A caesarean (C-section) birth is either planned or it is done as an emergency procedure.
The procedure takes about 45 minutes. It can be quicker or slower depending on the urgency. Usually your baby will be born in 5 to 10 minutes.
Preparing for a caesarean
Before a caesarean birth, you will need to have a few things done to prepare for the procedure. With a planned (elective) caesarean, you have time to prepare. There is less time to prepare for an emergency caesarean.
A planned caesarean
Before a planned (elective) caesarean, you will have the chance to talk to your obstetrician (pregnancy doctor) about the procedure and ask questions.
In some maternity hospitals and units, you will have an appointment a few days or weeks before the procedure.
During this appointment you will:
In other hospitals this is done on the day of the procedure.
Do not wear nail varnish or gel nails on the day you are admitted to the hospital. Your healthcare team will monitor your fingernails during the birth. This helps check your oxygen levels and your circulation.
When you might have a planned caesarean
Emergency caesarean
You may have an emergency caesarean if there are complications before or during labour. There may be a sense of urgency and things may move fast.
You may still have blood tests and be asked to sign a consent form.
When you might have an emergency caesarean
Getting ready in hospital
A small area of pubic hair is usually shaved or trimmed from your bikini line area. The hospital staff will do this if needed.
You'll need to wear a hospital gown for the birth.
Fasting
You will be asked to fast (not eat) for a few hours before the procedure. You may be allowed to drink water until shortly before going to the operating room. Your obstetrician or midwife will tell you when to start fasting.
Blood tests
You usually have a blood test to check your blood group and check for anaemia. This is in case you need a blood transfusion during or after the procedure. Blood transfusions are not common.
Consent form
Your obstetrician and midwife will talk to you about the procedure. They will ask you to sign a consent form.
Before you sign the form, make sure you understand everything they have told you. Ask them to explain anything you are unsure about. Ask any other questions you may have.
If you're under age 16, your parent or guardian will be asked to sign the consent form on your behalf.
In cases of extreme emergency, there may not be time for you to sign a consent form. Your obstetrician may need to act quickly in the best interests of you and your baby.
Only you can give consent. You cannot ask a birth partner to do it for you.
Medicine before a planned caesarean
You may get some medicine to take the night before and the morning of your procedure. The medicine is called omeprazole. It reduces the acid in your stomach.
Having your birth partner there
Your birth partner may be given a gown and mask to wear during the birth. They may have to wait outside until the procedure has started.
A screen will be placed across your chest. This means you and your birth partner will not be able to see the procedure.
If you have a general anaesthetic, your birth partner cannot go in the operating theatre. They can wait close by and will be updated during the procedure.
The start of the procedure
Most caesarean births happen in hospital operating theatres. All staff wear medical scrubs and hats. Some wear surgical gowns and masks and gloves.
The theatre team includes doctors, midwives, nurses, porters and care attendants.
You will be brought into the theatre on a trolley and moved onto the operating bed.
Anaesthetic
You will be given an anaesthetic by an anaesthetist. This is a doctor that specialises in anaesthetics, pain medicine and intensive care.
Usually you are given an epidural or spinal anaesthetic. This means you're awake for the procedure and you get to meet your baby as soon as they are born.
You will not feel pain during the procedure. You may feel pulling or tugging.
Sometimes a general anaesthetic is needed. This means you are put to sleep for the procedure.
Testing the anaesthetic
Before the procedure starts, the anaesthetist checks that the anaesthetic is working. They may touch or spray your chest with something cold. They might repeat this lower down in your tummy area.
If the spray feels cold, the anaesthetic may need more time to work. You may be given slightly more anaesthetic.
Catheter tube
A small flexible tube called a catheter is placed in your bladder. The tube is passed through your urethra (the passageway that connects your bladder to the outside).
If you had an anaesthetic, you will not feel the catheter being inserted. If not, you may have some mild discomfort as the tube is being placed.
Position and screen
You will be lying on an operating bed for the procedure. A screen can be placed across your chest if you do not wish to see the procedure being done. If you would like to be able to see your baby being born, talk to your obstetrician.
The procedure
Your tummy will be painted with a disinfectant solution to reduce the amount of germs on your skin. Your obstetrician will make a small cut (measuring 10cm to 20cm) in your skin and womb.
This is usually done below your belly button.
The birth
Your baby is born through the cut in your tummy. You may feel some tugging or pressure on your tummy during the birth.
The baby will be lifted up so that you can see them. The placenta (afterbirth) will usually be delivered then. The umbilical cord will be clamped and cut. You may hear your baby's first cry.
After the birth
You'll be given an injection called oxytocin. This is a hormone to help your womb contract and reduce the risk of bleeding.
The cut in your skin will be closed. This is either done with dissolvable stitches or staples that need to be removed after 5 to 7 days.
Your baby
Your baby will be checked by a midwife. Depending on your situation there may be a paediatric (children's health) doctor at the delivery.
Babies born by caesarean may need to be given a small amount of oxygen. They may need mucus sucked out of their mouth and nose to help them cry.
Your midwife will help you and your partner enjoy safe skin-to-skin contact with your baby as soon as possible.
