Questions to Ask Your Doctor About a C-Section
For anyone who has been told a cesarean is likely or has one on the calendar, and for anyone planning a vaginal birth who would rather not meet the idea for the first time in labor. The list runs in the order the decision does: whether to have one at all, the date and the days before, the operating room, your baby's first hour, recovery, and safety and the next pregnancy. Much of it comes down to how your own hospital works, so take the list to an appointment and write the answers beside the questions.
The questions
Each question, and why to ask it
Why a cesarean
Why are you recommending a cesarean for me rather than a vaginal birth?
Why ask it
Ask for the reason in a sentence you could repeat at home: the baby's position, where the placenta sits, an earlier surgery, a health condition of yours. If it rests on an estimate, such as the baby's size, ask how reliable that measurement is.
What are my other options, and what would each one involve?
Why ask it
Depending on the reason, the list might include waiting for labor, an induction, an attempt to turn a breech baby, or a planned try at labor with a clear stopping point. Have the doctor say which of them they would consider reasonable for you, which they would not offer, and why.
What are the main risks of the surgery itself, for me in particular?
Why ask it
A general list is on the consent form. What helps more is hearing which one or two the doctor has in mind for you, and what the team does to lower them. Weigh the answer against the risks of waiting for labor, since neither list means much alone.
What are the risks to me and to the baby if we wait for labor instead?
Why ask it
Have the doctor name the specific thing they are trying to avoid by operating, and say how likely they think it is for you and not only in general. 'Rare but serious' and 'common but manageable' lead to different decisions, so find out which one this is.
Is a cesarean the only safe route for me, or one of two reasonable choices?
Why ask it
Doctors use the word 'recommend' for both, and the two ask different things of you. If it is a real choice, find out what the doctor would want to know about your priorities before advising one way.
What could change between now and the date that would take the cesarean off the table?
Why ask it
Some reasons can shift in the last weeks, a breech baby who turns for one, and others cannot. If yours is the kind that moves, request a final scan or exam shortly before the surgery and find out what result would cancel it.
Would it be reasonable to get a second opinion, and is there time for one?
Why ask it
Find out how long the decision can safely wait before you book anything. Your doctor can usually say who the right person would be, another obstetrician in the practice or a specialist in high-risk pregnancy, and can send your scans ahead.
If I plan a vaginal birth, what would have to happen in labor for you to call for a cesarean?
Why ask it
Useful even when no surgery is planned, because it tells you what the team will be watching. The follow-up is which of those situations leave time to talk and which do not.
If a cesarean is decided during labor, how fast does it move and what will I be told?
Why ask it
There is a wide gap between 'we should do this within the hour' and 'we are going now'. Hearing how each one runs at your hospital, including who explains things to your partner, makes the fast version less of a shock if it comes.
Can I choose a cesarean if there is no medical reason for one?
Why ask it
Policies on this differ by doctor, hospital, insurer and country, so ask how it works there. Expect to be asked your reasons and give them plainly, fear of labor included, because the doctor may have other help to offer for that.
Date and prep
How is the date chosen, and how many weeks pregnant will I be?
Why ask it
Ask why that week and not the one before or after. You should hear what the date is balancing, such as the baby's readiness against the chance of labor starting first, and whether your own health could move it.
What should I do if contractions start or my water breaks before the scheduled day?
Why ask it
Get the number to call at night and on weekends, and where to go when you arrive. One detail to settle now is whether you stop eating and drinking the moment it starts.
When do I stop eating and drinking, and which of my regular medicines do I take that morning?
Why ask it
Fasting rules come from the hospital's anesthesia team and are not the same everywhere, so ask for them in writing. Go through your medicine list one item at a time, including blood thinners, diabetes medicine and supplements.
What tests or visits do I need in the week before?
Why ask it
Blood work, a pre-admission call and a talk with anesthesia are common, and each has its own deadline. Put them in your calendar before you leave the office so that a missing result does not hold up the morning.
What time do I arrive, where do I go, and how long is it usually before the surgery starts?
Why ask it
A scheduled slot can be pushed back when an emergency comes through the unit. Knowing that ahead of time helps whoever is waiting with you, and tells you how long you may go without food.
