A cesarean section is delivery of the fetus through incisions in the abdominal and uterine walls. In the United States the rate of cesarean sections is about 25 percent of all births.

No one goes into a pregnancy expecting a cesarean section — also called a c-section — but it could become necessary if there are complications during delivery. Read the answers to these commonly asked questions and you'll be prepared in the event that you need one.

Why Are C-sections Performed?
The following are the most common reasons a doctor has to perform a c-section:

• Failure to progress in labor and cephalopelvic disproportion (meaning the baby's head is too big to fit through the pelvic cavity): These factors account for about 30 percent of c-sections.
• Repeat c-sections: A patient who has already had a c-section may elect to have another one. This accounts for 30 percent of all c-sections. In fact, 60 to 80 percent of patients who have had nonemergency c-sections may safely undergo vaginal birth after cesarean (VBAC). You and your physician will make this decision based on the reason for your previous c-section.
• Breech presentation: When the baby is breech, or positioned feet first, a c-section may be necessary. Cesareans due to breech presentation are especially prevalent in preterm fetuses.
• Fetal distress: A c-section is required to hasten a safe delivery if the baby's health is jeopardized from decreased oxygen flow caused by factors such as maternal illness, cord compression, prolonged labor, or infection.
• Placenta previa or premature separation of the placenta: A c-section is clearly the safest way to protect mother and baby when these conditions are present.

How Are C-sections Performed?
Once it's determined that a c-section is absolutely necessary, you'll be given anesthesia, which is typically an epidural or a spinal block through a needle in your lower spine. In an emergency delivery, general anesthesia is given because it's faster to administer.

When you and the medical staff are certain that you're numb, a horizontal cut is made through your lower abdomen, followed by an incision in the lower uterine segment to ease out the baby (you may feel pulling). The time from the uterine incision to delivery should be less than three minutes. Since your baby does not have the advantage of being in the birth canal, which aids in squeezing the excess fluid lodged in the respiratory tract, suctioning the baby's nose and mouth to clear secretions is necessary. After that you should be able to hear that first wonderful cry!

At this time, the doctor will stitch you back up, while your baby is being given his first physical. After this, with assistance, you'll be able to hold and nurse your newborn.

What's Recovery Like After a C-section?
What is the recovery period like? Will I be in pain? What will my scar be like? These are some of the many questions you probably have about c-section recovery.

Recovery is only uncomfortable when you use your abdominal muscles too strenuously. You need to position yourself carefully when nursing and not do any lifting — including baby — for the first week. You'll be given pain medications to take if you're feeling very uncomfortable. If your physician knows that you're planning on nursing, she'll only give you pain medication that's completely safe for your nursing baby.

The area around your scar will be tender for a few weeks. If it becomes very red or inflamed, call your physician as the incision may be infected. Sometimes wearing a big bandage over the area will protect it from getting irritated and facilitate healing. Typically, the area around the scar is numb from the cutting of the nerves. Over the next several months the numbness should diminish.

The appearance of your scar will continue to improve throughout your first year after delivery. Try to stay calm through the purple and pink stages of healing, and know that the scar will indeed continue to fade. C-section incisions are usually made very low, below the navel, so it's easy to hide.

Will a C-section Affect Sex?
If you had a c-section, your vagina didn't experience the stretching and trauma of a vaginal birth. When you resume sexual activity you'll probably find sexual intercourse more comfortable than you would if you had delivered vaginally. However, you do need to wait until your incision is healing well and until your cervix returns to normal. This is usually about four weeks after delivery, but ask your doctor when it's safe to resume sexual activity — each case is different. Other than having to wait until you're healed, having a c-section should not impact your sex drive, enjoyment of sex, or ability to have sex.

Can I Lower My Risk of Having a C-section?
There is really nothing a woman can do to decrease her chances of having a c-section once she's developed a complication affecting the delivery of the baby. But in certain cases, there is a trial period of labor to see if it might be avoidable. This would only be allowed if it's safe for both the mother and the baby.

The best thing is to try to emotionally prepare yourself for this possibility. Speak with your physician, take a childbirth class, and make sure your partner is prepared to support you in any eventuality during childbirth. Remember that a good physician will not consider doing a cesarean unless absolutely necessary for you and/or your baby.

If you have to have a c-section, remember that you haven't done anything to cause it, so don't feel guilty. You might experience feelings of being cheated out of the experience of childbirth, and that's natural. But do your best to focus on the positive and keep your eye on the end result — a beautiful, healthy baby along with a healthy mother to care for him!

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.

Content courtesy of American Baby.