What happens during a c-section?

Find out what will happen during your c-section. Learn about the preparation, anaesthetic and what goes on during the procedure itself.

If your caesarean section (c-section) is planned, your midwife will give you information about what to do on the day, including:

  • date and time to arrive at the hospital
  • when to stop eating and drinking – this is usually six to eight hours before your c-section
  • having a shower before you leave home, to reduce the risk of infection
  • whether you should take any medicines that you normally take
  • whether you should take any medicine at home to stop you feeling or being sick during the c-section
  • whether your birth partner can go into the operating theatre with you.

You may also have a blood test to check whether you are anaemic, in case you lose blood during the c-section.

You may be offered antibiotics before your c-section, to reduce your risk of infection.

Giving your consent

The doctor or midwife will explain what will happen and ask you to sign a consent form. The consent form describes what happens before, during and after the c-section. It also explains the risks of the c-section and the anaesthetic.

If your c-section is planned, you will be asked to sign the consent form at an appointment before your operation. Ask your doctor to explain anything you don’t understand before you sign the form.

If you’re having an emergency c-section and your baby needs to be delivered quickly, you may be asked to sign a consent form or you may be able to give verbal consent. If there’s time, your midwife or doctor can answer any questions you or your birth partner have about the operation before you give consent.  

The anaesthetic

Most women have a spinal or an epidural anaesthetic. Both types of anaesthetic are given as an injection in your spine that numbs the lower part of your body. You may have the anaesthetic in the operating theatre or in a side room. You will either lie on your side or sit leaning forward, curving your back, while the anaesthetist inserts a very fine needle into your spine.

‘When I was having the spinal anaesthetic, I had to keep very still. I was well supported by the medical team but I found it a bit overwhelming and I got a bit tearful as it hit me that I was about to meet my baby for the first time!’ Laura

A spinal anaesthetic is the most common type used for planned and emergency c-sections because it starts to work quickly. If you are having an emergency c-section and you have already got an epidural in place, the anaesthetist can top it up with a stronger anaesthetic for the c-section.

You may have a painkiller called diamorphine injected into your spine at the same time as your spinal or epidural anaesthetic. This relieves pain for 12-18 hours and so reduces the amount of pain relief you need after the operation.

You will be awake throughout the operation. You won’t feel any pain but you may feel some pressure or tugging sensations.

‘I had an emergency c-section. Nobody told me I would be able to feel it. I was worried that something was wrong because I thought I wouldn’t feel anything at all.’ Facebook user

If you can’t have a spinal or epidural anaesthetic, or if your baby needs to be delivered very quickly, you may need a general anaesthetic. This means you will be asleep for the operation. Your birth partner won’t usually be able to go into the operating theatre but they should be able to be with you in the recovery room.

‘I didn’t feel any pain during the c-section (I didn’t even know they had started!) but I did feel a pressure, pushing down on the top of my bump as they lifted the baby out. This was uncomfortable but very quick.’ Laura

The c-section operation

If you are having a planned c-section, you will be asked to put on a hospital gown and walk to the operating theatre.

Your birth partner can usually stay with you throughout a planned or emergency c-section. The midwife or operating assistant will give them a top, trousers and hat to wear in the theatre for hygiene reasons.

There will be lots of people in the operating theatre, including two obstetricians (who will do the operation), an anaesthetist, a midwife and other support staff.

You will lie on your back on the operating table, which will be tilted so you’re leaning on to your left side. This reduces the risk of your blood pressure dropping during the operation.

You will have:

  • fluids through a needle in your arm (a drip), to stop you getting dehydrated and to reduce the risk of low blood pressure during the operation
  • anti-sickness medicine to stop you feeling or being sick
  • a small tube (catheter) into your bladder to drain urine - this will stay in place for at least 12 hours and until you feel able to walk to the toilet.

The top part of your pubic hair may be shaved or clipped. Do not do this yourself at home in case it causes an infection. Read more here about how to prepare for a c-section.

'Since I was chatting away to the anaesthetist and my husband, the surgery itself seemed quick, and all I felt was a bit of jostling and tugging while the surgeons worked behind the cloth.' Annie. Read more about her c-section experience.

The doctor makes a cut along the top of your bikini line and womb. Your baby is then lifted out. There will be a screen between your head and lower body so you can’t see the operation but you can ask for it to be lowered so you can see your baby being born. You may want to ask your birth partner or one of the theatre staff to take some photos of this moment.

If you don’t want to have a screen up during the operation, speak to your doctor in advance to find out if this is possible.

Your baby may be placed on your chest while the doctor removes the placenta and closes your wound using stitches or clips. This early skin-to-skin contact helps you bond with your baby and can help you start to breastfeed.

Unless your baby needs help to breathe, the doctor should wait a few minutes before clamping the cord, to increase the amount of blood your baby gets from the placenta. This is called delayed or optimal cord clamping. Not all hospitals do this routinely, so you may want to include this in your birth plan.

The midwife will then check the baby and dry them to help them stay warm, before placing them on your chest. If you plan to breastfeed, you can start trying while you’re in the theatre.

If you’re not able to hold your baby in the operating theatre, you can usually have skin-to-skin contact after the operation. Your birth partner can also have skin-to-skin contact with your baby.

The whole operation takes about an hour.

‘I asked for the surgeon to delay the cord clamping. It was very peaceful until the cord was cut and he began to scream! I had asked for him to be placed on my chest but I actually found this quite suffocating because I was lying flat and didn’t have much room, so my husband held him next to me.’ Laura

Read about what happens immediately after a c-section.

Sources

  1. Encarnacion B, Zlatnik MG (2012) Cesarean delivery technique: evidence or tradition? A review of the evidence-based cesarean delivery. Obstet Gynecol Surv. 67(8): 483-94.
  2. Moore ER et al. (2016) Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews Issue 11. Art. No.: CD003519.
  3. NICE (2011) Caesarean section. Clinical guideline 132, London National Institute for Health and Clinical Excellence.
  4. Royal College of Obstetricians and Gynaecologists (2015) [Accessed 9 March 2018] Obtaining Valid Consent. Clinical Governance Advice No. 6  www.rcog.org.uk/globalassets/documents/guidelines/clinical-governance-advice/cga6.pdf
  5. WHO (2014) [Accessed 8 February 2018] Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva, World Health Organization. http://apps.who.int/iris/bitstream/10665/148793/1/9789241508209_eng.pdf?ua=1
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Last reviewed on April 24th, 2018. Next review date April 24th, 2021.

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