Should I shave, or wash with anything special, before I come in?
Why ask it
Hospitals hand out their own instructions on washing, shaving, lotion, nail polish and jewelry. Go by that sheet over anything you have read elsewhere, and ask for it if nobody gives you one.
What will this cost me, and who can tell me what my insurance covers?
Why ask it
The doctor often cannot answer this, but the office can point you to the person who can. Charges and coverage depend on your country, plan and hospital, so ask whether the surgeon, the anesthesia and the baby's care are billed separately where you are.
In the operating room
What kind of anesthesia will I have, and will I be awake for the birth?
Why ask it
If the answer is a spinal or an epidural, ask how it is given and how the team confirms it is working before they begin. Mention any back surgery, bleeding problem or bad reaction to anesthesia, yours or a close relative's.
In what situation would you use general anesthesia, and what changes for me if you do?
Why ask it
It can change who is allowed in the room and who holds the baby first. If being asleep for the birth worries you, say what you would want in that case, such as your partner holding the baby skin to skin until you wake.
Can I talk to the anesthesiologist before the day of surgery?
Why ask it
Some hospitals arrange a visit or a phone call, and others introduce you that morning. If something in your history matters, ask your doctor to pass it on ahead of time so it is not news in the pre-op bay.
Can my support person be with me the whole time, including while the anesthesia is placed?
Why ask it
A hospital may bring the support person in only once the anesthesia is in and the drape is up, which leaves you without them for the needle. Get the rule for your hospital, how many people it allows, and whether a nurse stays at your shoulder until they arrive.
Will you be the one operating, and who else will be in the room?
Why ask it
In a group practice the surgeon may be whoever is on call that day. Residents or students may take part at a teaching hospital, so speak up now if you have a preference about that.
Can you walk me through the operation, and how long does each part take?
Why ask it
You want rough times for three stretches: getting ready in the room, from the start of surgery to the birth, and closing up afterward. Find out which is longest, since your support person may be asked to leave with the baby during the last.
What is normal to feel during the surgery, and what should I say out loud right away?
Why ask it
Pressure, tugging, shaking and nausea come up in most descriptions, and pain is a different matter. Agree on the words you will use and who hears them, which is usually the anesthesiologist sitting at your head.
Can the drape be lowered, or a clear one used, so I can see the baby being born?
Why ask it
Some hospitals offer this under names like a family-centered or gentle cesarean, along with music or a quieter room. Whichever parts are possible there, write them into your birth preferences so the team on the day sees them.
Are photos or video allowed in the operating room?
Why ask it
The rule often differs for the birth itself and for the minutes after, and staff may ask not to be filmed. Settle who holds the phone, because it will not be you.
How will you close the incision, and where will the scar be?
Why ask it
Dissolving stitches, staples and skin glue each mean different aftercare, and staples have to come out, so find out when and where that happens. The cut on the uterus is a separate matter: it cannot be seen from outside, and its direction can matter for later births.
If I want permanent birth control or an IUD at the same time, what has to be arranged beforehand?
Why ask it
Consent rules and waiting periods for sterilization vary by country, state and insurer, and some hospitals do not offer it at all. Raise it weeks ahead so paperwork is not the reason it cannot happen.
Your baby
Can I hold my baby skin to skin in the operating room, and if not, how soon?
Why ask it
Hospitals that say no tend to give staffing, the temperature of the room or the baby's condition as the reason, so find out which applies and whether your arms will be free. If it has to wait, your support person may be able to do it in the meantime.
Can the cord be left a little while before it is clamped?
Why ask it
Practice differs between surgeons, and between planned and urgent operations. What you need is this doctor's default, in seconds or minutes, and what would make them clamp sooner.
Who checks the baby straight after birth, and is that done where I can see?
Why ask it
The warmer may be a few feet away or in the next room, and the answer decides whether your support person stays beside you or goes with the baby. Decide between the two of you now which you would prefer.
Is there anything the team watches more closely in a baby born by cesarean?
