We hear so much about natural child birth and how hard that is—and it definitely is one of the hardest things a woman will ever go through. But what about women who give birth via a cesarean section?

About 1.3 million American babies are delivered by C-section each year way, according to the Centers for Disease Control and Prevention (CDC). That’s a lot of mamas!

What many people don’t know is that mothers who have a C-section typically are enduring it when vaginal delivery would put the baby or mother at risk, thus this is one of the hardest situations to be in. Sometimes a C-section is planned ahead of time, but that doesn’t make it any easier either.

Like any surgery, there are risks to having a C-section. For one thing, babies born by C-section are more likely to develop a breathing problem called transient tachypnea, which is marked by abnormally fast breathing during the first few days after birth. It’s also possible a doctor may accidentally nick the baby during the surgery.

There are also risks for Mom—the risk of getting a uterus infection, postpartum hemorrhaging, blood clots, wound infections, the list goes on and on.

What we’re trying to get at is that there’s lots that happens in the event of a C-section—and moms who’ve been there want to share what it’s like. Here are 5 things to know about C-section mothers:

Image of newborn baby being held by nurse.Vox
  1. They might have mixed emotions

    When a C-section is unplanned, this can be hard on a mom with a birthing plan. “One minute you might feel, ‘I’m mad. I’m angry,'” says Sharon Muza, a childbirth educator and doula in Seattle who hosts childbirth classes for families who deliver via C-section. “But then that mingles with, ‘My gosh, I’m so grateful to have a healthy baby, and an avenue that allowed me to have that baby. Shouldn’t I be grateful, why am I angry?'”

  2. They are seriously strong women (physically and emotionally)

    A C-section is a major surgery. To go through that and then have to parent is no easy feat. Women who have them can’t even drive for a week or so, let alone even lift their baby comfortably, which can be emotionally tough. Typically, C-section moms are forbidden from lifting anything over 15 pounds for a few weeks.

  3. The recovery process is substantial

    While those who give birth vaginally, they typically heal a bit quicker than those who’ve had a C-section. But the thing is, even when the scars heal, you might still have pain around the area of the surgery. “Even after my scar healed, the thing still burned like hell for four to six months,” says Kate Spencer, a writer for Cospmopolitan and C-section mom. “Anything that even brushed up against it—my kid’s foot while in the carrier, the seam of my yoga pants—felt like someone stabbing me with a million tiny thumbtacks. Then, it was tender and numb for almost a year. Not to mention that even your insides can sometimes feel like a bunch of Cold Stone Creamery toppings mushed around with some strawberry ice cream and shoved into a sugar cone.”

  4. You’ll be proud of your scar

    That is, after all, the spot where your baby came into the world for the very first time. Most C-section moms find pride in looking at their scar. Oh yeah, and that they’re-super-strong thing applies here. That incision is no joke! “Most incisions are typically 5-6 inches long to allow the head and shoulders to be delivered,” says Dr. Bruce Flamm, MD, clinical professor of obstetrics and gynecology at the University of California at Irvine.

  5. The bond with your baby is just as great

    Some people believe that when a baby isn’t delivered naturally, the bond between baby and mom will be lessened because you don’t necessarily get to hold the baby right away, but that simply isn’t true. “I personally don’t think a C-section has anything to do with bond,” says C-section mom Kumari Revi. “There are so many ways to be a mom or parent—whether it’s through C-section, vaginal birth, surrogacy, or adoption.

Are you a C-section mom or do you know someone who’s ever given birth this way? Did you know any of these facts about C-sections?