Elective C-Section


I am booked for an elective C-section. What should I expect?

If you are booked in for a C-section most hospital trusts will invite you to their clinic a week before the elected date to discuss the procedure. At this meeting, a blood sample will be taken and checked to ensure that your iron levels are within the normal range. A specimen of your blood will be kept by the hospital so that if you require any blood or blood products during the procedure there will be a reference in the laboratory.

You will need to be nil-by-mouth 6 hours before the procedure and your doctors will tell you when this should start, depending on the time of your planned operation.

During your procedure you will be looked after by a team of staff consisting of an anaesthetist and their assistant, the surgeon and their assistant, the midwife who will care for the baby, the midwife or nurse who will assist the surgeon and sometimes a paediatrician.
There are usually other women due to have their caesarean section on the same day and at times there can be a delay. Your procedure can only take place when the team have made an assessment of the labour ward and deemed it safe to proceed. It is of paramount importance to secure the safety of labouring women and their babies before undertaking any planned operations. 

You will wear a gown that ties at the back and your partner will wear the theatre blues (the ER George Clooney uniform). Someone will show them where to change. All jewellery and nail polish should be removed before the operation. You will be taken to the theatre where you will sit or lie on the operating table ready for the spinal to be sited. A spinal is similar to an epidural but it is a heavier block so you will still feel touch but no pain.

Your anaesthetist will explain the spinal procedure and site a cannula (a small tube in your hand which will enable them to deliver fluids quickly). Once the spinal is in you will feel numb from the top of your bump to your toes.

Once the surgeon and anaesthetist are happy that the area is numb they will proceed. You will feel pulling and pushing but no pain. Some say it is like someone washing-up in your tummy! Your abdominal area will be cleaned and then sterile drapes will be placed over your body to make a sterile environment. There will be a screen up between you and the surgeons so you wont be able see what they are doing.

The baby will be born very soon after the procedure starts (approximately 6 minutes). You can decide if you want the screen to be taken down when the baby arrives. Be sure to tell the team if you would like to see for yourself whether you have had a baby girl or boy. Most hospitals will be happy for you to take photographs, so dont forget your camera.

When your baby is in the womb the lungs are filled with amniotic fluid. The process of birth squeezes your babys lungs to remove the fluid making it free to oxygenate the lungs. Having a caesarean means your baby has not been pushed through the birth canal so needs to remove the amniotic fluid itself. The baby does this by coughing and sneezing mucous out of its nose and mouth. Your midwife will make sure this continues to follow the normal process and if there are any signs of respiratory distress the relevant medical aid will be called.

You can still adopt skin to skin contact following a C-section. This is in fact highly recommended, especially as the theatre has a special circulating air unit to reduce infection rates which can be fairly cold, especially for newborn babies. Cold stress can cause respiratory distress and other problems in a newborn baby.

Once the operation is finished you will be transferred to a bed in the recovery area. Your midwife will take your blood pressure, temperature and pulse regularly to ensure you remain stable. The wound and bleeding will be checked and they will make sure you are pain free. If you havent already fed your baby, this will be a good time to initiate a feed.

Once happy with your recovery, your midwife will arrange a transfer to the postnatal ward where you will stay for 2-3 days.