It may also be necessary if you have previously had a Caesarean. This was once thought essential, because it was feared that the scar of the previous Caesarean section would open up during labor. But experience has shown that this does not happen with the horizontal or “bikini” cut, which is now usually employed. Doctors often suggest that you try a normal vaginal delivery, known as a “trial of labor”. However, remember that it is your uterus that is on trial, not you, so don’t feel you have failed if you end up having a Caesarean.

Non-emergency Caesareans are often carried out under an epidural anesthetic. This has several advantages over a general anesthetic: it is safer for your baby; you have no post-operative nausea or vomiting; and because you are conscious, you can hold your baby as soon as he is born. In addition, it is usually possible for your partner to be with you during the operation, just as he would be if you were having a vaginal delivery.

When you have a Caesarean, you may feel disappoint­ed or even cheated that you did not have a vaginal delivery. Such feelings are perfectly natural, and the best thing you can do is talk about them with your partner. It will probably help if he can describe the birth to you in detail — this will help you to visualize and accept it.

It also helps, of course, to prepare yourself in advance for this type of birth. With your partner present, find out from the obstetrician what the operation entails, the procedures that will be used, and whether your partner is allowed to be present. Ask if you can see a video so you will know what is going to happen to you. If at all possible, talk to other women who have had Caesarean sections. They will not only provide you with useful information but with emotional and moral support.

Caesarean with an epidural

Caesareans are now rarely performed under a full anesthetic but you are given an epidural anesthetic, which numbs the lower part of your body. It also means that you can be conscious throughout the operation, your partner can be with you, and because it is very quick, within 5-10 minutes of the incisions being made the baby is delivered and you are able to hold your new son or daughter.

Emergency Caesarean Section

This is often needed when something goes wrong during labor, such as a prolapsed umbilical cord or hemorrhage from placenta praevia, or if there is evidence of fetal distress. Emergency Caesarean sections may be carried out under an epidural and the hospital may not allow your partner to be present at the operation.

After a Caesarean Section

As is the case with any major surgery, it takes time to recover from a Caesarean, but even so you will be encouraged to get up and walk around a few hours afterwards to stimulate your circulation. You will be given painkillers if you need them, and the dressings will be removed after three or four days. Your internal stitches will be made with absorbable sutures, which will dissolve away naturally, and your external stitches will be removed within about a week.

Fatigue

Getting enough rest and sleep is essential if you are to combat the inevitable fatigue of the first weeks of caring for your newborn baby.

Try to rest whenever you can, especially during the first week or so when you will still be recovering from the exhaustion of labour. Avoid climbing stairs and heavy lifting as much as possible, and get your partner or someone else to help you with the baby and the general housework. Take advantage of your baby`s daytime naps to rest or nap yourself, and try not to waste these valuable chances for rest by using them to catch up on the ever-present chores.

Make sure that you get enough sleep. At night, go to bed half an hour or so before you plan on going to sleep, and unwind slowly. Try sipping a warm, milky drink, listening to music, watching television, or doing a little light reading to relax you physically and mentally before you sleep.

If you are breastfeeding express milk into bottles so that your partner can share the night­time feeding duties just as he would if you are bottle-feeding.

A healthy diet is an essential part of combating fatigue, but don’t eat too much late at night because digesting it might interfere with your normal sleep pattern.

Breech Birth

If your baby is in a breech position (buttocks down), and your obstetrician decides that he can be delivered safely without a Caesarean section, he will be born vaginally. The breech birth should not be thought of as an abnormal birth — it is better to think of it as a variation of normal, because four out of every hundred babies are born in the breech position and most of them do so i smoothly and are healthy.

In most breech births, the buttocks are delivered first, then the legs. In some births the feet descend ahead of the buttocks. The body slips out next. Before the head is delivered, you will almost certainly have to have an episiotomy because the head is the widest part and your baby`s bottom will not have stretched your birth canal sufficiently for his head to pass through it without some pressure being applied.

Once the baby`s body is born, his weight pulls the head down. His body is then lifted upwards by the midwife, and one more push is usually enough to deliver him. Forceps may be used to protect the baby`s head (see column, opposite).

It is now fairly common practice for you to be given an epidural if you are having a breech birth. This is so that if you need a Caesarean section it can be done quickly and simply without further anesthesia, and you will be able to hold your baby as soon as he is born.