What is an emergency caesarean?

A caesarean birth, also known as a caesarean or C-section, is an operation that allows your baby to be born through a cut in your abdomen (tummy) and uterus (womb).

An emergency caesarean is when a caesarean needs to be done quickly. This may occur if:

• your doctor recommends a caesarean section once you are already in labour
• you need to have a caesarean urgently when you are not in labour

Even if you plan to have a vaginal birth, sometimes things don't go as expected and you may need a caesarean.

What are the reasons for an emergency caesarean?

Your doctor may recommend an emergency caesarean if:

• there are concerns for your health or for your baby's health
• there is a medical emergency affecting you or your baby
• your labour is not progressing normally
• you have severe bleeding
• you have pre-eclampsia (very high blood pressure during pregnancy)

What happens if I need to have an emergency caesarean?

Before having a caesarean:

• your doctor will explain why you need to have a caesarean
• your doctor will talk to you about the risks of the operation
• you will be asked to sign a consent form for the operation. If the caesarean is very urgent and there is no time to sign a consent form, you may be asked to give verbal consent.

In Australia, your healthcare rights mean that you can ask questions and make decisions about your labour and birth. It's important to make an informed decision about what is right for you.

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

A caesarean may be planned before your labour starts. This is known as an elective caesarean. You may have an elective caesarean if:

• you choose to have a caesarean birth rather than a vaginal birth
• your doctor recommends you have a caesarean birth

An emergency (unplanned) caesarean may be needed if there are problems with your health or your baby's health during pregnancy or labour.

How quickly will the caesarean be performed?

Your doctor will follow guidelines that identify how quickly your baby should be born by emergency caesarean.

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

• Category 1 — this means there is an urgent threat to your life or your baby's life. The caesarean will usually happen within 30 minutes.
• Category 2 — this means there are problems affecting your health or your baby's health, but they are not immediately life threatening. The caesarean will usually happen within 60 minutes.
• Category 3 — this means your baby needs to be born earlier than planned, but there is no immediate risk to you or your baby.
• Category 4 — this means the operation will take place at a time that suits you and the caesarean team.

If more than one emergency caesarean needs to be performed at the same time by the same healthcare team, the order will be decided based on the level of urgency. This means you may have to wait a while, even if your healthcare team has told you it's an emergency.

What happens during an emergency caesarean?

If you have a caesarean birth you will usually be in the operating room for about an hour. The operation usually takes 30 to 40 minutes. Your baby is often born in the first 10 minutes.

A screen is put across your chest so you can't see what is happening. The operation usually follows these steps:

1. Your tummy will be cleaned.
2. The obstetrician (doctor) will make a cut through the skin of your abdomen (tummy) near the bikini line.
3. The doctor will cut through layers of fat and muscle and then through your uterus.
4. Your baby will be birthed through this cut in your tummy.
5. Your doctor will remove the placenta and close the cut with stitches or staples.

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, your doctor will hand them to the midwife or paediatrician who will remove any amniotic fluid and check your baby.

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.

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

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

If the caesarean birth was traumatic, it's possible to develop postpartum 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.

Read more about recovery after a caesarean.

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

If you are unhappy with how you were cared for, speak to the team who cared for you when you gave birth. Each hospital has a process to manage complaints.

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

Birth Trauma Australia has information about caesarean section.

The Royal Women's Hospital has a web page all about caesarean birth.

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

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

Languages other than English

Health Translations Victoria has fact sheets in multiple languages, including:

• managing your pain following a caesarean
• going home after a caesarean birth
• anaesthetic medicines used during a caesarean