What No One Tells You About C-Sections

Your nurses and doctors will want to look at your nails to assess your oxygen levels during and after surgery, so it is better if you skip the acrylics/manicures beforehand. If you really want to have your nails done, Genevieve Smith, a labor and delivery nurse in Summit, New Jersey, recommends that you “leave [one] finger with just a clear coat.”

Whether you’re going in for a planned C-section or end up having an unplanned C-section after being in labor for some time, you will be wheeled into the operating room without your partner or support person so the nurses and doctors can prep you for surgery. The process can take 15 to 20 minutes, during which the anesthesiologist will place a spinal block or top up your epidural. You’ll also get a catheter to collect urine while you’re under anesthesia (insertion usually doesn’t hurt at all!), a blood pressure cuff, an oxygen pulsometer, an IV line in your hand, wrist, or arm (wherever your veins are biggest), and two heart monitors — one for you and one for your baby.

Once you’re all prepped and the team is ready to start the surgery, your plus-one will be invited in. After your baby is born and the surgery is complete, they will be asked to step outside while the medical staff cleans you up, but you’ll be reunited in the recovery room. (For more on exactly what happens during a C-section, read our minute-by-minute guide to the procedure.)

As part of preparing you for surgery, the nurses will use a razor to shave your lower abdomen around the site where the incision will be. It’s no Brazilian — they won’t go below your lower belly — but it’s necessary to give the surgeon a clear view while making the incision. Resist the impulse to get waxed or otherwise tidy things up yourself right before delivering, as doing so can increase the risk of infection.

People undergoing a C-section are often surprised to find that, despite being numbed and not feeling pain, they still feel things during the surgery — they feel a lot, actually. This is normal. The spinal or epidural numbs you from your chest down and blocks all of the pain, but you will still be awake. That means you’re able to talk and move your arms, and it also means you will feel your baby leaving your body.

“When the baby is about to be born, the doctor has to push very hard to move the baby out of the pelvis,” says Emily Bruno, a birth doula based in Richmond, Virginia. That means pushing the baby’s body up against your ribs to position the head to emerge through the incision. “This often causes an intense shortness of breath, pressure, and nausea because the stomach is being compressed,” Bruno continues. “I prepare my clients for that beforehand. The doctor often announces, ‘OK, you’re going to feel some pressure…’ It’s more like, ‘OK, you’re going to feel like someone is sitting on your ribs and squeezing you!’”

Nausea and vomiting are very common side effects of the anesthesia and other drugs they give you during a C-section. Though not pleasant, the good news is that the anesthesiologist (who is right by your side during the entire procedure) will be monitoring your symptoms and can give you medicine to treat the nausea if needed. Don’t be afraid to ask.

It’s common for people to shiver after the surgery. Sometimes you even start shaking during surgery. It doesn’t mean you’re cold; shaking is a common side effect of the anesthesia and can also be caused by the normal hormonal surges that people experience during childbirth. There is no risk for you or the baby, but it can be uncomfortable. Unfortunately, there isn’t much you can do to stop it. Even though you aren’t actually cold, asking for warm blankets after surgery can be comforting, and doing skin to skin with your baby can help regulate your hormones and calm you (and your baby).

You can do skin to skin in the operating room and the recovery room, so if you’re interested in that, make sure to let the nurses know ahead of time. You might need your partner’s help to hold the baby at first, but you can definitely have the baby on your chest as soon as you are ready for them. (For more on everything that happens after your C-section is finished, read our complete Guide to Healing.)

Immediately after surgery and during the first days postpartum, your nurse will have to palpate your abdomen to massage your uterus. They do this to make sure the uterus is contracting. (After growing to the size of a watermelon during pregnancy, it starts contracting back to its normal size, about the width of your wrist, right after birth.) During the massage the nurse also watches to see that your bleeding is controlled.

Unlike other types of massage, this one will not be comfortable, especially as the anesthesia wears off. Smith, the New Jersey-based labor and delivery nurse, suggests that patients “place their hand under the RN’s hand and massage the uterus together so the discomfort is lessened.” It doesn’t hurt as much when you can modulate the palpitations yourself.

Vaginal bleeding is normal and expected. Your uterus needs to get rid of all the byproducts of your healing womb, including lots of blood and tissue. This is called lochia, and you should expect to see if for the first six weeks postpartum or so. It’s a sign that your body is healing. Call your doctor if you see clots bigger than a golf ball or are soaking through a thick maxi pad in one hour or less.

Your body may take days after a C-section to begin making breast milk, says Carrie Dean, an international board certified lactation consultant. “The body has just undergone a major surgery, and it spends a lot of energy on healing from that, so milk production may take a back seat for a while,” she explains. If you want to begin body-feeding, she recommends getting a jump-start on milk removal as soon as the baby is born by using hand expression or pumping, in addition to nursing. All hospitals have breast pumps available (so you don’t need to bring yours!), and they should be able to give you one right away if needed. Their pumps are hospital-grade pumps, so they tend to be more efficient extracting milk than your at-home pump.

If you’re someone who remains interested in having a vaginal birth the next time you deliver, it is often possible to have one after a C-section. This is called a VBAC — vaginal birth after cesarean. Research indicates that unless you have a specific circumstance that rules out a vaginal birth for subsequent pregnancies, you can absolutely deliver future babies via the birth canal.

When you know you’re going to have a C-section, it’s normal to assume your baby will be born on the date the procedure is scheduled. Just keep in mind that surprises are still possible! Alex Fine, a New York City-based sexologist who founded the sexual wellness company Dame, had to rush out the door one day before her scheduled C-section because her water broke. “I didn’t even have my hospital bag packed, and I had to go,” she recalls. Now she cautions others scheduled for C-sections, “Continue to be prepared for the unknown.”

Unfortunately, there remains a widespread perception that C-section births are somehow lesser births than vaginal births. “There’s definitely still this overwhelming narrative that cesarean birth is something other than normal birth or real birth,” says Cheyenne Varner, another Richmond, Virginia-based birth doula. The stigma often leaves parents who have C-sections feeling disappointed postpartum. (See here for more on figuring out — and owning — your C-section story.)

If you’ve been pregnant and delivered a baby, then you’ve given birth. “At the end of the day, you’ve done the work. You’ve done it. You’ve birthed your baby,” Varner reassures clients who have C-sections. But to avoid feeling that way in the first place, you can start thinking about what a C-section would mean for you long before you deliver.

When Romper Editor-in-Chief Elizabeth Angell was pregnant with her first child but still a month or two away from giving birth, a friend made a point to tell her, “If you end up having a C-section, you’ll feel intense pressure as they pull the baby out. That feeling is your baby being born.” After a 24-hour induction, Angell did end up having a C-section.

“As they wheeled me into the operating room, I remembered what she had told me, and I focused on that sensation,” she says. “I could feel him coming out of my body, and it allowed me to be very present for the moment his life began. I had a doula and a doctor, and neither of them mentioned anything like this. It was my friend and her advice that gave me that moment.”