It's not a real birth - FALSE
"Giving birth is the act of bringing a child into the world", whether by caesarean or vaginal birth. Although the sensations between a vaginal birth and a caesarean differ, a caesarean remains a birth.
During a caesarean with epidural or spinal anaesthesia, you are conscious and may feel sensations of touch but without any pain.
Finally, depending on the unit, it is not uncommon for the mother to be invited to push during a caesarean birth in order to participate in the delivery of her baby, or for the surgical drape to be lowered so she can witness her baby's arrival.[3]
There is no birth partner allowed or no contact with the baby during a caesarean - FALSE
In most cases, whether for a planned or emergency caesarean, a birth partner may be present. Most of the time, a caesarean is performed under regional anaesthesia (spinal block or epidural anaesthesia).
The father is asked to wear surgical scrubs and may attend the caesarean birth, remaining by the mother's head throughout. After the birth, the medical team places the baby on the mother's chest to help establish the mother-baby bond. Skin-to-skin contact may also be offered to the father, creating the father-baby bond while the caesarean is completed. At the end of the procedure, the mother can hold her baby for a few minutes before going to the recovery room for two hours of monitoring. The majority of maternity units do not allow babies in the recovery room.
If general anaesthesia is required, in that case there is no birth partner present. It may be planned in rare circumstances. In an emergency, it is used when the urgency of the situation does not allow for a spinal block and there is no epidural already in place. At that point, the father is not permitted to enter the operating theatre and the mother will only see her baby when she wakes up. In the meantime, the baby is cared for by the medical team and then the father.[4] The rate of general anaesthesia use has declined to less than 6% of caesareans.[5]
In summary, whether it is a planned or unplanned caesarean under regional anaesthesia, it is simply a matter of talking to the care team (particularly the midwives) to express your wishes. [6]
If I have a caesarean, it must be my fault - FALSE
A caesarean may be performed for many reasons: cord around the neck, placental haemorrhage, a baby that is too large, preterm birth with complications, poor foetal positioning, twins, a mother carrying a virus… None of this is obviously your doing, and what matters most is that you and your baby are well. A perfect birth is one where you felt reassured, where the risks and benefits of any interventions were explained to you, and where everything ends well. You could have chosen the best food supplement for pregnant women that it would probably not have made much difference.
A caesarean is less tiring - FALSE
A caesarean remains a surgical procedure, which means a longer recovery period and generally greater fatigue. The scar takes time to heal and also causes pain during the recovery period.
The abdomen has been opened through 4 layers and therefore needs time to heal; there are staples and it is often difficult to sit up or stand in the first few days, as you need to relearn how to use your abdominal muscles. In addition, the scar left at the lower abdomen requires particular care. To find out more, see our article: caesarean scar.
If the caesarean was performed as an emergency, or if it is related to a maternal or foetal condition, the stay in the maternity unit may also be longer, to monitor all factors and provide enhanced care.[7]
To help you recover, you can take a post-partum food supplement rich in vitamins and minerals, to support the body and healing.
You don't need pelvic floor rehabilitation after a caesarean - FALSE
Even if the baby, as in a vaginal birth, has not caused any relaxation of the perineal tissues during its passage, the perineum was nonetheless put under significant strain throughout the pregnancy. The uterus grew larger, pressing on the bladder, while the foetus also gained weight day by day, bearing down relentlessly on the lower abdomen and therefore on the pelvic floor, which gradually became distended. In fact, even before the baby arrives, the perineum is already considerably weakened.
A caesarean scar is very large - TRUE AND FALSE
A caesarean scar is not insignificant, but today, thanks to medical advances, scars are made as small as possible and sutured so that they are as discreet as possible afterwards. They are positioned as close to the pubic area as possible and generally measure between 10 and 15 centimetres.
A first caesarean inevitably leads to a second caesarean - FALSE
The likelihood of having a second caesarean if you have already had one is indeed higher, but it is far from 100%!
At the time, doctors were concerned about the fragility of the uterine scar, but today we know that the risk of uterine rupture is extremely low. Even French health authorities recommend attempting a vaginal birth after a caesarean where possible.[8][9] This is referred to as a vaginal birth after caesarean (VBAC). Women who do not have a high-risk pregnancy and who are generally in good health are often candidates for a VBAC.