Why ask it
Doctors often bring up breathing in the first hours, so let yours describe what those checks involve and what would lead to extra monitoring. If your date falls on the early side, ask whether that changes the answer.
If the baby needs the special care nursery or NICU, how soon can I get there?
Why ask it
After surgery you may not be able to leave the recovery area for some hours. Some units will wheel you over in the bed, and where that is not possible, photos or a video call from your support person can fill the gap.
Where will the baby be while I am in the recovery area?
Why ask it
With you, with your support person on the postpartum floor, and in the nursery are all possible answers. Say which you want, since it may need to be noted in your chart before the day.
How soon can I feed the baby, and who will help me find a position that keeps weight off the incision?
Why ask it
Whether a lactation consultant sees cesarean patients as a matter of course or only on request differs by hospital, so find out and put the request in early. If you plan to use formula, the same question applies to holding and lifting the baby comfortably.
Recovery
How many nights should I plan for, and what has to be true before I can go home?
Why ask it
The discharge list tends to include things like walking, eating, passing urine and pain you can manage with tablets. It gives you something to work toward each day, and tells you how many nights of care to arrange for older children or pets.
How will my pain be treated in the hospital and at home?
Why ask it
Ask whether doses come on a schedule or only when you request them, because that changes how you should use the call button. Check that what you are sent home with suits breastfeeding if you are nursing, and what to do if it is not enough.
When will I get out of bed, and when do the catheter and IV come out?
Why ask it
The first walk is usually with a nurse beside you, and it helps to know roughly which hour to expect it. When you can drink and eat again belongs in the same answer, since hospitals differ on that.
How do I look after the incision, and what should it look like while it heals?
Why ask it
Get specifics: showering, drying, dressings, and when a bath or swimming is allowed. A photo taken on the day you go home gives you something to compare against if you are unsure a week later.
Which symptoms mean I call your office, and which mean I go straight to emergency care?
Why ask it
Ask for the list in writing and for the after-hours number, and put both where your partner can find them. It should cover more than the incision: bleeding, your legs, your breathing, a bad headache and your mood are all worth raising by name.
What should I not do in the first weeks: lifting, stairs, driving?
Why ask it
Push for specifics over 'take it easy': the heaviest thing you may lift, and whether that includes a toddler or a car seat with the baby in it. For driving, ask the doctor and also your car insurer, because either may have a rule.
How much help will I need at home, and for how long?
Why ask it
Have the doctor describe an ordinary first week so you can ask family for something concrete. Which jobs to hand off, such as laundry, school runs and the night-time lifting, is easier to settle before the birth than after.
How long before I can go back to work, and what will you need to fill in for my leave?
Why ask it
Describe what the job involves, since a desk and a warehouse floor get different answers. How much leave you have and what a doctor must certify depend on your country and employer, so find out from work which forms they use and bring them to a visit before the birth.
When will you see me after I go home, and is there an earlier check of the incision?
Why ask it
Book the visits before you leave the hospital if the office allows it. Ask who to call about problems in between, since the answer may be a nurse line and not the doctor.
When can I start exercising again, and would pelvic floor or abdominal physical therapy help me?
Why ask it
Walking, core work and running each tend to get a different date. Whether physical therapy is routine, needs a referral or is something you book yourself depends on where you live, so ask how you would get it.
If the birth turns out very different from what I pictured, who can I talk it through with afterward?
Why ask it
A visit to go over what happened and why is offered at some hospitals, and it is worth knowing about before an unplanned operation and not after. Find out, too, who to tell if your mood stays low or the birth keeps replaying in the weeks that follow.
Safety and next time
Does anything in my history make the operation harder: earlier abdominal surgery, anemia, my weight, a clotting problem?
Why ask it
Name each one yourself, since old records do not always travel between offices. The useful reply is what the team will do differently because of it, such as extra blood work or a different plan for anesthesia.
What do you do to prevent infection and blood clots, and what is my part in that?
Why ask it
Hospitals have their own routines, such as antibiotics, compression sleeves on the legs and early walking, and some patients go home with injections. Your part is knowing which of them apply to you, for how long, and what carries on once you are home.
What happens if I bleed more than expected?
