Knowing what happens during a c-section birth and immediately after – when you meet your baby for the first time – can help you feel more prepared.
Here, we help to prepare you with what happens before the operation, what happens when it’s an emergency c-section, the anaesthetic used, and what happens afterwards.
When am I likely to have a planned C-section?
An elective caesarean section is usually planned after 39 weeks of pregnancy. This is because there’s a chance your baby might have breathing problems soon after birth if they’re born any earlier. This is less likely if they’re born after 39 weeks (NICE, 2011).
How will I be prepared for a caesarean?
For a planned caesarean, you will already have had some discussion with health professionals about why you’re having one.
The exact procedure on the day varies from hospital to hospital. The procedure will depend on whether you’re having a planned or emergency caesarean and the reasons behind it, if it’s unplanned (NHS Choices, 2016).
You will usually be asked to sign a written consent form, unless it’s an emergency that needs immediate treatment (NICE, 2011). If you’re having a planned caesarean you might be asked to sign your consent form in advance at a pre-op appointment (NHS Choices, 2016).
What happens before a planned (elective) caesarean birth?
If you have a pre-op meeting, you might be given medication to take before the operation. This might include antibiotics, anti-sickness medication or anti-acid medication.
You might also have a blood test. This will check for anaemia, your blood group and whether you have methicillin resistant Staphylococcus aureus (MRSA) (Guys and St Thomas’, 2017).
This appointment is your chance to ask any questions, before you sign the consent form (NHS Choices, 2016). You’ll be asked to go into hospital the night before or early on the morning of the operation. You’ll also be asked not to eat for a few hours before the surgery (NHS Choices, 2016).
What happens just before a caesarean?
Before the operation, your blood pressure, pulse and temperature will be checked and your baby’s heartbeat monitored. You’ll get pressure stockings to reduce the risk of a blood clot in your leg (Guys and St Thomas’, 2017).
You might need a bikini shave and your nail varnish, make-up, glasses or contact lenses and jewellery will be removed before the op. The nursing staff will also put a named wristband on you (Guys and St Thomas’, 2017; LabourPains, 2018).
After all of this, you and your birth partner (if you have one) will go to the operating theatre (NCCWCH, 2011; NICE, 2011).
What happens if I need an emergency caesarean?
It’s the same process if you’re having an emergency caesarean. Depending on how urgent it is will determine how quickly the operation is done.
Most emergency caesareans are urgent but the reason for them is not immediately life-threatening to either mum or baby (Thomas et al, 2001). So they can be done in a similar way as a planned caesarean section.
Some caesarean sections do need to be done very quickly. In these cases, the preparation for the emergency caesarean section would normally be changed and some steps might be left out (LabourPains, 2018).
What sort of anaesthetic will I have?
If you’re having a planned caesarean, you’ll often be able meet the anaesthetist first to discuss your options.
Usually, you’ll be given a regional anaesthetic (spinal or epidural). This is a one-off injection in the lower back, which numbs the lower part of the body. That means you will be awake during the operation.
The anaesthetic works very quickly, but you have to sit very still in a forward position when it’s administered (NICE, 2011; NCCWCH, 2011). (This can be challenging with a pregnancy bump, particularly if you’re also having contractions.)
If your caesarean is unplanned and you’ve already had an epidural during labour, this can usually be topped up for an emergency caesarean. Occasionally, an epidural alone is not sufficient, in which case other options include a combination epidural and spinal block, or a general anaesthetic (NCCWCH, 2011).
Will I need to have a general anaesthetic?
Around 10% of caesareans are performed under general anaesthetic. General anaesthetic can be less safe than a spinal or epidural but might be used for various reasons.
One reason is that you might not want to be awake during the operation, or you may have a medical reason that prevents the use of a spinal or epidural. Some evidence suggests that with general anaesthetics for caesareans, mothers experience more blood loss and more babies need resuscitation compared with those having regional anaesthesia (NCCWCH, 2011).
A general anaesthetic might be used if your baby needs to be born quickly (NHS Choices, 2016). If so, your birth partner (if you have one) isn’t usually allowed into the operating theatre (LabourPains, 2018).
What happens during a C-section?
The procedure is similar whether the caesarean is planned or an emergency.
Don’t be surprised if there are a lot of people in the operating theatre. Depending on the reason for your caesarean, staff might include:
- a midwife
- two obstetricians
- a theatre nurse and an assistant
- an anaesthetist and an assistant
- paediatrician (a doctor specialising in children). (LabourPains, 2018)
If you’re awake during the procedure, a screen is usually put up so you and your birth partner can’t see the operation (NHS Choices, 2016). If you prefer, you can ask to have the screen lowered when your baby is being born (NICE, 2011).
You should also have your birth preferences, like playing music in theatre, or silence so your voice is the first your baby hears, accommodated where possible (NCCHCW, 2011; NICE, 2011)
Generally, the anaesthetist will talk to you during the operation and give you more pain relief if you need it (NHS Choices, 2016; LabourPains, 2018). Your skin will be cut slightly below the bikini line and you will hear the sound of instruments and suction of fluids from around the baby.
You shouldn’t feel any pain during the operation but you might feel some pressure (NHS Choices, 2016). You might also feel some mildly uncomfortable rather than painful sensations. Some women say it feels like ‘having someone doing the washing-up in my tummy’ (LabourPains, 2018).
If you’ve had a general anaesthetic, you won’t be aware of anything until you’re awake. This will usually be in the recovery room rather than the operating theatre (LabourPains, 2018)
When will I meet my baby for the first time?
If you’re awake and your baby is well, you can cuddle and have skin-to-skin contact straight away. This might not be the usual practice at your hospital, so it’s worth asking and requesting skin-to-skin as part of your birth plan (NCCHCW, 2011; LabourPains, 2018). Your partner can also do this for you.
You can also ask about delayed cord clamping, as well as breastfeeding, in the operating theatre as these are sometimes possible (NCCHCW, 2011).
If you have a general anaesthetic, your baby might be able to be given to your birth partner for skin-to-skin contact in another room. This would be a different room than the operating theatre.
Sometimes, you might be able to have assisted skin-to-skin contact in the operating theatre even if you’re not awake. Your baby can be placed on your chest and supported by a midwife while your wound is stitched.
If your baby needs any help breathing, or has other problems, they may need to be taken to the special care baby unit (NICE, 2011; LabourPains, 2018).
What happens after a caesarean?
While you’re staying in hospital you will be given pain relief (NHS Choices, 2016). You should also be able to have close contact with your baby and start breastfeeding if you would like to (NICE, 2011).
You’ll be encouraged to get out of bed as soon as possible and eat and drink as soon as you want to (NHS Choices, 2016). You won’t be able to drive for around six weeks so will need to arrange transport home (NHS Choices, 2016).
You should receive advice on looking after your wound at home. Your wound might be tender for a week or two, but you can take painkillers at home if you want to (NHS Choices, 2016).
You can read more about other aspects of caesarean birth in some of our related articles.
This page was last reviewed in October 2018
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You might want to watch this film. It offers ideas on making caesarean births better for women and their babies. It offers an approach that might be new for some doctors and the norm for others:
For statistics on your local hospital’s caesarean section rates, see which birth choice.
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