Having a Caesarean Section (C-Section) when you’re plus size

Plus size and pregnant? Read on!

After a failed induction (started due to pre-eclampsyia) and a baby in distress, I had an emergency caesarean section (that’s a c-section from here on out). At the time I wished that I’d spoken to more women who had a c-section so I’d hear first hand from plus size women who’d been there. Athough it was over quickly, not being prepared led me to have anxiety and fear that could have been minimized. The biggest question I had that no one could tell me was how being overweight would affect both the c-section itself, and my recovery.

This is not a medical article. It contains no medical advice. I want to share my experience and some practical tips that I learned after having an emergency c-section as a plus size woman. You should talk to your healthcare provider about any fears or questions that you have, and of course talk to your care team after giving birth. I would recommend this article by OB-GYN Cornelia Van der Ziel for further reading on the subject.

So let’s talk about the practicalities of having a caesarean section or an emergency c-section (EMCS) when you’re plus sized.

I have always been a plus size and during pregnancy I was a size 26. This brings extra risks and extra worries. One of my biggest worries was actually the practicality of it. I carry most of my weight in my stomach and have a large apron stomach – that means my stomach hangs out and over. How would the surgical team deal with a big stomach when they have to go in just above the pubis for a c-section? And especially in an emergency situation, when there wasn’t any time for planning or messing around?

How do they do a caesarean section with a plus size stomach

I was too embarrassed to say “What are you going to do with my fat?!” to the c-section team but the answer was really simple!

The surgical team actually held up my belly with very strong medical tape! It was certainly not the most dignified thing, but it was safe and gave the team full access to the entry point so they could access my uterus with minimal cutting. My belly was taped up to just underneath my breasts, and the surgical tape held it there very securely for the entire procedure without anyone having to physically manipulate me. Just think of it as when you hold your belly up for the ultrasound, as most plus-size pregnant women have had to do – except no one has to hold it. Brilliant and simple!

The only downside was the super strong sticky tape took about a week and multiple showers for me to get all the glue off!

I have heard people say if you are plus size you have a much larger scar. Every c-section is different, healing can be different for everyone, and you should talk to your midwife and surgeon if you’re concerned, but for me my c-section scar is small and no bigger than scars I’ve seen on all shapes and sizes of women despite it being a very quick emergency situation.

How do they lift you when you’re plus size

I was also worried about having to be lifted as a plus size pregnant woman. After having the spinal you cannot feel anything below your chest. Mine was so good that everything from my nipples down was completely numb. It just didn’t exist anymore (bliss after all that pain!). This doesn’t wear off for some time after the operation (about 8 hours for me to get feeling back in my toes completely) so you can’t just hop off the table and climb into a bed. You need to be lifted. This is actually really simple too. The surgery will take place on a board that’s placed on top of the bed. The team will then securely SLIDE the board from the surgical bed to your ward bed, which will be wheeled in right next to it. There is minimal lifting involved and they will make sure they have enough team members for you to feel secure. You’re in no risk of rolling off, and your weight is carefully and safely handled in about 1 minute flat. Again, a really simple and efficient way of them moving larger patients.

If you do need to be lifted in an emergency situation without a board to slide you, the hospital staff are experienced and trained and will be able to use the right staff and equipment to get you where you need to be. No one made any comments at all about my weight and I was made to feel comfortable at every step of the way.

How does being plus size affect your recovery after a c-section?

Because your belly is overhanging the surgical site there may be some complications. This site needs to be kept dry and as gross as this sounds, the best way I found of keeping it dry was to put a sanitary pad underneath my stomach across the top of the wound. My wound was very weepy so this needed changing frequently, and it also stopped any sweat from pooling there, and meant I could shower and make sure it was completely dry. I was frequently told that not keeping it dry could result in infection. Another tip is to hold or tape your belly up and ask your partner to use a hair dryer on cold setting to air-dry the area. Works a charm.

Otherwise, despite being plus size my c-section site healed well. It is uncomfortable and difficult for the first few weeks, but that is true for all women!

Other practical information about being plus size and giving birth

Not all directly related to having a c-section when you’re plus sized, but here is some other information you might want to know if you’re plus size and pregnant, whether you have a hospital stay or not:

Bring your own bathrobe / towels: I found the hospital towels absolutely tiny and life is hard enough walking to the shower and getting dried without a towel being barely enough to cover your boobs, let alone your butt.

Ask for assistance getting out of bed if you need it: Lifting your weight out of the bed can be hard for any woman straight after a c-section, but it can be particularly hard for plus size folks who aren’t used to the bed size or height. I found the hospital bed particularly awkward to get in and out of because it’s much higher off the ground than my bed at home. If you need help getting out of bed do not struggle by yourself which could potentially lead you to fall and have an injury, push the nurse button and ask for assistance and don’t feel embarrassed about it.

You may need to supersize on the underwear: You want your underwear to go up over your belly. If you have a big belly or if you prefer low rise underwear you might not usually wear underwear in this size. You don’t want any rubbing on your c-section site, so super size those undies if necessary. I ended up ordering a size up with next day delivery whilst on the ward just to get some with a good fit as I wasn’t prepared.

Make sure you have sanitary pads that are comfortable and a good fit: Although the hospital I went to did provide sanitary pads if needed, they were not a good fit for me at all. You know the shape of your underwear and what makes you comfortable, make sure you bring some pads that are long enough and wide enough. Bleeding can occur whether you had a vaginal or c-section birth.

Make sure your compression socks are a good fit: Make sure the nurse measures the top of your calves where the compression socks will go. You will need to wear them after surgery, and they have to be tight, but you don’t want to be wearing the wrong size. I have huge meaty calves and had to ask for a size bigger as they were so painful to wear. Better to get it right the first time.

Use the disabled toilets: If your ward has an option between normal toilet cubicles and a disabled toilet as mine did, use the disabled toilet. Lifting yourself off the loo when you’ve just had a c-section can be challenging. The disabled toilet will have hand rails to help you get up, and a cord for you to pull if you find you need assistance. Don’t be embarrassed to use it.

I hope that if you’re pregnant and plus size that sharing my experience has helped you feel a little less worried about having a c-section, as well as given you some practical tips for being as comfortable as possible after giving birth!