What is an emergency caesarean?

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.

A caesarean section (C-section) is an operation to birth your baby. About 2 in every 5 caesareans are unplanned. These are known as emergency caesareans.

What are the reasons for an emergency caesarean?

An emergency C-section may be recommended if:

• there are concerns for the safety of you or your baby
• there is a life-threatening emergency for you or your baby
• your labour is not progressing normally
• there are complications, such as severe bleeding or severe pre-eclampsia

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

Your doctor will explain why it is necessary to have a C-section. They will talk with you about the complications and risks.

You will be asked to complete a consent form for the operation. It is important to make an informed decision, so make sure you ask questions and discuss concerns with your doctor. Your partner or next of kin can give written permission if you can’t.

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. 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. It depends on the reasons for the operation.

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.

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

Most emergency caesarean births are Category 2 and 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?

Caesarean surgery usually takes 30-60 minutes, 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, although this is rare. When you wake up you may feel dizzy, nauseous, and you may have a sore throat.

In most cases your partner or support person can be with you. You will also usually have a midwife that stays with you. They will look after you and your baby in the theatre and recovery area.

Emotional support after an emergency caesarean

Some women feel happy after having a caesarean birth, but others can feel a range of overwhelming emotions, particularly if it was unexpected. Very urgent caesareans (Category 1) happen very quickly and can be a traumatic experience for parents and support people.

• 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 birth was very 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. You doctor will be able to guide you to the appropriate support. If needed, therapy or medicines can be used as treatment.

You can also call:

• 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

Support is also available for partners and support people.