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Emergency caesarean

3-minute read

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, and there may not be time for you to consider all the options.

About 2 in every 5 caesareans are unplanned. These are known as emergency caesareans.

An emergency caesarean may be necessary if:

  • you are carrying more than one baby and complications occur
  • labour is not progressing normally — for example, if the cervix does not dilate normally or you have a prolapsed umbilical cord
  • you have a medical emergency, such as severe bleeding or severe pre-eclampsia
  • the baby’s health is in danger — for example, if the monitor detects an abnormal heart rate
  • the baby is too large and can’t fit through the mother’s pelvis

How quickly will the caesarean be performed?

Your doctor has guidelines to identify how quickly your emergency caesarean should be done. It will depend on the reasons for the operation.

If several women need caesareans at the same time, they will be prioritised according to the level of risk. Usually, the mother and/or baby most at risk goes first. This means you may have to wait a while, even if you have been told it is an emergency.

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

  • Category 1 — immediate threat to the life of the mother or baby.
  • Category 2 — there are problems affecting the health of the mother and/or baby but they are not immediately life threatening.
  • Category 3 — the baby needs to be born early but there is no immediate risk to mother or baby.
  • Category 4 — the operation will take place at a time that suits the woman and the caesarean section team.

Most emergency caesareans are Category 2 and mostly are done about an hour after the decision is made. Life threatening Category 1 caesareans aim to be done within 30 minutes.

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

In an emergency, there might not be time to give you an epidural or spinal block. You may need a general anaesthetic, although this is rare. When you wake up you may feel dizzy, nauseous, and you may have a sore throat.

Your baby may need to spend some time in neonatal intensive care.

Your emotions after an emergency caesarean

Many women are happy after an emergency caesarean and relieved that the baby is healthy. But some women may feel upset and disappointed that the birth didn’t go to plan. How you feel often depends on your expectations before the birth.

You can be helped to recover emotionally by going over the reasons why the emergency caesarean was necessary. Discuss this with the midwives, doctor or obstetrician before you leave hospital, or arrange to meet them afterwards to talk about why you needed the caesarean and what this means for any future pregnancies.

If the birth was very traumatic, it is possible to develop post-traumatic stress disorder (PTSD). Symptoms of PTSD include:

  • intrusive memories or flashbacks, which make you feel anxious and panicked
  • avoiding anything that reminds you of the birth, like television programs or conversations about childbirth
  • sleep problems, angry outbursts and difficulty concentrating

If you have any of these symptoms, or if you feel like hurting the baby or yourself, contact:

  • Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse
  • Lifeline on 13 11 14
  • beyondblue on 1300 22 4636
  • PANDA on 1300 726 306

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: September 2019

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