’s heart rate is not good, or the baby is not coping, or the labour is not progressing as we would like,” Assoc Prof Unterscheider says.

Maternal complications such as pre-eclampsia or severe bleeding can also result in an emergency C-section.

What happens during a planned caesarean?

If you are having a planned caesarean, you will be given a scheduled day and time to arrive at the hospital to have your baby, usually at about 39 weeks of gestation.

Assoc Prof Unterscheider says this is what to expect on the day of your surgery:

Step 1:  Consent

Hospital staff will discuss the procedure, including anaesthetic options, with you and you will be asked to sign a consent form for the operation.

Step 2: Pre-op checks

Chat with a midwife and undergo pre-op checks including bloodwork and making sure your baby is in the same position.

Step 3: Pain relief

You are taken into theatre to meet the delivery team and given pain relief via an epidural, a spinal block or general anaesthetic (in rare cases), and a catheter will be inserted.

Step 4: Surgery

Your partner or support person is invited in and curtains are placed up before surgeons make a 10-15cm incision at the bikini line.

Within 10 minutes, your newborn will be lifted out.

Step 5: Welcome, baby

After delayed cord clamping, your baby is checked before being placed on you for skin-to-skin time.

During this time, your doctor delivers the placenta before cleaning up and suturing the incision, which can take between 20 and 40 minutes.

What happens in an emergency caesarean?

Assoc Prof Unterscheider says if there is a need for an emergency caesarean due to complications during labour, the process will happen quite fast.

Once an emergency C-section is deemed necessary, it will follow the same process as an elective caesarean before you are whisked into theatre.

This process can be quite confronting, Assoc Prof Unterscheider notes, and antenatal and birth education is vital to help pregnant mothers prepare for any scenario.

What to expect after a caesarean

Following the birth, you will spend about an hour in recovery for monitoring and to spend time with your baby before being taken to the postnatal ward.

You can expect to stay in hospital between two to five days, depending on the hospital and your recovery.

You are restricted to bed until the catheter is removed; and you will be encouraged to get up and move around as soon as possible to help reduce your risk of blood clots.

Midwives are able to help with breastfeeding and will take you through a birth debrief and what to expect when returning home, Assoc Prof Unterscheider says.

How long does it take to recover from a caesarean?

The initial recovery time is six weeks, and includes not driving – but Australian Birth Stories Podcast founder and mum-of-three Sophie Walker says rest is essential for healing and strengthening after abdominal surgery.

She says women are often encouraged to bounce back and get on with it, but connective tissue can take up to two years to heal.

“In short: take it easy and don’t return to exercise until you’ve seen a women’s health physiotherapist who will best guide you with your body and pelvic floor in mind,” Sophie says.

Can you prepare for a caesarean?

Accessible birth education and preparation are paramount for positive maternal outcomes, and it is important to write a birth plan including your caesarean preferences, Sophie says.

Fear is very normal, she notes, and your care provider can give reassurance by answering your questions and clarifying exactly what will happen on the day, from admission to hospital through to pain relief, birth and recovery.

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Written by Laura Armitage.