What happens during a Caesarean?
If you are having an emergency Caesarean, a lot of things will happen very quickly. If you are having an elective Caesarean, the atmosphere will be rather more calm!
The preliminary procedures are as follows:
- You need to sign a consent form for the operation (if you are too ill, your birth partner will be asked to sign for you)
- You will have a drip put into your arm or the back of your hand
- The top few centimetres of your pubic hair will be shaved off. (If there is time, you may be invited to do this for yourself!)
- You will be asked to drink a small quantity of medicine to neutralise the acid in your stomach
- You will be asked to remove all your jewellery. If you have a special ring you want to keep on, the midwife will tape over it
- An anaesthetist will give you an epidural or spinal anaesthetic, or a general anaesthetic
- A tube will be put into your bladder to empty it.
What kind of Anaesthetic?
Nowadays, most hospitals do Caesarean sections (and many other operations) under local rather than general anaesthetic. This means that you will be awake when your baby is born. You will probably lose less blood if you have a local anaesthetic and your recovery will be quicker because you will be able to get up and about much sooner.
- Local anaesthetic
- General anaesthetic
Local Anaesthetic
A local anaesthetic means an epidural or a spinal. If you are in labour when the decision is made to deliver your baby by Caesarean, you might already have an epidural in place for pain relief. In this case, it is often possible simply to top up the epidural for the operation.
Or you could have a spinal anaesthetic which is a single injection into your back. Spinals take effect quickly, give excellent anaesthesia for the Caesarean and wear off over a period of five to six hours, offering you some pain relief after the operation.
General Anaesthetic
You may feel that you would be absolutely terrified if you had to be awake during a Caesarean and that you would definitely prefer a general anaesthetic. In this case, you will be asked to breathe some oxygen through a mask for a few minutes before the anaesthetic is given into the back of your hand.
As you drop off to sleep, the anaesthetist will press on your neck. This is to prevent the contents of your stomach being regurgitated into your lungs. Then you will be aware of nothing until you start to come round about an hour later, after the surgery is over.
You will probably feel groggy for quite a while and perhaps not very interested in your baby. If you want to breastfeed, make sure that your midwife knows this before you have the Caesarean so that she can put your baby to the breast while you are regaining consciousness. Breast milk is produced whether or not the mother is awake.
Step by Step
the mother has been draped with sterile drapes and is in the operating room as they make the initial incision into her abdomen.
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There are multiple layers that your surgeon must go through before reaching the baby. All in all from the start of surgery, until the birth of your baby is about 5-10 minutes.
he doctor will use a combination of sharp instruments and blunt dissection as s/he goes through each layer. You may also hear whirring noises as a machine is used to caterize or burn small blood vessels to prevent bleeding.
When the doctor reaches the uterus, you will also hear suctioning. After cutting through the uterus, the amniotic fluid will be suctioned away to make a bit more room in the uterus for the doctor's hands or instruments such as forceps or a vacuum extractor.
Your baby is usually engaged in the pelvis, usually head down, but perhaps rear first or breech. Whatever part has entered the pelvis will be lifted out by the doctors. You may feel pressure at this point and some women report feeling nauseated during this intense, but brief moment.
The baby's head is born!
Once the head is out, your doctor will suction the baby's nose and mouth for fluids. In a vaginal birth these are normally squeezed out by labor and birth. In a cesarean birth, the baby needs some extra help getting rid of these fluids. If meconium is present there may be extra suctioning required.
Once your baby has been well suctioned, the doctor will start to help the rest of the body be born. S/he will check of umbilical cord entanglement or other complications as the body is born. You may also have the assistant surgeon pressing on the upper part of your abdomen of fundus to assist in the birth.
The moment you've been waiting for - your baby's birth! It's been about 5-10 minutes since your surgery started. Your baby will briefly be held over the drape to show you the baby and the taken away by a nursery nurse or neonatologist to a nearby warmer.
Usually the warmer is in the same room as the surgery. Here your baby will be suctioned again to ensure that they have help clearing the amniotic fluid.
The surgeon will remove the placenta and then it takes about 40 minutes to sew up each of the layers of muscle, fat and skin which have been cut through in order to deliver your baby. The final skin layer may be closed with staples, a long running stitch or individual stitches.
