Babypalooza
C-section Questions

OB/GYN Answers Members Cesarean Section Questions

Dr. Sima Baalbaki with UAB Health System took the time to answer some of the most common questions Babypalooza moms have about C-sections.

If I Have a Cesarean Section for Delivery with One Baby, Will I Need a Cesarean for All Future Deliveries?

Dr. Baalbaki: This is a very common question we get from mothers who underwent a Cesarean in a prior pregnancy and are now pregnant again.

The short answer is “it depends”. Most of the time, if you have had one, or even two, prior deliveries by Cesarean, you are still a candidate for a “Trial of Labor after Cesarean” (or TOLAC) in future pregnancies. Whether you are a potential candidate for this depends on the type of incision your doctor made on your uterus at the time of the C-section. In most cases, the incision is made through the lower part of the uterus; if this is the case, a TOLAC is likely an option in a future pregnancy. If a different kind of incision is made, then the risk of complications is higher, and therefore, we recommend a repeat C-section for delivery.

If someone is going to need a repeat C-section in future pregnancies, most doctors will notify you of that information before you leave the hospital because it is very important to know in case you do not deliver with the same provider in the future. If you have a C-section and your doctor does not mention if you would be able to try for vaginal delivery in the future, you should ask them that question. Of course, there are other factors that go into determining if a TOLAC is a good option for you specifically, so talking with your provider is recommended to determine the best plan of care for you and your baby.

I Heard That Having A Cesarean Section is Easier Than a Vaginal Delivery. Is This True?

Dr. Baalbaki: While a Cesarean section may be the faster way to meet your baby compared to the labor process, it does not come without its own risks. In general, a vaginal delivery is the preferred mode of delivery due to the benefits this kind of delivery provides for both the mother and baby. A Cesarean section is a major abdominal surgery that comes with an increased risk of blood loss, infection, and potential damage to the organs in the abdomen.

These maternal risks are present even in the most routine situations. In addition, the recovery process following a Cesarean delivery is often longer and more difficult than after a vaginal delivery; again, this is because a Cesarean is a major surgery that the body will have to heal from. While delivery by Cesarean is required and recommended in some instances, when a vaginal delivery is an option, it is preferred. It is important for each expectant mother to speak with their provider about the best mode of delivery for their specific situation.

What Does The Hospital Stay Following a Cesarean Delivery Look Like For Most Women?

Dr. Baalbaki: A Cesarean section is major abdominal surgery and the recovery process is often longer than that following an uncomplicated vaginal delivery. That being said, providers and other members of the delivery team are available to help women with this process using a variety of tools. Immediately following surgery, our Anesthesia colleagues do a wonderful job helping monitor pain levels. In many cases, this involves the administration of pain medication through an IV.

However, once you are able to eat more normally (which is usually not long after surgery), we transition to oral pain medications. Oral pain medications last longer and generally work better than IV medications for the type of pain women have after delivery.

Most standard regimens include scheduled Tylenol and a high dose non-steroidal anti-inflammatory drug (NSAID), like Ibuprofen, with additional narcotic pain medication available if needed. Many women will need at least one dose of the oral narcotic, but using both Tylenol and Ibuprofen, as well as heating and ice packs and an abdominal binder, will decrease the need for this. In addition to providing pain medication, we also recommend patients get out of bed, walk around their room, and sit in chairs to avoid lying in bed constantly.

This helps promote faster recovery and avoids the risks associated with limited mobility after surgery (like blood clots). Most women are in the hospital for three to four days following their delivery. Once they are stable for discharge, patients are encouraged to continue using their pain medication at home and to ambulate regularly. Providers and nurses should provide detailed information specific to each woman regarding limitations for lifting and physical exercise prior to discharge.

If I Am Taking Pain Medications After A Cesarean, Can I Still Breastfeed?

Dr. Baalbaki: YES! We strongly encourage breastfeeding following either type of delivery, vaginal or Cesarean. While breastfeeding may initially be more of a challenge due to positioning in the operating room, it can be initiated either in the operating room itself or shortly after in the recovery room.

Providers take special care to ensure that all medications we provide you with during your hospitalization and afterward are safe for breastfeeding if this is something you desire to do. Most hospitals also have excellent lactation consultants who can help with any breastfeeding questions or concerns both during and after your stay.

Of course, there are specific circumstances in which breastfeeding may not be recommended due to maternal health conditions or required medications for the management of these medical problems. For this reason, you should always notify your provider of any medical problems or medications you are taking or are prescribed to ensure they are compatible with breastfeeding.

If I Need A Cesarean Delivery, Will I Miss Out Parts of The Delivery Process?

Dr. Baalbaki: Because a Cesarean section is a major surgical procedure, some modifications to the delivery process must occur to ensure the safety of the mother and baby. However, our goal is for your delivery to be as close to what you envisioned as possible while maintaining safety for all. In most situations, you are able to have one support person with you in the operating room. This person generally sits in a chair by the head of the surgical table to provide support to the patient.

Since a Cesarean requires opening your abdomen, precautions to decrease the risk of infection must be taken. This means we place a clean, blue drape over you that leaves only the area where we are operating exposed. This drape does limit your ability to see the baby immediately after birth.

Unfortunately, this also means that your support person will not be able to cut the baby’s umbilical cord as maintaining a clean surgical area is very important. However, as long as the baby is doing well, the pediatricians will bring him or her over to you shortly after birth. While positioning is sometimes a challenge, skin-to-skin can often be performed in the operating room while the procedure is being completed. This is something many mothers strongly desire following delivery so being able to help them with this goal is important.

It is important to discuss with your provider any aspects of the delivery process that are important to you during your prenatal visits so that he or she can help formulate a plan to accommodate as many of them as possible; this also provides time for you and your provider to come up with alternative options if a request you have cannot be fulfilled due to safety concerns or hospital policy.

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