Congratulations, you’re expecting! This exciting time includes a lot of changes for you, as well as planning for the arrival of your baby and the not-so-distant future. It can also mean lots of anxiety and trying to make your birth plan just right.
Sometimes we plan, and the universe gently smiles. For many reasons, your birth plan may change — sometimes in regards to its smaller details, and other times in regards to its bigger ones, including how you want to give birth.
Whether your plans are for a vaginal birth or scheduled cesarean delivery (also called a C-section), both of these options will be off the table if you need an emergency C-section.
Don’t worry. You and your baby are in expert hands. Although almost
An emergency C-section is one that happens very quickly due to immediate concern for the health of the mother and/or baby. The goal is that no more than
Any kind of C-section is a major surgery that requires a room full of healthcare professionals and a great deal of organizing. This means that when a patient needs an emergency C-section, a lot of doctors and nurses have to get ready faster than normal.
You can end up having an emergency C-section even if you already had a scheduled, planned, or even unplanned C-section in the works. All of these are sometimes called medical C-sections, as they happen for health reasons. In comparison, an elective C-section is one that you choose to have.
What’s the difference between the types of C-sections?
- Scheduled C-section. This is when you and your doctor decide that it’s safest for you and your baby to deliver via C-section, potentially because you’ve had a C-section before. Your doctor will schedule a C-section date around your estimated delivery date, possibly months in advance.
- Unplanned C-section. This is when you were planning to have a vaginal birth, but a little while before your delivery your doctor decides that a C-section is best for you and your baby. This decision can be made a few weeks, days, or even hours before you’re about to give birth. With an unplanned C-section, there’s no emergency, but the change in plans is made to get you and baby onto the safest birth route.
- Emergency C-section. This happens when delivery must occur urgently to make sure both you and baby are safe. This can happen whether you’re planning to have a vaginal birth or a C-section.
They might seem like the same thing, but not all C-section experiences are created equal. Your experience, as well as the actual procedure for an emergency C-section, will be different than those of a scheduled or unplanned C-section.
What will happen during an emergency C-section?
One main difference is how you might be prepared for it. Everything must move quickly, including administering pain medications and getting the baby delivered.
Most scheduled C-sections are performed with local or regional numbing (anesthesia). This means you’ll still be awake, but you won’t feel pain during the procedure. Local anesthesia is usually administered via a spinal injection, and this can take time.
In an emergency C-section, the timing and details of your situation, along with hospital policies, can affect your options for anesthesia.
Your doctor and the anesthesiologist may decide that there’s time to administer a spinal injection. Or, you may already have an epidural in place, which helps with the surgery preparations. However, depending on multiple factors, some of these options may not be possible.
Alternatively, you may have general anesthesia, using both injected and inhaled drugs to make sure you’re pain-free during the surgery. This will allow the C-section to happen more quickly, but this combination means you’re not able to be awake during the procedure.
Another difference may be the incision used during the surgery. In non-emergency C-sections, a horizontal (bikini) cut is typically performed. If you’re at term, you’ll likely have this type of incision, even in an emergency.
However, during an emergency surgery in which your baby’s health needs immediate attention, the surgeon may opt to use a vertical incision on your uterus to get to your baby faster. This type of incision may be necessary in cases of preterm birth, as well as due to adhesions from previous surgeries or fibroids that may be in the way of the uterus.
Again, this is dependent on the circumstances of your birth. Your surgeon’s training, as well as your and your baby’s health needs, are taken into consideration.
The reasons you might need an emergency C-section are also different than the reasons you might have a scheduled C-section.
Basically, an emergency C-section means that your baby isn’t cooperating with the planned exit or decides they want to come out before a scheduled or unplanned C-section. It may also mean that your health is a concern and waiting for progress isn’t the right choice.
In most cases, there’s nothing you or your doctor can do to change the need for an emergency C-section.
The following are several reasons why this might happen:
Very long labor
Prolonged or delayed labor is when labor goes on for much longer than normal. This can sometimes cause health problems for both baby and mom. Prolonged labor is the most common reason for an emergency C-section. About
When this happens, your doctor may decide that it’s much healthier for you and your baby to have an emergency C-section than to try to deliver vaginally. You might have a prolonged labor because:
- Your labor didn’t really start. Sometimes you’ve had contractions for ages, but they don’t seem to be doing anything. Plus, you may not be dilating as you should.
- Your labor stalls. Everything might be on track as you start having contractions and even begin dilating, but then everything stops. Sometimes this happens because your baby’s head cannot fit through your pelvis.