One in 2 women who have had a caesarean will have another caesarean. If a trial of vaginal birth is offered after a caesarean, it is successful 7 times out of 10.[10]
The risks are lower with a caesarean - TRUE AND FALSE
There are risks associated with every type of birth. Some risks are specific to caesarean birth, while others are shared with vaginal birth.
Among the specific risks, those related to surgery include, for example, injury to organs near the uterus (bladder, urinary tract, intestine, or blood vessels) requiring specific management. It is important to emphasise that the majority of caesareans proceed without complications, and the vast majority without major complications.
In the days following a caesarean, a haematoma or an infection (abscess) of the scar is possible, requiring close monitoring.
During a pregnancy following a caesarean, the main risks are failure to achieve a vaginal birth, uterine rupture (rare) — a tear in the uterine scar — or abnormal placental positioning (adherence at the scar site, placenta accreta) [11].
Other factors should be monitored regardless of the type of birth:
Uterine involution: the uterus gradually returns to its original size and position through contractions of varying intensity, known as afterpains. This process can last up to 6 weeks, causing blood loss called lochia, which continues for approximately one month and gradually decreases in volume. These two phenomena reflect your body's recovery after birth and are entirely normal. Breastfeeding, through the secretion of oxytocin, can also help speed up the process.
The return of bowel function, marked by the first passing of wind or first bowel movement, can take several days and also depends on diet.
The onset of an infection (urinary or uterine), with temperature monitoring in particular.
Deep vein thrombosis, commonly known as DVT. The lower limbs are examined for signs of redness, swelling, warmth, and pain. As a preventive measure, wearing compression stockings is recommended (though recent studies have not demonstrated a clear benefit…). A daily anticoagulant injection may be prescribed for a variable duration depending on your situation.
After returning home, if pain, bleeding, vomiting, fever, or any other concerning symptoms appear, it is advisable to consult a healthcare professional directly.[12]
The number of caesareans is limited - TRUE AND FALSE
The risks increase with each successive caesarean, particularly after 3 or 4. The scar tissue that forms on your uterus after a caesarean remains quite fragile. The more times it is repaired, the greater the likelihood of placental implantation problems (placenta accreta, growth through the scar), as well as bladder lacerations, intestinal complications, infections, or bleeding [13].
These are risks that must be taken into consideration when planning a future pregnancy.
Antenatal classes are not as important if I'm having a caesarean - FALSE
Antenatal classes are now more aptly called "birth and parenthood preparation classes". Vaginal birth represents only a small part of these classes, and caesarean birth is also covered. Moreover, what characterises birth is the unexpected — so whatever your plan or programme, it is always better to be informed about all possibilities!
If I wasn't able to do skin-to-skin immediately after birth, it's too late - FALSE
It is never too late for skin-to-skin!
Do not hesitate to ask the care team.
You cannot breastfeed after a caesarean - FALSE
It is entirely possible to breastfeed after a caesarean. However, it is true that several factors which support the establishment of breastfeeding may be missing: immediate and prolonged skin-to-skin contact, first feed within the first hour, the mother's body bathed in oxytocin during labour — and a caesarean can also make it more difficult to find a comfortable position for latching.
Fortunately, all of this is manageable! First and foremost, as soon as possible, do as much skin-to-skin as you like. Ask for help to move around and to find comfortable breastfeeding positions that do not put pressure on the caesarean scar.
It is important to know that the milk coming in, in this context, may come in a little later than with a vaginal birth (around day 5 versus day 2 or 3). This is the time to persevere and keep cuddling your baby to stimulate as much oxytocin as possible!
Please note that you can breastfeed and take pain relief medication at the same time. Consult the CRAT website for more information on medications compatible with breastfeeding.
If you have a planned caesarean, you can express a little colostrum beforehand and store it in a syringe, which the other parent can give to your baby while you are in the recovery room.
If you are separated from your baby (they need care, they are premature…), you can still initiate lactation through hand expression (the most effective method) or by asking for a breast pump. Do not hesitate to consult our article on how to express breast milk for more information.
A huge thank you to Julie, midwife, who helped us write this article!
