Last updated September 2011. Planned review date: September 2013

Premature labour - caesarean delivery
A caesarean delivery may be the safest way for your premature baby to be born.
One in five premature babies are delivered by caesarean. A caesarean will be recommended if the healthcare team thinks that an early delivery is the safest option for you or your baby.
In a caesarean (also known as a C section) a small cut is made in your abdomen and the baby is lifted out through it. The cut is usually made horizontally, low down near your bikini line, although sometimes it needs to be vertical and higher up on your tummy.
Types of caesarean
Planned (also known as elective) caesarean
This will be booked in advance, so you will know what date to expect your baby. You will have time to pack a bag and make preparations before going into hospital.
Unplanned (also known as emergency) caesarean.
If complications arise before or during labour that threaten your health or your baby's, you may need an emergency caesarean. If this happens, events may seem to unfold very quickly, but there should still be time for the healthcare team to talk you through what is going on. An unplanned caesarean doesn't necessarily mean that you or your baby are in serious danger, just that it has not been planned.
What happens during a caesarean?
- The procedure is explained and you will be asked to consent.
- The top part of your pubic hair may be shaved.
- You will be given some medicine to settle your stomach.
- A drip will be put in your arm.
- An anaesthetist will give you a regional anaesthetic (an epidural, or a spinal epidural, which is similar) that numbs your pelvic area but doesn't send you off to sleep.
- Once you have had the anaesthetic, the midwife will insert a small tube into your bladder to drain urine until the next day when you are able to walk to the toilet.
- A small cut will be made along the top of your bikini line and your baby will be lifted out. You won't be able to see what's happening as a screen will be put up.
- After the placenta is removed, you'll be stitched up.
The whole operation takes about an hour, from making the cut to stitching you up afterwards. Your birth partner can be there too. It takes time to recover from a caesarean section, and you will need to stay in hospital for about three to five days.
Your stitches will take time to heal and you may need strong painkillers for two to three days. You may also be on a drip for a while. You'll usually have stitches that dissolve on their own on the inside, and maybe one stitch on the outside that your community midwife will remove in around five days.
Depending on his needs and the care available on the hospital you are at, your baby may be moved to a different hospital so you may need to be patient about seeing him.
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Source
NHS Choices (accessed Sept 2011) Health A-Z, Pregnancy and Baby, Premature baby, http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/premature-early-labour.aspx
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'The caesarean was beautiful. It was really lovely. They wanted to do it under a general anaesthetic, but I begged and begged to have a local. I wanted to stay awake in case the baby died, so that I would be there with my husband. It was very serene and everyone was very quiet. My husband is usually really bad with blood, but he was really calm this time. He stayed right by my side and we talked about our honeymoon.'
JESSICA