C-section: What are the side effects?

A caesarean section, or C-section, is a surgical method of childbirth1. It is usually done when a vaginal delivery might be unsafe for you or your baby. 

The history of caesarean sections stretches back to ancient times, but the procedure has advanced dramatically thanks to modern medical technology and improved surgical methods. Today, C-sections are a standard part of childbirth, making up approximately 21% of births globally ². However, in South Africa, the rate is significantly higher, reaching as much as 75% ³.

A C-section can be planned or performed in an emergency ⁴. An elective caesarean section is scheduled in advance, often recommended when specific medical conditions make vaginal delivery risky. It allows you and your medical team to prepare for the procedure. The planning allows your partner and loved ones to be present at the hospital or clinic and support you at this time.

An emergency C-section, on the other hand, happens when complications arise during labour or delivery that require immediate action to ensure your and your baby’s safety ⁵'⁶. While an emergency C-section is unplanned, it’s performed swiftly to protect both lives. Because of this unplanned nature, your loved ones aren’t likely to be present. But your partner can still be in the surgery room with you if the conditions allow it.

For example, you can have a caesarean, planned or emergency, if:

• Your baby is in a position that makes vaginal delivery difficult (like a breech position, feet or bottom first).

• You carry multiple babies, such as twins or triplets.

• The labour is taking too long or is very painful for you.

• Your baby’s health is at risk, and delivery needs to happen quickly.

During the procedure, a doctor makes a small cut in your lower belly and womb. You’ll be given medicine to numb the area (or put you to sleep completely) so you won’t feel pain. After your newborn baby is delivered, the cut is carefully stitched up.

If your doctor has suggested a caesarean section, it’s because they believe it’s the safest way to deliver your baby. This decision is taken carefully and based on your health, your baby’s well-being, and the progress of your pregnancy. Here are some common reasons why a C-section might be the best option for you ⁷.

In certain health situations, a C-section becomes the safest way to deliver your baby. 

For example:

• If the placenta is covering your cervix (placenta previa), a C-section is essential to prevent dangerous bleeding during delivery.

• If you’re experiencing severe high blood pressure (preeclampsia), a C-section can reduce the risks associated with prolonged labour.

Mothers with heart conditions or a history of uterine surgeries are often advised to avoid the physical strain of labour by opting for a C-section.

Certain infections, such as HIV or genital herpes, may also make a C-section the better choice. This is because delivering via C-section reduces the chances of passing these infections to your baby.

A caesarean may also be necessary if your baby shows signs of distress, such as an abnormal heart rate, or if they are in a breech position (bottom or feet first). Similarly, if the umbilical cord is wrapped around your baby’s neck, a C-section can ensure a safer delivery.

In these situations, a C-section isn’t just an alternative—it’s a critical step to protect you and your baby. Your doctor will make this recommendation after carefully evaluating your health and the needs of your little one.

For some mothers, a planned C-section offers a sense of control during childbirth. Knowing the exact date and time of delivery allows you and your family to prepare emotionally and practically. Your partner or loved ones can arrange to be with you, and you have time to get everything ready, from your hospital bag to your home.

The medical team will also be fully prepared. The operating room is set up, the surgical team is in place, and specialists like anaesthesiologists or paediatricians can be scheduled in advance if needed. This level of coordination is especially important in high-risk pregnancies or if you have specific medical conditions, such as a history of uterine surgery, which increases the risk of complications like uterine rupture.

For many mothers, this organised approach makes the birthing process feel less overwhelming, creating a smoother and more predictable experience.

One of the lesser-known benefits of a C-section is that it reduces the strain on your pelvic floor ⁸. During vaginal delivery, the muscles and tissues that support the pelvic organs stretch significantly and, in some cases, may tear. 

While most women recover well, some experience issues like:

• Difficulty controlling your bladder (urinary incontinence)

• Organs shift from their normal position (pelvic organ prolapse)

• Chronic pelvic pain that can take time to resolve.

A C-section bypasses these risks by avoiding the stress that labour places on the pelvic floor. This can be especially helpful for mothers who are more likely to face these issues, such as those expecting a larger baby, having a long labour, or having pre-existing pelvic health concerns.

Preserving pelvic floor health benefits you long-term, improving your recovery and overall postpartum quality of life.

Your doctor’s recommendation for a C-section is based on what’s best for both you and your baby. Every pregnancy and birth is different, and choosing a C-section doesn’t mean you’re doing anything “wrong.” It means you’re making a decision to ensure a safe and healthy delivery. Trust in the care and experience of your medical team, and remember—you’re bringing your baby into the world in the way that’s right for you.

While a caesarean section is a safe and common procedure, it is still an important surgery, and there are some risks to consider ⁹'¹⁰.

Recovering from a C-section usually takes 6 to 8 weeks, compared to a few weeks for vaginal birth. This is because the surgical incision in your belly and uterus needs time to heal.

You may feel pain or discomfort around the wound, especially when moving, coughing, or lifting objects—even your baby. Recovery can also mean a longer hospital stay, typically 3 to 5 days, which may feel inconvenient and costly. Physical limitations during this time might temporarily delay bonding activities, such as breastfeeding or skin-to-skin contact.

As with any surgery, C-sections carry certain risks. The incision site may become infected, requiring antibiotics or, in rare cases, further treatment. Blood clots in the legs or lungs (deep vein thrombosis or pulmonary embolism) are another concern, but they are manageable with prompt medical care.

Reactions to anaesthesia, ranging from nausea to more serious complications, can also occur. Rarely, internal organs like the bladder or intestines may be accidentally injured during surgery, though this is uncommon.

A C-section leaves a scar on the uterus, which can increase risks in future  pregnancies ¹¹, such as uterine rupture (when the scar tears) or placenta previa (where the placenta blocks the cervix). These risks are higher if the C-section involved a vertical incision.

If you’ve had a C-section, you may be advised to deliver future babies the same way. While most women are limited to 3 or 4 C-sections, this can vary. Your doctor will assess your situation and guide you on what’s safe for you.

For some mothers, having a C-section—especially if unplanned—can lead to feelings of disappointment or sadness ⁷'⁹'¹⁰. It’s completely normal to have mixed emotions, but it’s important to remember that safely delivering your baby is what truly matters.

The longer recovery period and physical challenges can sometimes contribute to postpartum depression or anxiety. Additionally, if you were under general anaesthesia or if your baby required immediate medical care, you might feel disconnected from the experience or your baby at first. Lean on your support system, and don’t hesitate to seek help if you feel overwhelmed.

Babies born via caesarean section are generally healthy and thrive just like those born vaginally. However, a few side effects may occur because a C-section bypasses the natural delivery process ¹²'¹³.

During a vaginal birth, the pressure of the birth canal helps push out fluid from the baby’s lungs, preparing them to take their first breaths ¹⁴. In a C-section, this step doesn’t happen, so babies may retain extra fluid in their lungs. This can lead to:

• Rapid breathing due to excess lung fluid, which usually resolves within a few days (Transient Tachypnea of the Newborn) 

• A more serious condition, often affecting very premature babies born via C-section, where their lungs aren’t fully developed (Respiratory Distress Syndrome).

Don’t worry: your healthcare provider will monitor your baby closely after birth and provide any necessary care to address these issues.