About elective caesarean birth
A caesarean section is an operation to give birth to your baby.
Sometimes health problems or pregnancy complications mean that a caesarean birth is a safer option than vaginal birth for you and your baby.
You might have a planned or elective caesarean birth for medical reasons or because there are signs late in your pregnancy that you or your baby might have problems with a vaginal birth.
A caesarean section is also called a caesarean, a c-section or a caesar.
If you feel worried or there’s something you want to know about caesarean birth, talk with your doctor or midwife before you go to hospital. You can also let them know beforehand about any preferences you have for the birth so they can try their best to support you.
Before you go to hospital: getting ready for your elective caesarean
A caesarean birth can be done only if you give your written permission. Before your hospital admission, your doctor will explain the benefits, risks and possible complications of an elective caesarean birth. Then you’ll need to sign a consent form.
You’ll need to fast before an elective caesarean birth. This usually means having no food or drink, including water, for 6 hours before the surgery. The length of fasting before surgery varies from hospital to hospital, so make sure to ask your hospital about their fasting requirements.
Most hospitals give you a list of what to bring, like clothing for yourself and your baby. Before you leave home it’s a good idea to check that you have everything you need.
You might like to ask your support person to bring a camera or phone, but remember to check with hospital staff that it’s OK to take photos or videos of your baby being born. You’ll also need permission to take photos of hospital staff or equipment.
In the maternity unit before your elective caesarean
At hospital, you’ll usually be admitted first to the maternity unit. You might have to arrive at the hospital very early in the morning.
Being pregnant and having an operation can increase your chance of developing blood clots. To help prevent this, you’ll be given compression stockings to wear during and after the surgery.
The top few centimetres of your pubic hair and your lower tummy might be clipped. This is so the area is clean and clear for the cut. It might also make it less likely you’ll get an infection.
Before you have a caesarean section, medical staff will want to talk with you about whether you have any health problems, allergies, and bleeding or bruising problems, and whether you take any medicines. This is to make sure you’re given the most appropriate treatment and care.
Caesarean section surgery usually takes 30-60 minutes. But the entire process can take a few hours, from going to the operating theatre, preparing for surgery, having the surgery, going to the recovery room, and then returning to your room in the maternity unit.
In the operating theatre: anaesthetics and other preparations for surgery
You’ll be taken to an operating theatre for your elective caesarean birth. Your theatre team will prepare you for surgery, which can take some time.
You’ll be prepared for your anaesthetic so that you don’t feel any pain during the surgery. A spinal anaesthetic is most common for elective caesarean births. An epidural is more likely to be used for an unplanned (emergency) caesarean birth.
With spinal anaesthetic and epidurals, you’re awake and can breathe normally.
You might have a general anaesthetic if you can’t have a spinal or epidural anaesthetic. You might also have a general anaesthetic if your baby needs to be born very quickly. In this case, you’ll be asleep during your baby’s birth.
You’ll have a small plastic tube inserted in the back of your hand or the crook of your elbow for your fluid drip.
Your tummy will be cleaned with antiseptic by the theatre team and covered with sterile cloths to lessen the chance of infection.
A plastic tube (a catheter) will be put into your urethra (where urine comes out) to keep your bladder empty. This protects your bladder from being injured during surgery.
Operating theatres can be quite cold, so ask for some extra blankets if you feel cold.
It’s common to feel anxious and sometimes teary as you go into surgery.
During preparation and surgery, you can usually have a support person with you, unless you need a general anaesthetic or there are serious medical problems. Your support person can sit next to you, hold your hand and be there to welcome your baby.
Your caesarean section surgery
There’ll be many people in the operating theatre with you, including the obstetrician, an assistant surgeon, an anaesthetist, theatre nurses, a midwife and sometimes a paediatrician. Each person in the room has an important role in keeping you and your baby safe.
You’ll have a drape or curtain over your chest area so that you and your support person can’t see the surgery.
Once the anaesthetic is working properly, the doctor will make a cut through your tummy and uterus. The cut will be about 10 cm long.
Your baby will be lifted out through the cut. You might feel a tugging or pulling sensation, but there won’t be any pain. Sometimes the doctor might use forceps to help with lifting out your baby’s head. If everything is OK, you can ask the doctor to hold up your baby so you can get a first look.
The umbilical cord will be cut and your placenta removed. Then the doctors or midwives will check your baby very carefully.
Your doctor will recommend an injection or medicine through an intravenous drip to make your uterus contract and to reduce bleeding. You’ll be given antibiotics through your drip to reduce the risk of infection.
The doctor will stitch the layers of the uterus, muscle, fat and skin in your tummy back together and put a dressing over your wound.
Early skin-to-skin contact helps your baby to stay warm and feel secure. It also lets you and baby bond physically and helps with breastfeeding. If everything is OK with your baby, it’s good to have skin-to-skin contact as soon as possible. You should be able to have it in the operating theatre. If you can’t, your support person will probably be able to hold your baby instead.
After your caesarean birth
Midwives and nurses will look after you in the recovery room until you’re ready to go back to the maternity unit. You’ll probably have your baby stay with you.
If you had a general anaesthetic, you should be able to see your baby once you’re awake and medically stable.
You can ask a midwife to be with you in the recovery room to help you breastfeed your baby. If the medical staff are worried about your health or your baby’s, this might not be possible at first.
It’s normal to feel pain and discomfort after a caesarean, especially when you move. Let the midwives know how you’re feeling. It’s best to keep on top of pain, because this will help you recover faster.
The midwives will regularly check your blood pressure, your wound and how much vaginal bleeding you have. You’ll probably have a drip and a urinary catheter for the first 12-24 hours. After the first 12 hours, a midwife will help you get up so that you can shower.
Getting up and moving around as soon as possible after the surgery will help reduce your risk of blood clots. And you might be asked to keep wearing compression stockings or be fitted with another compression device over your lower legs to reduce your risk. You might also be given daily injections of blood thinning medicine.
Breastfeeding after caesarean birth
Breastmilk is the best possible food to help your baby grow healthy and strong.
After a caesarean birth, starting to breastfeed can take a while. It’s a good idea to ask for support from midwives and a lactation consultant, if the hospital has one. The midwives can help you find the most comfortable ways to hold your baby while breastfeeding.
The sooner you start with breastfeeding, the easier it is for you and your baby. The hospital should help you breastfeed as soon as possible after birth. This is usually in the recovery room but sometimes you can do this in the operating theatre.
It’s good to ask for practical help, especially in the first 6 weeks after a caesarean birth. For example, you can ask friends to help with housework or with driving your other children while you recover.