Why ask it
Hearing the steps in order, from medicine through to a transfusion, makes the worst case less of a blank. If you would refuse blood products for any reason, this is the visit to say so and have it written in your chart.
How would this cesarean affect a future pregnancy?
Why ask it
The doctor may talk about the scar on the uterus and how the placenta attaches next time. If you hope for several more children, say the number, since it may bear on what they advise now.
Could I try for a vaginal birth next time, and will my records show what is needed to decide?
Why ask it
Whether a later vaginal birth is offered depends on the reason for this cesarean, the type of cut on the uterus and what the hospital you use then supports. Ask for a copy of the operative report before your follow-up ends, because a future doctor will want it.
How long should I wait before getting pregnant again?
Why ask it
Get this doctor's figure and the reasoning behind it, and whether it runs from birth to conception or from birth to birth. Then ask which contraception fits that gap and when you can start it.
This is not my first cesarean. What is different this time?
Why ask it
Bring the earlier operative report if another hospital did it. Ask whether scar tissue is likely to lengthen the surgery, whether the old scar is reused, and whether the doctor has a number of cesareans past which they would advise stopping.
Getting ready to talk through a cesarean
Practical guidance for the conversation itself
Before you sit down with your doctor
Know which conversation you are having
A cesarean that is already booked, one that is being suggested and one that is only a possibility each call for a different set of questions. Start with the first group if the decision is still open, and skip to the date and the operating room if it is made.
Bring whoever will be in the operating room
The person who will sit by your head needs to hear the plan too: when they come in, where they stand, and what happens if the baby leaves the room. Hand them the questions about the baby, so you are not carrying the whole list.
Take the reason down in the doctor's words
Write the medical term as well as the plain explanation, and ask for the spelling. It lets you read about it afterward, and repeat it accurately to a second doctor or to the hospital.
Ask for the consent form ahead of time
The form you sign on the day lists risks you may never have discussed. Ask whether you can take a copy home, because an office visit is a calmer place to query a line you do not understand than a pre-op bay.
Who can answer which question
Your obstetrician
The reason, the alternatives, the date, the incision and what it means for later pregnancies belong to the doctor who will operate. If the surgeon may be someone else in the practice, ask whether your preferences are written where that person will see them.
The anesthesia team
What you will feel, whether you are awake and what you may eat beforehand are theirs to answer. Your obstetrician can describe the usual pattern, but the person who places the block has the final word, so save two or three questions for them.
The nurses on the unit
Skin to skin in the operating room, where the baby goes during recovery, visiting hours and what to pack are hospital routines. A call to the labor and delivery unit, or a pre-admission visit, often gets a more exact answer than the office can give.
The billing office and your insurer
Nobody in the exam room is likely to know what your plan pays. Ask the office for the procedure and hospital details the insurer will want, and make that call before the date so the bill is not a surprise that arrives with the baby.
If the cesarean is not planned
Choose a short list now
In labor there is no time to work through a list. Pick the handful you would still want answered: why now, how urgent, what anesthesia, who comes with you, and where the baby goes.
Tell your support person what matters most
They may be the only one able to speak up while you are being prepared. Two or three wishes they can say in a sentence, such as wanting the baby held skin to skin by one of you, carry further than a long written plan.
The question there is nearly always time for
'Is there time to talk about this, or do we need to go now?' The answer tells you which situation you are in, and it takes five seconds to ask.
Ask for the account afterward
Once you are both settled, ask the doctor to go through what happened and in what order. The parts you only half heard in the moment are easier to ask about while the team that was there is still on the unit.
Questions that keep until after the birth
On the postpartum floor
Pain relief, the first walk and feeding positions make more sense asked of the nurse in front of you than weeks earlier. Keep the list on your phone and ask as each one comes up.
On the day you go home
Do not leave without the warning signs in writing, the number to call at night, your limits on lifting and driving, and the date of your next visit. Ask how the incision was closed if nobody has said.
At the follow-up visit
This is the visit for the longer view: a copy of your operative report, what the doctor would advise for another pregnancy, and how long to wait. Ask while the details are fresh in the chart and the same doctor is in the room.