The Caesarean rate in the UK currently sits at about 26% with an fairly equal split between planned and unplanned. Reasons for caesarean can vary from medical need – to ensure the safety of both mum and baby; choice for personal reasons; preference if also faced with induction; labour and induction are taking a long time.
As an antenatal teacher, I do think it is important to know something about what to expect with a caesarean, even if you aiming to have as natural a labour as possible. Labour & birth can be unpredictable, so some caesarean knowledge can make a difference to you.
If you are having a PLANNED CAESAREAN, you will have a pre-op appointment, this is opportunity to ask questions and to gather the information you may need to feel secure and to know what is going to happen on the day.
If you are having an UNPLANNED CAESAREAN, so labour or induction has started, you should be informed of the reasons why a caesarean has become necessary and what is going to happen next. Ask questions, say what you need and gather all the information so you can know your options and feel secure.
SURGERY PREPARATION: This can include removing/taping jewellery and removing nail varnish; wearing a gown – you can wear this backwards so it is easier to have skin-to-skin cuddles with your baby; taking an antacid; having a catheter fitted; wearing surgical stockings; having a cannula fitted in your hand to administer medication; electrodes can be attached to your chest to monitor your heart rate; an oxygenation clip can be placed on your finger.
THE ANAESTHETIC: Most women have a spinal block anaesthetic for their caesarean – this means you are awake but you are anaesthetised from the top of your bump, right down to your toes.
Occasionally, women need to have a general anaesthetic – it is likely to be used in a more serious emergency such as if a baby needs to be born quickly or it can be used if the spinal anaesthetic is not effective.
THE MEDICAL TEAM: This can include two obstetricians, an anaesthetist, a scrub nurse or midwife to assist the surgical team, a midwife to provide ongoing support for you and your birth partner, a paediatrician or a paediatric team if there is any concern for your baby, medical students.
IN THEATRE: You can expect to be in the operating theatre for about an hour, although it can be longer if your obstetrician needs more time. It takes up to 15 minutes for your baby to be born, the rest of the time is taken with the delivery of your placenta and taking time with your stitches.
SKIN TO SKIN: Once your baby is born, as long as your baby doesn’t need any medical attention, you can have skin to skin on your chest – pop baby on your chest, covered with a blanket and that’s where your baby can stay.
RECOVERY WARD: When the surgical team are ready, you will move into the recover ward with your partner and your baby, where you will be monitored. You can continue to cuddle and feed your baby – ask for help from the midwife if you have any questions but it can be busy, so you may need to balance waiting with being insistent!
It’s also normal to feel shivery and cold in the recovery ward, get cosy under a blanket and ask for any reassurance.
POSTNATAL WARD: You may not move here until your spinal anaesthetic has worn off and you can move your legs again but you should be informed of what to expect.
Your catheter will stay in until you are able to walk to the loo.
When your pain relief has worn off, you will be encouraged to walk and move around, to aid your recovery.
It is not advised to twist and pick up your baby, so will need your baby handing to you for cuddles, feeding and settling. Your partner/visitors can help with that but, if you are on your own, you will need to buzz for assistance.
HOW YOU MIGHT FEEL: Initially, sore – it can be painful/ uncomfortable when walking and standing, as well as moving in the bed to sit up. You may experienced trapped wind as well.
Tired and, possibly, emotional as well.
Each day will get a little easier, ask for & accept support and taking it easy will help.
ASK QUESTIONS: All the way through, so you know what is happening, so you can say what you need, so you know what your options are, and what is happening next.
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