An elective cesarean, often referred to as a planned C-section, is a surgical procedure to deliver a baby through incisions in the mother’s abdomen and uterus. This procedure is scheduled in advance of labor, distinguishing it from emergency C-sections that occur due to unforeseen complications during labor or pregnancy. An elective cesarean is chosen for specific reasons, determined through discussions between the expectant parent and their healthcare provider.
Why Choose an Elective Cesarean
Individuals may choose an elective cesarean for various reasons, encompassing both medical indications and personal preferences, always in consultation with healthcare providers. Medical reasons include conditions where a vaginal birth could pose risks to the parent or baby. For example, placenta previa, where the placenta covers the cervix, necessitates a C-section to prevent severe bleeding. If a baby is in a breech or transverse position and cannot be safely turned, an elective cesarean is recommended.
Certain maternal health conditions, such as heart disease, high blood pressure, or infections like active genital herpes or HIV, can make a C-section a safer delivery method to prevent complications or transmission to the baby. A history of previous complicated births or multiple pregnancies also leads to a planned cesarean. Beyond medical necessity, some individuals opt for an elective cesarean due to personal preferences, such as intense fear of labor and vaginal delivery (tokophobia), which can stem from previous traumatic experiences or anxiety about pain. The desire for a scheduled birth can also provide a sense of control and predictability, aiding in childcare arrangements or managing anxiety about the onset of labor.
What Happens During an Elective Cesarean
The process of an elective cesarean begins with preparation at the hospital, involving an appointment in the week before the scheduled procedure to discuss details and conduct blood tests. On the day of the surgery, the expectant parent will be asked to stop eating and drinking a few hours beforehand and change into a hospital gown. In the operating room, regional anesthesia, such as a spinal or epidural block, is administered to numb the lower body while allowing the individual to remain awake.
A thin, flexible tube called a catheter is inserted into the bladder to keep it empty during the procedure, and a small area of pubic hair may be trimmed. The abdomen is then cleansed with an antiseptic, and sterile drapes are placed around the surgical site, often with a screen positioned to block the view of the operation.
The surgeon makes an incision, a horizontal cut just below the bikini line in the lower abdomen, followed by an incision in the uterus. The baby is then carefully delivered through these incisions, a process that takes a few minutes, and the umbilical cord is cut. After the baby’s birth, the placenta is removed, and the uterine and abdominal incisions are closed with dissolvable stitches or staples. The entire surgical procedure lasts less than an hour.
Recovering from an Elective Cesarean
Immediately following an elective cesarean, the mother is moved to a recovery area where nurses closely monitor vital signs, bleeding, and uterine firmness. During this time, pain medication is administered, and early bonding with the newborn, including attempting breastfeeding, is encouraged. The initial hospital stay lasts between two to four days, during which staff assist with pain management, ensure adequate fluid and food intake, and encourage early mobilization.
Upon returning home, continued rest and limited activity are advised for several weeks, as the abdominal incision takes time to heal. Individuals are advised to avoid lifting anything heavier than their baby, twisting movements, or strenuous exercise for several weeks. Wound care involves keeping the incision clean and dry, and any external stitches or staples are removed, while dissolvable stitches underneath the skin will dissolve on their own. Vaginal bleeding, known as lochia, is common after a C-section and can last for several weeks, gradually becoming lighter. Full recovery can vary, but most individuals feel significantly better by two weeks postpartum, with continued healing and scar tissue remodeling occurring over several months.
Factors to Discuss with Your Doctor
When considering an elective cesarean, a thorough discussion with your healthcare provider is important to address individual circumstances. This includes reviewing your complete health history, as certain medical conditions or previous surgeries can influence the decision and the approach to the procedure. Also consider the implications for future pregnancies, particularly the potential for a vaginal birth after a cesarean (VBAC) and the associated considerations.
Understanding the potential short-term and long-term outcomes for both the parent and the baby is an important part of the conversation. Discussions should cover the type of anesthesia to be used, pain management strategies for the post-operative period, and whether blood thinners will be necessary to prevent clots. Preparing for the emotional and psychological aspects of a surgical birth and identifying support systems for recovery at home can also be discussed. Inquiring about what to expect for the baby immediately after birth, including any specific monitoring or care they might need, helps ensure a comprehensive understanding of the entire process.