A caesarean section (c-section) can be the safest option if there are concerns about your, or your baby’s, health. But there are benefits and risks to having a c-section. Speak to your midwife or doctor about how these may affect you.
What are the benefits of a c-section?
For women who have not had a c-section before, a planned c-section might reduce the risk of:
- pain during and after the birth
- injury to the vagina
- heavy bleeding after the birth
- loss of bladder control
- the womb, vagina, bowel or bladder pushing against the wall of the vagina (pelvic organ prolapse).
This doesn’t mean that these things won’t happen, but your risk is lower than if you had a vaginal birth.
Your risk of pain during sex and bowel problems is no higher than for a vaginal birth.
Risks of having a c-section
Having a c-section can increase some risks to you and your baby. This doesn’t mean that these things will happen to you, but there may be a higher chance of them happening than if you had a vaginal birth. Speak to your midwife or doctor about how these risks may affect you and your baby.
Possible c-section risks to you include:
- infection of your wound or the lining of the womb
- bleeding that leads to a blood transfusion or having the womb removed – this is uncommon and may be more likely if you had problems with the placenta or bleeding during pregnancy
- heart attack
- problems getting pregnant in the future
- problems in future pregnancies, such as low-lying placenta, placenta accreta, miscarriage and stillbirth
Caesarean sections performed late in labour have been linked to a risk of preterm birth in the next pregnancy. When done at full dilatation (in the second stage of labour) the risk is increased from 2% to around 15%.
Possible c-section risks to your baby include:
- a cut to the skin, caused during surgery – this is usually minor and heals quickly
- a higher risk of admission to the neonatal unit
- breathing problems – this is more common if your baby is born before 39 weeks of pregnancy. Most breathing problems get better after a few days but some babies need to go into the neonatal unit. Speak to your midwife if you are worried about your baby’s breathing while you are in hospital. If you are at home and your baby isn’t breathing properly, call 999.
C-sections and links to long-term conditions
There is limited research into how c-sections affect the long-term health of children. There is some evidence that children born by c-section may have a higher risk of long-term conditions, such as childhood asthma, type 1 diabetes or obesity. The reason for this increased risk isn’t clear. There isn’t enough evidence to show that it is caused by the c-section itself. For example the health of the mother and the reason for having a c-section could equally be the cause of the child’s risk of long-term conditions.
One theory however is that the baby isn’t exposed to bacteria in the mother’s vagina. This bacteria is called the microbiome, and it is found in the guts of babies who have been born vaginally and may help protect against asthma and obesity during childhood.
It could also be linked to the fact that women who have a c-section are more likely to have problems with establishing breastfeeding, which protects against obesity in the baby.
C-section and future pregnancies
For women who have had up to four previous c-sections, the risks linked to having another c-section compared with the risks of a vaginal birth for following pregnancies is the same. There is a slightly higher risk of the scar from a previous c-section tearing during a vaginal birth (uterine rupture), but this is rare.
Even if you have had a previous caesarean, you may be able to have a vaginal birth for your next baby if you want one. This is called vaginal birth after caesarean (VBAC). You may need to give birth in a hospital where you can have an emergency c-section if you need one.
If your labour needs to be induced for any reason, you can choose whether to go ahead with induction or have a planned c-section. There are benefits and risks with both options so you should discuss your personal situation with your healthcare team.
While you are still in hospital, your midwife should give you written information on your birth options for future pregnancies.
What should I expect after a c-section?
It usually takes longer to recover from a c-section than from a vaginal birth. After your operation you may:
- find it painful or uncomfortable to move around
- find it more physically difficult to look after your baby
- take longer to start exercising or be active after the birth
- find it harder to establish breastfeeding – for example, if you have pain or can’t move around easily
- have an increased risk of blood clots – your midwife may give you blood-thinning drugs and compression stockings, and encourage you to get up and move around, and drink plenty of fluids to reduce your risk
- have vaginal bleeding (lochia) for two to six weeks – this is the same as after a vaginal delivery
- have trapped wind, which can be painful – peppermint tea may help with this
- feel a range of emotions – such as sadness or disappointment if you hadn’t planned to have a c-section. There may be a link between having a c-section and postnatal depression.
You will stay in bed for several hours after your operation, until the anaesthetic has worn off. During this time, you will need help from other people to pass your baby to you.
Having a c-section usually involves a longer hospital stay. Women who have had an uncomplicated vaginal delivery may be able to go home after a few hours. After a c-section, you may need to stay in hospital for between two and four days, although you can usually go home sooner if there are no complications and you have support at home.
It can take about six weeks to recover from a c-section. While you’re recovering at home, wait until you feel ready and you don’t have any pain before carrying anything heavy, driving, having sex or exercising heavily. Gentle exercise, like walking, will help you recover.