Emergency caesarean

What is an emergency caesarean?

A caesarean section (C-section) is an operation to birth your baby. Your doctor may recommend a caesarean section once you are already in labour, or you may need to have the operation urgently when you are not in labour (for example, if your blood pressure is dangerously high or your baby is in distress) — these are known as emergency caesareans.

Even if you plan a vaginal birth, sometimes things don’t go as expected and you may need a caesarean. It may be the safest option if you or your baby is at risk. An emergency caesarean may need to be done very quickly.

What are the reasons for an emergency caesarean?

Your doctor may recommend an emergency C-section if:

• there are concerns for your health, or for your baby’s health
• there is a life-threatening emergency for you or your baby
• your labour is not progressing normally
• there are complications affecting you such as severe bleeding or pre-eclampsia

What happens if I need to have an emergency C-section?

Your doctor will explain why you need to have a C-section. They will talk with you about the chance of complications and other risks. In most cases you will be asked to sign a consent form for the operation. If it is very urgent and there is no time to, you may be asked to give verbal consent.

A caesarean section may be the safest birthing option for you or your baby. It is important to make an informed decision, so make sure you ask questions and discuss concerns with your doctor.

What is the difference between an emergency and a planned caesarean?

A C-section might be planned in advance (elective) if there is a reason that prevents your baby being born by a vaginal birth or you prefer a caesarean section. The birth will usually happen before you go into labour.

Unplanned (emergency) caesareans can happen when there are problems either with your health or your baby’s health in your pregnancy or during your labour. An emergency caesarean may need to be done very quickly.

How quickly will the caesarean be performed?

Your doctor has guidelines to identify how quickly your baby should be born by emergency C-section.

There are four categories that describe the urgency for caesarean section:

• Category 1 — urgent threat to your life, or your baby’s life.
• Category 2 — there are problems affecting your health or your baby’s health but they are not immediately life threatening.
• Category 3 — your baby needs to be born earlier than planned, but there is no immediate risk to you or your baby.
• Category 4 — the operation will take place at a time that suits you and the caesarean section team.

If more than one emergency caesarean needs to be performed at the same time by the same health team, or in the same operating room, the order will be according to the level of risk. This means you may have to wait a while, even if your health team has told you it is an emergency.

It can depend on the hospital facilities and staffing, but category 2 are mostly done about an hour after the decision is made. Life threatening category 1 caesareans aim to be done within 30 minutes.

What happens during an emergency caesarean?

You will usually be in the operating room for at least one hour, although it might be several hours before you’re back in the maternity ward with your baby.

In an emergency, there might not be time to give you epidural or spinal block. You may need a general anaesthetic, which means that you will be asleep when your baby is born.

Unless you need a general anaesthetic, your partner or support person can be with you. You will also usually have a midwife who stays with you and looks after you and your baby in the operating room and recovery area.

Can I have my support person with me?

Usually, you can have one support person, for example your partner, with you in the operating room.

If you need to have a general anaesthetic your partner will not be in the operating room because you will be asleep.

What happens to my baby during a caesarean section?

After your baby is born, the doctor will hand them to the midwife or paediatrician who will dry your baby from the amniotic fluid and check them over.

If your baby is well, you will be able to have skin-to-skin contact with your baby while you are still on the operating table. If your baby is having trouble breathing or there are any other worries, then the paediatrician will care for them.

Emotional support after an emergency caesarean

You may feel a range of emotions after having a caesarean birth, especially if it was unexpected. You may feel joy, relief or fear; you may feel overwhelmed or numb, or a mixture of all of these.

Emergency caesareans can happen very quickly and can be a traumatic experience for parents and support people. If you are dealing with difficult emotions after a C-section:

• talk to a midwife immediately after the birth about your experience
• talk to your doctor, midwife or maternal child health nurse at any time, about how you feel
• ask for practical and emotional support from friends and family

If the caesarean birth was traumatic, it is possible to develop post-traumatic stress disorder (PTSD) or postnatal depression.

If you have negative feelings about your birth, it’s important to seek help as early as possible. Your doctor will be able to guide you to the appropriate support. They may recommend therapy or medicines as treatment if you or they feel you need it.

Who can I speak to if I am not happy with my healthcare?

If you are unhappy with how you were cared for, you should start by asking to speak to the team who cared for you at the time you gave birth. Each hospital has a process to manage complaints. You are more likely to be happy with the outcome when you deal directly with the people at the hospital who provided you care during the birth.

If you don’t feel that you have resolved your concerns, there are organisations in each state you can contact to make a formal complaint. Find out more about your healthcare rights and how to make a formal complaint.

Resources and support

The Australasian Birth Trauma Association has information about caesarean section.

If you or your partner or support person needs support you can contact:

• Lifeline on 13 11 14
• Beyond Blue on 1300 22 4636
• PANDA on 1300 726 306