What Actually Happens During a Cesarean Delivery?

Most of us know the gist of a belly birth: mom’s belly is cut open and the baby is pulled out by a doctor. It wasn’t until I had a Cesarean that I learned some surprising details, like usually the baby is actually pushed out of the incision by pressure that’s placed on your belly and the doctor gently guides baby out. Whether you’re preparing for or recovering from a belly birth, understanding what actually happens during a Cesarean delivery—both medically and emotionally—can help remove fear and replace it with empowerment. Cesareans are a marvel of modern medicine, allowing for safe births in cases of fetal distress, breech presentation, placenta previa, or medical complications like preeclampsia. This life-saving procedure has evolved dramatically, making it safer and more efficient than ever before. Belly births also require a lot of strength and resilience from mom; it’s considered a major abdominal surgery. Whether planned or not, a Cesarean is an act of love, courage, and resilience.

Let’s walk through the process, step by step, blending science with the sacredness of birth.

The Medical Process: A Step-by-Step Guide

Modern medicine has gifted us with the ability to safely deliver babies in situations where, in past generations, both mother and child might not have made it through birth healthily. This video of a playdough surgery helped me understand what my son’s Cearean birth looked like. It also gave me a new appreciation of what my body had endured.

1. Preparation & Anesthesia
   Before surgery begins, you’ll be prepped with an IV for fluids and medications. A spinal block or epidural is administered to numb the lower half of your body, allowing you to be awake and present for the birth. Some hospitals also offer gentle C-sections, where a clear drape allows you to see your baby being born.

2. Incision & Opening the Uterus
   Once the anesthesia takes effect, the doctor makes a horizontal incision (in most cases) just above the pubic bone. Layers of tissue and muscle are carefully separated, and the uterus is opened with a second incision.

3. Baby’s Birth
   In just a few minutes, your baby is gently guided out—often with a bit of pressure on your belly to help them emerge. Their first cry fills the room, signaling the beginning of their journey earthside. If all is well, your baby may be placed skin-to-skin on your chest while the medical team continues their work.

4. Closing & Recovery
   After the placenta is delivered, the uterus and all incisions are carefully stitched up layer by layer. This part of the procedure takes longer than the birth itself, usually around 30 minutes. You'll then be moved to a recovery room, where medical staff will monitor you as the anesthesia wears off.

The Spiritual Side: Honoring Your Birth Experience

While a cesarean birth is a medical procedure, it’s also a deeply spiritual event. Many believe that birth happens exactly as it’s meant to, even if it wasn’t what we originally envisioned. I remember after my induction ended with a belly birth, my midwife said something like “We were trying to get the baby to move down, but he knew better.” Your body and your baby worked together to choose a belly birth. 

The Emotional Ride 

Some common emotions we experience during a Cesarean delivery are:

• Overwhelm: The bright lights, medical staff, and unfamiliar sensations (like tugging or pressure) can feel intense. Some women even dissociate or feel detached from the experience. Other women feel a sense of ease as the predictability of their baby’s arrival comes into focus.

• Excitement: After months of anticipation, meeting the baby is just a few minutes away. Eager to hear that first cry, some women begin to feel giddy.

• Lack of Control: Being on the operating table, unable to move much, can feel vulnerable. Some women struggle with feeling like they aren’t an active participant in the birth. This is a valid feeling. However, our bodies are hard at work during the entire procedure.

• Love & Joy: The moment a baby is born can bring an intense rush of emotions—tears, joy, and an overwhelming sense of love, even amidst the medical environment.

The Bottom Line

A cesarean birth is not a shortcut. It is a testament to the power of modern medicine and the strength of a mother making herself incredibly vulnerable to bring her child into the world. Belly birth is sacred and powerful. The recovery from it is often a physical challenge, but these tools can make it easier.