You’re probably aware that when it comes to giving birth, you have two main options: a vaginal delivery or cesarean section, aka C-section. But you’ve also probably heard the term “emergency C-section” thrown around and wondered what exactly that entails.
In the Vogue September issue, released this week, Beyoncé Knowles revealed that she had an emergency C-section with her twins. “I was 218 pounds the day I gave birth to Rumi and Sir. I was swollen from toxemia and had been on bed rest for over a month,” Knowles wrote. And she’s probably not the first person—celebrity or not—you’ve heard refer to this. Serena Williams and Jessica Biel have both talked about having an emergency C-section. “While I had a pretty easy pregnancy, my daughter was born by emergency C-section after her heart rate dropped dramatically during contractions,” Williams wrote in an essay for CNN.
While it’s clear that an emergency C-section is not in anyone’s birth plan, it’s not as obvious what differentiates this procedure from any other C-section.
First, let’s go over what happens during a standard C-section.
A C-section is a surgical procedure that’s used to deliver a baby through incisions made in a woman’s abdomen and uterus, the Mayo Clinic explains. It is possible to schedule or request a C-section in your birth plan, which may be recommended for a number of reasons, including the baby being in an abnormal position, a problem with your placenta, or having had a C-section in the past.
Before the procedure, your stomach will be cleaned, a catheter will be placed into your bladder to collect urine, and IV lines will be put in a vein in your hand or arm to give you fluid and medication. Most C-sections are done under regional anesthesia, which numbs a part of your body but lets you stay awake during the birth, the Mayo Clinic says. That generally involves an epidural block, which involves delivering medication into the epidural space in your lower back continuously through a catheter, per the U.S. National Library of Medicine, and a spinal block, which injects medication right into the fluid in your spinal cord.
During the actual procedure, your doctor will make an incision through your abdominal wall (usually horizontally near your pubic hairline), the Mayo Clinic says. Your doctor will then make incisions layer by layer through your fatty and connective tissue to separate your abdominal muscle to access your abdominal cavity. Then, your doctor will make an incision on your uterus, and deliver your baby through the incision. After your baby and placenta are removed, the incisions will be closed up with sutures.
The term “emergency C-section” essentially means that the decision to perform a C-section happened under intense, sudden circumstances.
A C-section is considered an emergency or “stat” C-section when it’s based on a situation where the health of the baby or mom is in danger, Jessica Shepherd, M.D., a minimally invasive gynecologic surgeon at Baylor University Medical Center at Dallas, tells SELF. Some of the most common reasons for that are that the baby’s heart rate is dropping, the woman is having severe vaginal bleeding, the umbilical cord prolapses (i.e. it starts to come out of the vagina before the baby), or the baby’s health is unstable, Dr. Shepherd says.
Whether the C-section is planned or not, the procedure is coded as a C-section and the steps for the actual surgery are similar. The main difference is that this is a deviation from the birth plan due to emergency circumstances, and this means that everything will need to be done much, much faster. “It requires more urgent care and more team effort to get everything done very quickly,” Dr. Shepherd says.
Once your doctor has determined that there’s an emergency situation, they act fast. Typically, the time from when your doctor has decided you need an emergency C-section to the delivery of your baby is less than 30 minutes, Jonathan Schaffir, M.D., an ob/gyn from The Ohio State University Wexner Medical Center, tells SELF.
An anesthesiologist will be called in ASAP and you’ll usually be given general anesthesia, which knocks you out. It takes time to put in the catheter for an epidural and to administer a spinal block, and you just don’t have that kind of time in these sort of situations, Taraneh Shirazian, M.D., assistant professor in the department of obstetrics and gynecology at NYU Langone Medical Center, tells SELF. “A general is much faster,” she explains. “You put a mask on and can get the woman to sleep much faster than you can with a spinal.”
Once you’re out, your doctor will work quickly to get the baby out. “In a true emergency situation, it’s possible to deliver a baby within one minute of making the skin incision,” Jonathan Schaffir, M.D., an ob/gyn from The Ohio State University Wexner Medical Center, tells SELF. “In a regular C-section, things are much more measured and done in a slow and methodical way. Typically from the time of skin incision it takes more along the lines of 10 to 15 minutes.”
There’s unfortunately nothing you can do to prevent an emergency C-section.
“It’s just like any emergency,” Dr. Shirazian says. “Sometimes things happen.” In fact, if you had a condition or situation where your doctor thought that you’d need a C-section, it’s likely they would plan a C-section in advance, Dr. Schaffir says.
Emergency C-sections are understandably scary, but it’s important to try to stay as calm as possible, Dr. Shirazian says. “In hospitals, we do this a lot,” she says. “Your team is prepared to be able to do an emergency C-section and to take care of you. You have to trust that they’ve done this a million times and are going to take the best care of you they possibly can.”