A caesarean birth, also called a C-section, is an operation to birth your baby through incisions in the abdomen and uterus. It may be planned during pregnancy or recommended unexpectedly before or during labour. When there are complications, it can be the safest way for your baby to be born.
It is also major surgery, with its own risks and recovery needs. Understanding the reason for the operation, what it involves and the support you’ll need afterwards can make decisions feel less overwhelming.
Why might a caesarean be recommended?
Reasons can include a placenta covering the cervix, a baby lying sideways, some breech pregnancies, or certain complications affecting you or your baby. During labour, it may be recommended if your baby needs to be born quickly or labour is not progressing safely.
These decisions are individual. A previous caesarean or twins does not by itself tell you which birth plan is right. Your obstetrician should explain how the specific circumstances affect your options.
A planned operation is sometimes called an elective caesarean; this can still be medically recommended. An emergency caesarean is unplanned, and the degree of urgency varies. Ask why it is recommended, how soon birth is needed and whether there are alternatives.
If you would prefer a caesarean, raise this early with your maternity team. Your concerns, previous experiences and plans for future pregnancies belong in the discussion. You should receive balanced information about the benefits and risks of both planned vaginal birth and caesarean birth.
Preparing for the operation
If there is no reason for earlier birth, a planned caesarean is generally scheduled around 39 weeks. For a planned caesarean, follow the hospital’s instructions about when to arrive, fasting and medicines. Don’t stop prescribed medicines or choose your own fasting times. If labour begins or your waters break before the scheduled day, call the maternity unit.
Before surgery, the team checks your details, discusses consent and anaesthesia, and prepares a drip and usually a catheter to drain your bladder. Measures such as antibiotics and blood-clot prevention are used according to your care plan.
Ask in advance about your support person, skin-to-skin contact, feeding and what will happen if your baby needs extra care. An interpreter or clear explanations before touch and examinations may be important parts of your plan.
What happens during a caesarean?
Most people have a spinal anaesthetic, or an existing epidural may be topped up, so they can stay awake while the lower body is numb. Sometimes a general anaesthetic is needed. You may feel pressure or pulling with regional anaesthesia, but tell the anaesthetist immediately if you feel pain.
A screen usually separates your view from the operation. The surgeon makes incisions to reach the uterus, births your baby, removes the placenta and closes the incisions. The skin cut is often low across the abdomen, but the approach depends on the situation. Your team checks your baby and monitors you throughout.
When you and your baby are well enough, ask for help with skin-to-skin contact and the first feed. If either of you needs treatment, the team can explain what is happening and help you reconnect when it is safe.
Benefits and risks to discuss
A caesarean can avoid the dangers of continuing labour or pregnancy in particular circumstances. A planned caesarean also avoids vaginal and perineal tearing during that birth. Those benefits need to be considered alongside surgical risks and your own preferences.
Risks include infection, bleeding, blood clots, anaesthetic complications and, less commonly, injury to nearby organs. Some babies have temporary breathing difficulties after caesarean birth. Your individual risk depends on factors including the reason for surgery and whether it is planned or urgent.
The scar in the uterus matters in future pregnancies. Repeat caesareans can increase the risk of placental problems and make later surgery more complicated. A vaginal birth after caesarean, or VBAC, is an option for many people, but needs an individual discussion about the previous operation and current pregnancy.
Recovery in hospital and at home
Your team will check your bleeding, wound, pain and recovery from the anaesthetic. Ask for help when first getting out of bed. Gentle movement is encouraged when safe, and some people need medicine or stockings to reduce clot risk. The length of your hospital stay depends on how you and your baby are doing and the support available at home.
Recovery takes weeks. Rather than expecting to feel fully recovered on a particular day, follow your discharge plan and ask for review if things are getting worse.
- Use your pain-relief plan. Tell your team if it isn’t working and check any additional medicines, including whether they are suitable when breastfeeding.
- Care for the wound as instructed. Keep it clean and dry and follow advice about dressings and any stitches or staples that need removal.
- Arrange practical help. Lifting a toddler, carrying shopping or doing strenuous housework may put strain on the wound. Avoid lifting more than your baby until your team advises otherwise.
- Build activity gradually. Short, gentle walks can be a starting point. Ask your clinician or physiotherapist about exercise and pelvic-floor recovery.
- Check before driving. You need to be able to move and brake safely, without pain or medicines affecting alertness. Follow medical advice and your insurer’s requirements.
Vaginal bleeding still happens after a caesarean because the uterus is healing where the placenta was attached. It should generally become lighter. Use pads and follow your team’s advice about recovery, sex and follow-up appointments.
Symptoms that need urgent help
Call 000 in Australia for chest pain, sudden difficulty breathing, collapse, a seizure, or very heavy bleeding, particularly with dizziness or faintness.
Get urgent medical assessment now for a painful or swollen leg, a severe headache, blurred vision or severe upper abdominal pain. These can signal complications after birth as well as during pregnancy. If symptoms are severe or you cannot safely reach care, call 000.
Contact your maternity unit or doctor now for fever, increasing wound pain, redness or swelling, pus or an opening wound, foul-smelling vaginal discharge, worsening abdominal pain, or difficulty passing urine. Bleeding that becomes heavier, large clots or soaking a pad in an hour also needs immediate advice. Do not wait for the routine postnatal check.
Feeding, closeness and your birth experience
Ask a midwife to help you find a feeding position that keeps pressure off the wound. You can also ask someone to bring your baby to you while movement is uncomfortable.
Skin-to-skin contact, when safe and supported, is one way to spend time together. If it is delayed, there will be further opportunities for closeness. You may feel pleased with your birth, unsettled by it, or a mixture of both. Ask for a discussion with the maternity team if you want to understand what happened, and seek support if distress persists.
For related preparation, read about labour and birth and induction of labour.
Sources and further reading
- ANZCA: pain relief and having a baby
- King Edward Memorial Hospital: caesarean birth and recovery
- RANZCOG: caesarean section
- Better Health Channel: caesarean section
- RCOG: considering a caesarean birth
- Raising Children Network: recovery after caesarean birth
- Queensland Health: blood clots in pregnancy and after birth
- Queensland Health: high blood pressure in pregnancy
- Queensland Health: bleeding after birth
This is general information for readers in Australia. Follow your maternity team’s advice about your operation and recovery.