Baby’s position
Your baby’s position might have already been a concern when your labor began, or an external cephalic version might have seemed successful, only to have baby return to a breech position at the last minute. Whatever the circumstances, labor may not progress as expected if your little one can’t be coaxed into turning around into a cooperative position.
If your baby is positioned with their behind first (breech), feet first, or stretched out sideways straight across your stomach (transverse), a vaginal delivery may not be possible. Your doctor may try to coax baby into position by turning your baby under controlled conditions, but this doesn’t always work.
Exhaustion
Sometimes all the pushing and trying in the world doesn’t seem like enough. Your doctor may have pulled out all the stops, even trying a vacuum-assisted delivery, to no avail.
At this stage you’ve likely been pushing for ages and are too exhausted to push any more. Your health may begin to show signs of distress, suggesting continued pushing is not an option.
At the same time, the fetal monitor might show that your baby’s heart is beating too fast or too slow. Your doctor may decide that it’s no longer safe for you and your baby to keep this up.
Health condition
If mama has a health condition or infection that comes up during labor, an emergency C-section might be recommended. For example, a herpes infection or other infection in the vaginal area can suddenly become active and harm the baby.
Alternatively, if your blood pressure or heart rate gets too high, it may not be a good idea to keep pushing. Also, if you have any kind of sudden heart or brain health issue, you may need an emergency C-section.
Tangled umbilical cord
If the umbilical cord gets compressed, tangled, or tries to come out before your baby, you’ll likely need an emergency C-section.
A prolapsed umbilical cord is a very rare complication that happens when the cord slides into the birth canal ahead of your baby. When this happens there’s a risk that it’ll be squeezed too much while your baby is trying to make their grand entrance. This can cut off baby’s blood supply.
Similarly, your baby might not be getting enough oxygen if the umbilical cord gets kinked or tangled like a garden hose.
Placental problems
Like the umbilical cord, the placenta can also complicate delivery.
Part or all of the placenta can come away from the lining of the womb. This is called placental abruption. When this happens your baby can’t get the necessary nutrients and oxygen inside the womb, and you may need an emergency C-section.
Womb tear
In very rare cases, the increased pressure on your body during birth can tear or rupture the womb. Having had a prior C-section increases your risk. If you have a womb or uterus tear (uterine rupture), you’ll need an emergency C-section.
Most of the risks of an emergency C-section are similar to those of any type of C-section.
Risks to your health include:
- an infection inside the womb or at the opening site
- opening or splitting stitches
- injury to the organs, nerves, or blood vessels near the uterus
- blood loss during the surgery
- heavy bleeding afterward
- blood clots
- a reaction to the anesthesia
- not being able to deliver vaginally in the future
Risks to your baby’s health include:
- accidental injury during the C-section
- temporary breathing problems for a few days after birth
There are also some risks to consider after the delivery is over.
If you’re asleep for the emergency C-section, you’ll likely not be able to have skin-to-skin contact with your baby right after birth. Also, the effects of the medications you were administered might make breastfeeding challenging for a while.
This does not mean that breastfeeding or bonding is impossible. You can begin a solid and satisfying breastfeeding relationship after an emergency delivery. Know that support is available, and you can work with a lactation consultant and your provider to meet your goals.
You may also be at higher risk of post-traumatic stress and its related effects. It’s important to spend time caring for yourself and your mental health. Discuss any issues or concerns you have with your provider or a mental health professional.
Like other major surgeries, you’ll need time to rest and recover after any kind of C-section. This could mean bed rest and not being able to climb stairs or lift anything heavy for a while.
It’s important to avoid putting too much pressure on the incision site to help it heal well. You might not be able to pick up or hold your baby for too long if you’re sore. You’ll need to change the bandages and see your doctor for follow-up visits to make sure the area is not infected.
You’ll also likely need a dose of antibiotics to prevent infection. And if you need pain meds to stay comfortable, you may not be able to breastfeed your little one until you stop taking them. Ask your doctor about when it’s safe to breastfeed.
Also, unlike other C-sections and most surgeries, your doctor decided to do an emergency C-section at the eleventh hour. This means you may not have felt emotionally or mentally prepared for it.
Again, an emergency C-section may lead to post-traumatic stress disorder (PTSD). Talk to your doctor if you’re having difficulty dealing with your birth experience or feel you may have postpartum depression.
You might need an emergency C-section if your doctor decides that it’s the best option for you to deliver a healthy baby, and the need may arise due to a number of reasons.
Neither you nor your doctor can control this outcome. While a C-section might be a major detour from your birth plan, the important thing is that you and your baby remain healthy and safe.