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 an hour. In an elective situation where a cesarean has been decided beforehand, the tasks performed are more planned and organized unlike in an emergency cesarean.



• 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 the surgery.



• 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 be shaved.



• 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 room.



• 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 later.



• 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 recovery.



• 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 surgery.



• 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 of distress.