Sometimes a cesarean birth is best for you and your
baby. Though it is normal to have your share of anxieties,
almost all mothers and babies recover well after a
c-section. An operation can be scheduled (planned)
or unscheduled (emergency), depending on circumstances
and choices made. Both forms involve a series of tasks
to be performed prior to the surgery, although some
of these steps will be left out totally in an emergency
procedure. Some form of anesthesia is always required.
C-sections usually take about 45 minutes to
In an elective situation where a
cesarean has been decided beforehand, the tasks performed
are more planned and organized unlike in an emergency
• You will be explained why a c-section is necessary
as well as the pros and cons of this surgical procedure.
You will then be asked to sign a consent form; in
emergency situations your partner will have to consent
• An anesthesiologist may visit you in your
hospital room and discuss the types of anesthesia
available and choose the one best suited to you; it
can be spinal, epidural or general although the latter
is used only in extreme emergency situations. The
anesthesia will be administered in the operating theater
if one wasn't given during labor.
• An antacid to neutralize your stomach acids
will be given either orally or by IV.
• The area just above the pubic region will
• A bladder catheter will be placed in the urethra
for about 24 hours to prevent your bladder from being
cut during the procedure and to drain the bladder
before, during and after the operation.
• You will be transferred into an operating
• Monitors to check on bodily functions like
heart rate and blood pressure will be placed on your
arm; a saturation monitor will be clamped onto your
finger to keep a tab on your oxygen.
In the Operating Room
• Many people (the medical team) and your husband
will be there since the surgery is a team effort.
• The incision area will be wiped clean with
an antiseptic. You will be placed on the operating
table which will be tilted to the left or a pillow
will be placed under your right lower back to keep
the pressure of your womb and the baby off key arteries
and thereby prevent your BP level from dropping. A
sheet will be formed into a tent like structure to
serve as a shield so that your view is blocked.
• Once the procedure begins, the birth happens
very fast, over in 10 minutes or less. The incision
with bikini cut being the most popular, is a horizontal
incision just above your pubic hairline. In some emergencies
a vertical or classical incision may be made under
the belly button.
• During the operation you should not feel any
sharp pain; if you do inform your anesthesiologist
immediately. An occasional tug, push or pull is normal.
• Once the cut has been made through all the
layers to reach the uterus, the amniotic sac will
be punctured. Your baby will be lifted out of the
pelvis and through the incision at which point you
may feel a strong tug if awake. The cord will be clamped
and your baby will be shown to you briefly and then
taken away for evaluation.
• The rest of the procedure will take about
30-40 minutes. This involves the delivery of the placenta,
positioning back your organs and to repair the layers
of incision. After the placenta is removed, you may
feel the pulling and pushing of tissues and organs;
your intestines, bladder and uterus will be put back
into proper place and the layers of abdominal tissues
will be sewed closed in two layers. The internal stitches
will dissolve on its own while staples may be used
to seal the outer incision which can be removed painlessly
• You will be sent to a recovery room after
the surgery where you will be monitored for postoperative
complications, postpartum bleeding and pain.
Recovery from Cesarean
• Post surgery, your vital signs will be monitored
closely every 15 minutes until you have stabilized.
In the recovery room your blood pressure, temperature,
pulse and respiratory rate will be observed. Abdominal
bleeding will be checked so will your sanitary pad
for vaginal bleeding. The urinary catheter will also
be monitored to check your urine level.
• You and your partner can use this space and
time to spend some minutes alone with your newborn.
You can begin breastfeeding if you feel up to it.
• You will be moved to a room in the maternity
ward after a couple of hours. Your nurse will be monitoring
you over the next 24 hours. Your vital signs, incision,
uterus and lochia will be periodically checked.
• You will be medicated for pain when the anesthesia
wears off – these can be given through the IV or injection.
• If the surgery was done early in the day you
will be encouraged to move around on the same day.
Typically you will be encouraged to walk briefly about
8 hours after the op because walking is vital to your
• The urinary catheter is usually removed within
12 hours of surgery. If there is no excessive bleeding
or fever, the IV line is usually removed the day following
surgery. You can take a shower on the day after the
• You will be allowed sips of water or ice chips
for the first 12 hours following the surgery; you
will probably receive fluids intravenously. Following
this you will be put on a liquid diet and can start
on a regular diet a day after surgery.
• Discharge can be as early as the third day
after the operation. Since anemia is very likely you
will be treated with oral iron tablets.
How you can Prepare
When the cesarean is elective, there are things you
can do on your part. Before the procedure it is advisable
to not drink or eat for a couple of hours. A consent
form needs to be signed before the operation, and
you will be thoroughly informed on what to expect
by someone from the medical team. Address your concerns
if you have any, for example, do you want to try to
breastfeed right away? The top of your pubic hair
will need to be shaved before the cesarean; it might
be a good idea to take care of this at home yourself.
When Cesarean is UNEXPECTED
Emergency and crash caesareans won’t be planned and
will probably take place once labor has begun and
when things are not going as expected. If the baby
is showing signs of distress or if labor is progressing
very slowly then an emergency c-section will be arranged.
Epidurals can still be used in an emergency. A crash
caesarean is an emergency when the baby needs to be
delivered quickly, and the mother will probably need
a general anesthetic. A crash caesarean is required
if the mother has placental problems, there is a problem
with the cord, or if the baby is showing severe signs