Emergency Caesarean Birth: When the Plan Suddenly Changes
Understand what happens during an emergency caesarean birth, why it may be recommended and what to expect in theatre and afterwards.
Reviewed by Courtney Garland, NICU Registered Nurse, IBCLC Lactation Consultant and Paediatric Sleep Consultant
One minute you're labouring, and the next, your maternity team is telling you that you need a caesarean.
Maybe your baby's heart rate has changed, your labour isn't progressing as expected, or something has happened that means your baby needs to be born sooner.
It can feel frightening, especially when everything suddenly starts moving quickly.
I haven't personally had a caesarean, but my first birth became an emergency forceps delivery. I remember more staff coming into the room, the change in everyone's voices and that feeling of trying to understand what was happening while still having contractions.
So let's talk about what an emergency caesarean can actually involve.
Why might I need an emergency caesarean?
An emergency caesarean is an unplanned operation to deliver your baby through your abdomen and uterus.
It might be recommended because your baby's heart rate is concerning, labour isn't progressing safely, there's significant bleeding or another complication has developed.
And something important to know is that emergency doesn't always mean you have seconds to get to theatre.
Some situations are extremely urgent. Others allow more time to explain what's happening and prepare you for surgery.
What happens when they tell me I need one?
Your team will explain why they're recommending a caesarean and start preparing you for theatre.
You may have an IV, blood tests, monitoring and a urinary catheter.
If there's time, ask three simple questions:
• Why do I need a caesarean?
• How urgent is it?
• What happens next?
You may not remember everything you're told, especially if you're exhausted or frightened. Your partner or support person can help listen and ask questions too.
Will I be awake during the birth?
Often, yes.
If you already have a working epidural, the anaesthetist may be able to give stronger medication through it.
Otherwise, you might have a spinal anaesthetic.
Both usually allow you to stay awake while your lower body is numb.
If your baby needs to be born immediately, or regional anaesthesia isn't suitable, you may need a general anaesthetic, which means you'll be asleep.
What will I feel during surgery?
With an effective spinal or epidural anaesthetic, you shouldn't feel sharp surgical pain.
But you may feel pressure, pulling or tugging as your baby is delivered.
If you feel pain, tell your anaesthetist immediately.
Your support person can often be beside you if you're awake, although this depends on the circumstances and hospital policy.
What happens to my baby?
Your baby may be checked by a neonatal or paediatric team after birth.
If you're both doing well, you may be able to have skin to skin in theatre or shortly afterwards.
If your baby needs extra care, those first cuddles may need to wait.
Your partner may also be able to hold your baby while you're being cared for.
What if I feel upset about how my birth happened?
It's okay to feel this way.
Maybe everything happened so quickly that you've barely had time to process it. You might still feel frightened, overwhelmed or worried about yourself and your baby.
And maybe you're grieving the birth you thought you were going to have.
There can be so many emotions and unanswered questions after an unexpected birth, and I can completely understand that.
If you can, talk to someone you trust about how you're feeling. And when your maternity team comes in, ask those questions.
Why did this happen? Is my baby okay? Am I okay? Could anything have been done differently?
You can also ask for a birth debrief to help you understand what happened.
And please know this: You did nothing wrong. Your body did nothing wrong.
Sometimes unexpected complications happen, and the birth you imagined changes in a way you never could have prepared for.
You deserve time, support and answers as you recover and process everything.
Read next
• Planned Caesarean Birth: What to Expect
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