You’ll most likely be admitted to hospital on the day of your procedure.
You’ll be asked to fast for at least 6 to 8 hours before your surgery (including water). Your stomach needs to be empty to reduce your likelihood of vomiting, which could cause pneumonia.
You may have to fill out a consent form if you haven’t done so already.
Waiting to go into theatre
Unless your caesarean is an emergency procedure, expect to wait around for a while, as you may not be first on your surgeon’s list.
Once you’ve been admitted, you’ll meet with the anaesthetist to discuss your anaesthetic options (if you haven’t already done this). Most planned caesareans are performed using either spinal or epidural anaesthetic (where medication is injected into the area surrounding the spinal cord), or a combination of the two. The anaesthetist is also responsible for your post-operative pain relief, so you may like to discuss your options for this as well.
If you have a spinal or epidural anaesthetic you’ll be awake during the procedure. You won’t be able to feel pain or move the lower half of your body, but you may feel pressure from the incision and a tugging sensation and hear suction sounds as your baby is removed from your uterus.
In some cases, you may need a general anaesthetic, which means you won’t be conscious during the birth, and the anaesthetist will insert a tube down your throat to help you breathe.
If your caesarean is planned, you should familiarise yourself with these options. If possible, meet with your anaesthetist ahead of time and make sure you’re comfortable with your anaesthetic choices.
In the operating theatre
Your abdomen is shielded with sterile drapes so that you and your support person can’t view your stomach or below. An antiseptic wash is painted onto your abdomen.
A catheter is passed into your bladder to keep it empty and an IV drip is inserted into the back of your hand or arm. A blood pressure cuff on your arm, heart monitor on your chest and oxygen monitor on your finger will give continuous readings throughout the procedure.
You’ll usually have a small wedge pillow placed under your right side to slightly tip your uterus away from major blood vessels, and ensure optimal blood flow for you and your baby.
After the anaesthesia has taken effect, your obstetrician makes an incision through your lower abdominal wall and the lower end of your uterus. Most incisions are horizontal, (called bikini cuts, because they sit below your bikini line). This type of incision enables the muscles in your uterus to safely stretch for future pregnancies.
Sometimes you could require a vertical incision of the uterus. This can be the case if you’re having an emergency procedure, if the placenta is lying very low, if your baby is lying sideways or if your baby is very small. A vertical incision can increase the chance of problems in later pregnancies and births.
Your obstetrician delivers your baby’s head through the incision and lifts the baby free of your uterus. Sometimes they’ll use forceps if your baby’s head is tightly wedged in your pelvis. Finally, your obstetrician removes the placenta and staples or stitches the incision closed.