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C-Section (Caesarean) Birth: What to Expect Before and After

Why caesareans are done, how the operation goes and how to recover.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

A caesarean (C-section) is an operation to deliver your baby through a cut in the abdomen and womb. Around one in three births in many countries is a caesarean. It may be planned in advance or carried out as an emergency during labour, and either way it is a safe, common operation that has helped many mothers and babies.

Common reasons

• Your baby is in a breech or other position that makes vaginal birth unsafe
• The placenta covers the cervix (placenta praevia)
• Concerns about your baby's wellbeing in labour, such as an abnormal heart rate
• Labour that is not progressing, even with help
• Twins or more, depending on their positions
• Certain medical conditions, or infections such as active genital herpes or HIV with a high viral load
• A previous caesarean or other uterine surgery, if you and your doctor decide against a vaginal birth
• Your own choice, after a full discussion of the benefits and risks with your team

Planned and emergency caesareans

A planned caesarean is usually scheduled from about 39 weeks, when babies are less likely to have breathing problems. An emergency caesarean is done when labour or the baby's condition means a quicker delivery is needed. Some emergency caesareans are urgent but not immediate, and your team will explain what is happening and why.

Preparing for a planned caesarean

• You will be told when to stop eating and drinking. Usually this is about six to eight hours before for food, and clear fluids are allowed up to about two hours before.
• You will have blood tests, a check of your blood pressure and a chance to ask questions and sign a consent form.
• You will change into a gown, and the nurse will insert a drip in your hand. You may be given antibiotics and a drink to reduce stomach acid.
• Pack your hospital bag for a longer stay. See our hospital bag checklist.

During the operation

Most caesareans are done with a spinal or epidural anaesthetic, so you are awake but numb from the chest down. A general anaesthetic is used only if needed, for example in some emergencies. A screen is placed across your chest, a catheter drains your bladder and your birth partner can usually be with you.

• Your baby is usually born within about 10 minutes of the start. You may feel pulling and pressure but not pain.
• The rest of the operation, including delivering the placenta and stitching, takes around 30 to 45 minutes.
• You can often hold your baby soon after, and in many hospitals skin-to-skin contact is possible in the operating theatre. Some hospitals offer a gentle or family-centred caesarean, with a clear drape or lowered screen. Ask your team what is available.
• You might feel shivery, sick or itchy, which are common effects of the anaesthetic. Tell the team, who can help.

Recovery in hospital

• Expect to stay in hospital for around one to four days, depending on your country and how you are doing.
• You will be encouraged to get up and walk the day after, with help. This lowers the risk of blood clots. You may be offered compression stockings or blood-thinning injections.
• Pain relief is given regularly, often paracetamol and an anti-inflammatory such as ibuprofen, with stronger medicine if needed. These are generally safe if you are breastfeeding. Ask your team.
• Gas pain and constipation are common. Walk, drink fluids and eat fibre, and ask for a stool softener if needed.
• You can usually breastfeed straight away. Side-lying and football-hold positions keep the baby off your wound.

Recovery at home

• Keep the wound clean and dry, wear loose, high-waisted clothing and pat it dry after a shower. Stitches usually dissolve.
• Support your tummy with a pillow when you cough, laugh, sneeze or feed.
• Avoid heavy lifting, lifting anything heavier than your baby, and strenuous activity for around six weeks, or as your doctor advises.
• Drive again only when you can do an emergency stop without pain. Check your insurance policy too, which can set conditions.
• Numbness or tingling around the scar is common and often improves over months.
• Rest as much as possible, accept help, and take your pain medicine on time.

Gentle walking is good for you, and our guide to returning to exercise after birth explains how to build up safely.

Your feelings

People feel many things about a caesarean: relief, disappointment, sadness or even grief if it was unplanned. All are valid. If you feel upset or traumatised, ask for a birth debrief, and talk to your doctor, midwife or a support group if feelings do not ease.

Possible risks

Like any surgery, a caesarean carries risks, including infection, heavy bleeding, blood clots, and, rarely, injury to the bladder or bowel. Recovery is usually longer than after a vaginal birth. Babies born by caesarean, particularly before 39 weeks, are slightly more likely to have temporary breathing problems. A caesarean can also affect future pregnancies, for example by raising the chance of placenta problems.

Future pregnancies

Many women who have had a caesarean can try a vaginal birth next time (VBAC), and a good proportion are successful. Your doctor will talk through the options based on why you had a caesarean and how your pregnancy goes. It is common to wait at least 18 months before the next pregnancy, but ask your doctor.

Call your doctor if

• You have a fever of 38 °C (100.4 °F) or higher
• You have heavy bleeding, such as soaking a pad in an hour, or large clots
• The wound is red, swollen, hot, leaking pus or opening
• You have severe pain, or foul-smelling discharge
• You have pain, redness or swelling in one calf
• You have burning when you pass urine, or you cannot pass urine
• You have a severe headache or changes in your vision

Seek emergency help straight away for chest pain or difficulty breathing, which could be a blood clot in the lung.

Where to check current advice

Recommendations differ between countries, so check with your own health service, such as NICE and the NHS in the UK, the HSE in Ireland, ACOG in the US, the SOGC in Canada and RANZCOG in Australia.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.