Women's experiences · Caesarean birth
The Caesarean Injuries No One Warns You About
The short answer
A caesarean is major abdominal surgery. Most women recover well, but some are left with bladder or bowel injuries, infection, adhesions (internal scar tissue), a hernia, severe abdominal separation, or long-lasting scar pain and nerve sensitivity. Some of these are known risks that can happen with good care. Others may point to a surgical error, a complication that wasn't recognised in time, or a caesarean that was done too late after a long, stalled labour. Your symptoms deserve a proper assessment. If your care fell short, a claim may be possible.
"Everyone said a caesarean was the easy option."
Maybe it was planned. More often, in the stories women share, it wasn't. Hours, sometimes days, of labour. Pushing that went nowhere. Then a rush to theatre.
Your baby arrived safely, and everyone said how lucky you were. But months later, you're still in pain. Your belly is rounded and tender. You can't bear clothing against your scar. There's a bulge near the incision. Or a pain deep inside that no one can explain.
A caesarean is surgery. When surgery leaves lasting problems, those problems deserve to be taken seriously.
The injuries women describe
The Royal Women's Hospital's fact sheet on caesarean birth lists risks including bladder or bowel damage, which may need further surgery, wound and bladder infections, blood clots, adhesions that can cause pain, and placenta problems in future pregnancies. It also notes that numbness and pain around the scar can last several months.
| What women describe | What it may be |
|---|---|
| A bulge near the scar, worse when coughing or standing | An incisional hernia |
| Deep, pulling pain, or bowel problems, months later | Adhesions: internal scar tissue sticking organs together |
| Blood in the urine, leaking urine, or bladder pain after surgery | A bladder injury |
| Fever, redness, discharge or a wound that opens | Wound infection or breakdown |
| Burning, shooting or extreme sensitivity around the scar | Nerve injury or entrapment |
| A rounded belly, back pain, weak core | Severe abdominal separation. See Pregnancy, Birth and Baby's guide to abdominal separation |
| Heavy bleeding during or after surgery | Haemorrhage. See postpartum haemorrhage |
Known risks, and when it's more than that
Some of these complications happen even when a caesarean is done well. A known risk isn't automatically negligence. But the questions a lawyer asks are about how it happened, and how it was handled:
- Was an injury caused by poor surgical technique? For example, a bladder or bowel cut during the operation that a careful surgeon would have avoided.
- Was an injury recognised and repaired at the time? An injury noticed and fixed in theatre often heals well. One missed until days later can cause far more harm.
- Were warning signs after surgery acted on? Fever, worsening pain, signs of infection or bleeding should lead to prompt review.
- Were your symptoms dismissed? Being told for months that pain is "normal healing" can delay treatment. See when being dismissed by a doctor becomes a legal issue.
If this is landing for you, and you've been living with pain or complications since your caesarean that nobody has properly explained, I'd be glad to listen. No pressure.
Our free case review looks at what happened in theatre and afterwards, with input from independent medical experts, at no cost to you.
When the caesarean came too late
Many of the hardest stories involve a caesarean at the end of a very long labour: 30, 48, sometimes 60 hours. Pushing went on and on. Instruments were tried and failed. By the time of surgery, the mother and baby were exhausted, and the surgery itself was harder and riskier.
Guidelines expect labour progress to be monitored, and delays escalated:
- Queensland's guideline on prolonged and obstructed labour says to escalate to an obstetrician as active pushing approaches two hours for a first baby, or one hour for later babies, and at the earliest concern about progress.
- The Royal Hospital for Women's procedure for delay in the second stage sets out when medical review must be called, and describes four hours (first baby) and three hours (later babies) as absolute maximums for the second stage.
A caesarean late in labour, especially after failed forceps or vacuum, carries higher risks of injury to the bladder, uterus and baby. If your labour was allowed to go on long past the point it should have been escalated, that's a question worth asking. See failed instrumental delivery and birth trauma after forceps or vacuum delivery.
What you should have been told
Whether planned or urgent, you're entitled to be told the material risks of a caesarean, and of the alternatives. That principle comes from the High Court's decision in Rogers v Whitaker. An obstetrician writing in O&G Magazine stressed that informed consent in the birth space depends on good antenatal education and clear communication, especially when decisions are time-critical.
My article on caesarean rates, safety and your legal rights covers this in more depth.
What to do now
- See your GP and ask for an examination of the scar and abdomen, and a referral if anything seems wrong
- Ask about imaging, such as an ultrasound or CT, if a hernia or internal problem is suspected
- Ask for a referral to a general surgeon, gynaecologist or urologist, depending on your symptoms
- See a pelvic health physiotherapist for abdominal separation, scar tissue and core rehabilitation. The Australian Physiotherapy Association's position statement describes their role after birth injury
- Request your records, especially the operation report, which describes what happened in theatre
- Ask the hospital what happened. NSW public hospitals call this open disclosure
When it may be negligence
A claim may be worth exploring if:
- an organ was injured through poor surgical technique, or the injury wasn't recognised in time
- signs of infection, bleeding or other complications after surgery weren't acted on
- the caesarean was delayed after a long or stalled labour
- you weren't told the risks, or the alternatives
- you've been left with lasting pain, further surgery, or problems with future pregnancies
You can also raise concerns with the Health Care Complaints Commission. For what a claim can cover, see what a birth injury claim can cover. For one woman's story of a uterine rupture and hysterectomy, see "Breaking the silence".
Frequently asked questions
Is it normal to have pain months after a c-section?
Some numbness and discomfort around the scar can last several months. Pain that's severe, getting worse, or comes with a bulge, bowel or bladder symptoms, or fever should be assessed.
Can you sue for an injury during a caesarean?
Possibly, if the injury was caused by poor technique, wasn't recognised in time, or followed a caesarean that was delayed. Not every complication is negligence. Expert review of the records is needed.
Can a hernia after a c-section be negligence?
Hernias can happen after any abdominal surgery. Whether one involves negligence depends on how the wound was closed, whether complications like infection were managed, and other factors.
Is there a time limit?
Yes. In NSW it's generally three years from when you knew, or ought to have known, about the injury and its cause, under the Limitation Act 1969. Please get advice early.
A closing thought
Being told you had "the easy way out" when you're living with the effects of major surgery is its own kind of hurt.
So here's a question to sit with: what would you want your surgeon to know about how your life has been since?
Keep reading: Free case review · Birth injuries and medical devices · Birth trauma and obstetric negligence
This article is general information only. It is not medical or legal advice, and it doesn't replace advice from your own doctor, midwife or physiotherapist. Reading it does not create a lawyer–client relationship. If you are in crisis, please call Lifeline on 13 11 14 or 000 in an emergency.
