A caesarean section is a surgical procedure in which a baby is delivered through an incision in the lower abdomen. It is performed under epidural, spinal or general anaesthetic, depending on the circumstances.
This page covers the two types of caesarean (planned and emergency), the anaesthetic options, and a step-by-step view of what to expect on the day. If you have been told you will need a caesarean, your obstetrician will also discuss the specific reasons that apply to you.
A planned caesarean. The date is usually arranged in advance at your antenatal visits.
When it happens: A planned caesarean is usually carried out at around 39 weeks, when there is a clinical reason that makes a vaginal birth less safe for you or your baby. Your doctor and midwife will discuss the reasons in detail with you.
Anaesthetic typically used: Spinal anaesthetic, in most cases. A general anaesthetic may sometimes be necessary; this will be discussed and decided with the anaesthetist on the day.
An unplanned caesarean, performed during pregnancy or during labour.
When it happens: When there is a concern for the wellbeing of you or your baby (or babies). The reason may be labour not progressing, your baby’s heart rate showing signs of distress, bleeding, or other urgent clinical findings.
Anaesthetic typically used: If you already have a working epidural, it can usually be “topped up” so you remain awake. If not, a spinal or, in very urgent cases, a general anaesthetic will be used.
1. Arrival You will be asked to come to the admissions department on the morning of your caesarean section. This is located in the Maternity Outpatients Department. Some women are already admitted to the hospital before the caesarean because of pregnancy complications.
2. Fasting You will have been fasting from 12 midnight the previous night (no food or fluids). On the morning of surgery, at 06:30, you may have 1 cup of clear fluid (diluted cordial, water, black tea or coffee).
3. Booking in and consent You will be seen by a midwife and a doctor, and bloods will be taken. The procedure will be explained and discussed with you, and you will be asked to sign a consent form for the caesarean.
4. Ward and baby’s heartbeat You will be admitted to the ward, and a tracing of your baby’s heart rate will be performed. A midwife from the Labour Ward will discuss her role in caring for your baby immediately after delivery.
5. Preparing for theatre You will be given anti-embolism stockings to help reduce the risk of a blood clot, and an antacid to neutralise the acid in your stomach. You will then be brought to theatre. Your birth partner will be asked to remain outside theatre until the section is about to start.
6. In theatre You will meet the theatre nurses and the anaesthetist. A drip (IV cannula) will be inserted in your hand or arm. A spinal anaesthetic is then inserted; this takes around 15 to 20 minutes to set up and work. A urinary catheter is inserted into your bladder to drain urine while you have no sensation. It is removed the day after your section, or earlier if indicated.
7. Your partner joins you Once the anaesthetic is effective and the operation is about to begin, your birth partner is brought into theatre to be with you.
A caesarean section itself takes around 40 to 60 minutes, although your baby is usually delivered within the first 5 to 10 minutes. The remainder of the operation is the careful closing of the layers.
You will hear voices and movement around you, and you will be aware of pulling and pressure sensations, but you should not feel pain. Tell the anaesthetist if you do.
After your baby is born:
After a caesarean, most women stay in hospital for 2 to 4 days, depending on how recovery goes. While you are with us:
At home, recovery continues for several weeks. Avoid lifting anything heavier than your baby, build up walking gradually, and ask for help with older children and housework. Most women feel substantially better by week 6.
Your doctor will discuss the management of future pregnancies with you, and whether a vaginal birth may be possible next time. In the case where this is your second (or more) caesarean section, a caesarean would generally be indicated for your next pregnancy.
