There can be differences in caesarean (C-section) births. They can vary depending on the level of urgency or the maternity hospital you are in.
The procedure takes around 45 minutes. It can be quicker or slower depending on the circumstances. Usually your baby will be born in 5 to 10 minutes.
Preparing for a caesarean birth
Before a caesarean birth, you will need to have a few things done to prepare you for the procedure.
A planned caesarean birth
You will have the chance to ask your obstetrician (pregnancy doctor) questions before an elective (planned) caesarean birth.
In some maternity hospitals and units, you will have an appointment a few days or weeks before the procedure. During this appointment you will have blood tests done. You'll also be asked to sign a consent form for the operation. In other hospitals this is done on the day of the operation.
Do not wear nail varnish or gel nails. Your healthcare team will monitor your fingernails during the birth. This helps check your oxygen levels and your circulation.
Getting ready in hospital
A small area of pubic hair is usually shaven 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.
Practice deep breathing to help stay relaxed before and during the procedure.
You'll be told to not eat and drink (fasting) for several hours before the procedure, unless it is an emergency caesarean. Your obstetrician or midwife will tell you when to stop eating.
Some blood will be taken from you to check your blood group and check for anaemia. This is in case you need to receive a blood transfusion during or after the operation. Blood transfusions are not common.
You'll be asked to sign a consent form for the procedure. You should make sure you understand as much as you want to about the procedure. This includes why it is being done, what could happen if you do not have it done, and any risks that there may be.
Never be afraid to ask questions. Your healthcare team is there to help you throughout your pregnancy and the birth of your baby.
If you're under the age of 16, your parent or guardian will be asked to sign the consent form on your behalf.
If you are unable to sign the consent form because you're very weak or have fainted, your next of kin may be asked to sign. This person is usually your birth partner.
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.
It's a good idea to tell your birth partner your birth preferences, so that they can give consent on your behalf.
You may get some medicine to take before the night before and the morning of your procedure. This medicine is most often omeprazole. It reduces the acid in your stomach.
Having your birth partner there
Your birth partner will wear a gown and mask if they attend the birth. They may have to wait outside until the operation has started.
A screen will be placed across your tummy. This means you and your birth partner will not be able to see the operation.
If you have a general anaesthetic, your birth partner cannot go in the operating theatre. They can wait close by and will be updated as soon as there is news.
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.
Staff can include doctors, midwives, theatre nurses, anaesthetic nurses, porters and care attendants.
You will be brought into the operating theatre on a trolley. You will be moved onto the operating trolley.
You will be given an anaesthetic by an anaesthetist. This is a doctor that specialises in anaesthetics, pain medicine and intensive care.
Normally this is an epidural or spinal anaesthetic. This means you're awake and you get to meet your baby as soon as your baby is 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 operation.
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 the anaesthetic first, you will not feel the catheter being inserted. If not, you may experience some mild discomfort as the tube is being placed.
Position and screen
You will be lying on an operating trolley for the operation. A screen can be placed across your tummy 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.
Testing of anaesthetic
The anaesthetist may touch or spray your chest with something cold. They might repeat this lower down in your tummy area. This is to make sure that the anaesthetic is working.
The spray on your tummy will not feel cold when the anaesthetic has started to work. If the spray still feels cold, the anaesthetic may need more time to work. You may be given slightly more anaesthetic.
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 in your womb.
This is usually done horizontally from below your belly button. The cut creates an opening through which your baby will be born.
You may feel some tugging or pressure on your tummy during the birth. This is a good sign and means that you'll soon be meeting your baby. Your baby is born through the cut in your tummy.
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 womb will be closed with dissolvable stitches.
The cut in your skin will be closed. This is either done with dissolvable stitches or stitches or staples that need to be removed after 5 to 7 days.
Your baby will be checked by a midwife. Depending on your situation there may be a paediatric (children's health) doctor present for the delivery.
Babies born by caesarean may need a small amount of oxygen. They may need mucus sucked out of their mouth and nose to help them to cry.
Your midwife will help you and your partner enjoy safe skin to skin contact with your baby when ready.