Sometimes, a cesarean delivery is planned. This may occur if the baby is in a breech, or bottom first, position, or if the baby is known to have a birth defect called spina bifida.
Cesarean delivery may also be planned if you’ve had a previous cesarean delivery, particularly when a vertical incision was used in that procedure, or if you’ve had prior surgery on the uterus, such as a myomectomy to remove fibroids.
In addition, carrying more than one baby, having a baby that weighs more than nine pounds, and diagnosis with a condition that makes vaginal delivery risky, such as human immunodeficiency virus (HIV), are all reasons for a planned cesarean delivery.
Sometimes, a cesarean delivery becomes necessary after labor begins. For example, your doctor may recommend surgery if you have a condition called placenta previa, in which the placenta is blocking the birth canal. A cesarean delivery may also be necessary if the umbilical cord prolapses, or “drops,” outside the birth canal, potentially cutting off the blood and oxygen supply to the baby.
If labor is not progressing, which is when contractions slow or stop, if the cervix doesn’t dilate, or if the baby shows signs of distress, your doctor may decide to perform surgery.
NYU Langone doctors are equipped to handle cesarean deliveries quickly and efficiently. One support person is welcome to remain in the room during the procedure.
In a cesarean delivery, an obstetric anesthesiologist provides regional anesthesia to numb the lower half of your body. Sometimes, general anesthesia is used in an emergency situation.
Fluids and medication are provided through a vein with IV infusion, and a catheter is inserted into the urethra to drain urine from the bladder. A screen is placed above your waist to block your view of the cesarean delivery incision. It can be lowered enough to see your baby being born.
Your doctor uses an antiseptic to clean your abdomen and makes a small, horizontal incision in the skin above the pubic bone. Then he or she cuts through tissue, separating muscles, and typically makes a horizontal cut in the bottom of the uterus called a low-transverse uterine incision. Your doctor lifts the baby from the uterus and cuts the umbilical cord.
Nurses perform the Apgar test and wrap a blanket around the baby, handing him or her to you. Your doctor closes the incision in your uterus with dissolvable stitches but may use staples to close the incision in the skin. These are removed by the doctor at a follow-up appointment. This can take 30 minutes.
After a cesarean delivery, you spend several hours in a recovery room while you are observed. If your baby doesn’t require special medical attention, he or she remains with you. You remain in the hospital for up to four days after delivery.
Because a cesarean delivery is an abdominal surgical procedure, it is associated with an increased risk of infection, blood clots, bleeding, and pain. After the procedure, your doctor monitors your condition and manages your pain with medication.