What to expect when you're expecting (128 page)

If the baby doesn’t need special care, can he or she room-in with you?

How much recovery time will you need both in and out of the hospital? What physical discomforts and limitations can you expect?

To find out what you can expect at a cesarean delivery, see
page 398
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Satisfaction.
Family-friendly policies have made for a much more satisfying surgical birth experience. Since mom can be wide awake and alert during a cesarean section and family-friendlier hospital policies allow dad to be right alongside her, baby meet-and-greets can often take place right on the delivery table. What’s more, a C-section is very quick, lasting a mere 10 minutes or less for the delivery itself (suturing mom back up takes about another 30 minutes).

Even with C-section rates as high as they are these days (and they’re far lower for midwives, who attend only low-risk births), keep in mind that surgical deliveries still comprise the minority of births. After all, two out of three women can expect to deliver their babies vaginally.

“Do you generally know in advance that you are going to have a cesarean delivery, or is it usually last minute? What are the reasons you might have one?”

Some women won’t find out whether they’re having a C-section until they’re well into labor, others will get the heads-up ahead of time. Different doctors follow different protocols when it comes to surgical deliveries. The most common reasons for a scheduled C- section include:

A previous cesarean delivery, when the
reason for it still exists (Mom has an abnormally-shaped pelvis, for example), or when a vertical incision was used before (instead of the more common low horizontal, which can better withstand the pressure of labor); a C- section is also called for when labor has to be induced in a woman who’s already had a cesarean delivery

When a fetus’s head is believed to be too large to fit through mom’s pelvis (cephalopelvic disproportion)

Multiple births (almost all triplets or more are delivered by C-section; many twins are delivered by C-section)

Breech or other unusual fetal presentation

A fetal condition or illness (heart disease, diabetes, preeclampsia) in the mother that may make labor and vaginal delivery risky

Maternal obesity

An active herpes infection, especially a primary one, or an HIV infection

Placenta previa (when the placenta partially or completely blocks the cervical opening) or placental abruption (when the placenta separates from the uterine wall too soon)

Sometimes the C-section decision isn’t made until well into labor for reasons such as:

Failure of labor to progress, such as when the cervix hasn’t dilated quickly enough, or it’s taking too long to push the baby out. (In most cases, physicians will try to give sluggish contractions a boost with oxytocin before resorting to a cesarean.)

Fetal distress