If you know in advance you are going to have a Cesarean, you can plan for it. You can choose to have the operation done under an epidural anesthetic. That way, you can see and participate in the birth and see or hold your baby as soon as he or she is born. Your husband or partner is also likely to be present for the entire operation. You can make plans for the extra support you will need when you come out of the hospital. If the operation is done as an emergency, however, you are likely to be given a general anesthetic, because setting up an epidural takes time. Your partner may not be able to be with you. In addition, you are likely to suffer aftereffects of the anesthetic, making it more difficult to bond with your new baby right after birth.

A typical Cesarean section usually takes about 45 minutes from start to finish. The baby is delivered in the first 5 to 10 minutes, and the rest of the operation is concerned with stitching you up. The surgeon makes a cut about 12cm long, usually horizontally and just below the “bikini line.” He or she then cuts horizontally through the lower part of the uterus, where there are no main blood vessels. The bag of waters may break of its own accord or have to be broken, and the fluid is sucked away. The surgeon then puts his or her hands into the uterus and rotates the baby’s head so that it appears in the incision. The surgeon helps deliver the baby’s head using his or her hands, or sometimes forceps, and an assistant usually presses gently on the top part of the uterus. A drug to make the uterus contract and stop any bleeding is given, and the rest of the baby is brought out. Then the placenta is delivered. Next, the uterus is sewn up and then the abdominal wall.

Although the Cesarean section is a very safe operation, it is major surgery. The risk of complications, although small in this case, exists wherever surgery is concerned. Many women experience a lot of postoperative pain and may find they cannot get comfortable for breast-feeding. Mothers often find it takes them longer to bond with their baby because they feel so uncomfortable in the days following the delivery:

“Having a Cesarean leaves you so incapacitated that it takes much longer to do things for the baby. Everything the baby does makes you feel so uncomfortable-lifting, feeding-and you are tied down with drips and bottles draining the wound for two days. Your mind is geared to you and not to the baby-it is harder to bond. Because of this I really appreciated the time I had with her at the beginning. My Cesarean was planned, so it was done with an epidural and I was awake. She was born onto me, although I couldn’t feel it. I was able to hold her right away. I was able to think, ‘This is my baby, all right,’ and the three of us had about 1-1/2 hours together after the birth. Without that I think it would have been really hard.”

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