What Happens During a Cesarean Birth: A Step-by-Step Guide

Written by a pelvic floor physical therapist at Empower Your Pelvis, in Kansas City, Missouri (Lee Summit, MO and Overland Park, KS)

A Cesarean birth, also known as a C-section, is a surgical procedure used to deliver a baby through incisions made in the mother's abdomen and uterus. This method is often necessary when a vaginal delivery isn’t safe for the mother or baby, but it can also be voluntary in certain situations. Understanding the process can help you feel more prepared, so let’s walk through what typically happens during a Cesarean birth.

What to Expect During a Cesarean Section

1. Preparation for Surgery

Before the procedure begins, you’ll be prepped in a hospital room or surgical suite. Medical staff will insert an IV for fluids and medications, and you may receive an epidural or spinal block to numb your lower body while keeping you awake. A catheter will also be inserted to drain your bladder during the procedure. Once everything is ready, a sterile drape is placed to maintain a clean surgical environment.

2. Making the Incision

The surgeon will make two incisions. The first cut is through the skin and the abdominal tissue, typically low and horizontal, just above the pubic hairline (commonly called a “bikini cut”). The abdominal muscles are not cut; instead, they are gently separated to allow access to the uterus. The second incision is made in the uterus, through which the baby will be delivered.

3. Delivery of the Baby

Once the uterus is opened, the baby is carefully lifted out. This often happens just a few minutes after the start of surgery. You may feel some pressure or pulling, but the anesthesia will prevent any pain. After the baby is delivered, the doctor will clear the airway and evaluate the baby’s health. You may hear your baby’s first cry shortly after delivery, a truly emotional moment for many parents.

4. Post-Delivery Care

After your baby is born, the umbilical cord is cut, and a pediatric nurse may quickly assess the baby’s health. Many hospitals encourage immediate skin-to-skin contact, even during a C-section, if both mother and baby are stable.

Meanwhile, the surgeon will remove the placenta and begin closing the uterus and abdominal layers with stitches. This part of the procedure typically takes longer than the delivery itself—about 30-40 minutes.

5. Recovery After a C-Section

After the surgery is complete, you’ll be moved to a recovery area where medical staff will monitor your vital signs and pain levels. Most mothers stay in the hospital for 3-4 days following a C-section, although this may vary depending on your recovery progress. During this time, you’ll begin to heal while bonding with your newborn.

Why Might a C-Section Be Necessary or Chosen Voluntarily?

There are several reasons why a healthcare provider might recommend a Cesarean birth. These include:

• Fetal distress: When the baby is not getting enough oxygen.

• Labor complications: If labor does not progress as expected.

• Multiple pregnancies: Twins or more can sometimes require a C-section.

• Placental issues: Such as placenta previa (when the placenta covers the cervix).

• Maternal health conditions: Including high blood pressure or infections.

• Breech position: When the baby is not positioned head-down for birth.

• Elective C-section: Some mothers choose a C-section voluntarily, for reasons including a previous difficult vaginal birth, a desire to schedule the delivery, or personal preference. Elective C-sections are typically planned in consultation with your healthcare provider to ensure it’s a safe option for both mother and baby.

Preparing for Your Cesarean Birth

Whether your C-section is planned or a possibility due to labor complications, it’s essential to prepare both mentally and physically. Discuss your concerns and questions with your healthcare provider so you feel fully informed. Preparing your home for recovery and arranging postpartum support can also help make the process smoother once you return home.

Final Thoughts on Cesarean Births

Cesarean births are common, safe procedures, and understanding what happens during a C-section can help ease any concerns you might have. Whether planned, unplanned, or elective, a C-section is a safe and effective way to deliver your baby, and your healthcare team will support you every step of the way.

If you’re preparing for a C-section or considering an elective Cesarean birth, reach out to your healthcare provider for personalized care and advice to make the best decision for you and your baby.

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Join the C-Section Exercise Group

Looking for recovery guidance following a Cesarean birth? Join the C-Section Exercise Group for comprehensive support and solutions.

With wellness in your pelvis-

Amanda Fisher, PT, DPT
Owner, Empower Your Pelvis, a pelvic floor physical therapy clinic in Kansas City (Lee’s Summit, MO and Overland Park, KS)