If your doctor has recommended a cesarean section, it’s to ensure that you and your baby have a safe delivery. A C-section is a surgical procedure that involves an incision low on your abdomen and into your uterus.
“A C-section may be planned ahead of time if you have pregnancy complications, if you’ve had a previous C-section and aren’t considering a vaginal birth after cesarean (VBAC) or because of complications with a previous vaginal birth,” said Marcy Mulconry, MD, obstetrician and gynecologist at Rochester Regional Health.
Knowing what to expect during a C-section can help you prepare and feel more at ease about the procedure and your recovery.
Steps during a C-section
Preparing for surgery
When you arrive for a scheduled C-section, your nurse will draw blood to obtain baseline lab values, start an IV, perform a non-stress test to assess your baby, and ask you admission questions.
There are two different forms of anesthesia used during a C-section: general and spinal. For most cesarean sections, spinal anesthesia is administered. This type of anesthesia allows you to remain awake during your delivery and bond immediately with your baby. In rare cases, general anesthesia is used and the patient is asleep for the procedure.
When spinal anesthesia is used, your support person typically stays with you throughout the C-section, with the exception of the time during which the spinal anesthesia is given. Other people in the operating room include your obstetrician, the anesthesiologist, two nurses (one for you and one for baby), and other necessary support staff. In the rare case that general anesthesia is used, your support person will wait in the recovery room and will meet you there directly after the surgery.
Once in the operating room, patients sit on the operating table to receive spinal anesthesia. Spinal anesthesia is administered through a woman’s back. If an epidural is in place from labor, this can be used for anesthesia as well. Once the spinal anesthetic has been administered, you will be instructed to lie on your back on the operating table. Your team will then begin prepping your body and the area for surgery, including placement of a urinary catheter into your bladder.
When everyone is ready to begin, you will hear a “time out” be completed. This is the point during which all team members verify your identifying information (name and date of birth) and the procedure that is to be performed. There are other safety measures on the checklist that will be mentioned at this time. When this process is complete, your support person enters the room and joins you at the head of the table. There will be a large blue drape separating your upper and lower body. You and your support person are behind the drape and unable to see the surgery being performed.
During the procedure
Typically, the obstetrician will make an incision across the top of your bikini line, carry down to your uterus, make an incision in the uterus, and then deliver the baby. On rare occasions, the incision may be vertically up and down on your abdomen. If this is the case, your obstetrician will have discussed this with you before surgery.
Once delivered, your baby will be dried off and the umbilical cord will be clamped and cut. The doctor will hand him or her to the delivery nurse, who will do an assessment of the baby’s breathing and heart rate. After this assessment and when safe to do so, the nurse will place the baby on your chest while your obstetrician finishes the surgery.
Post-surgery
Once the surgery is complete, you and your baby will be taken to your postpartum room to recover and your nurse will make sure that your vital signs are stable and pain is managed. During the immediate recovery time (about two hours), you may have two support people at your bedside (subject to current visitation guidelines). For your safety, no other visitors will be allowed until after the initial recovery period. Your nurse will be checking in with you frequently to provide pain management options as needed. You may begin to walk with assistance once the feeling in your legs is back to normal.
At this point, IV fluid is typically stopped and the urinary catheter is usually removed. You may be asked to record your own fluid intake once the IV fluid has been stopped. A support person can be helpful with this task. Our team will continue to support you and your baby through your postpartum period up until discharge. The nursing team will be checking baby frequently and will provide education as needed on baby’s care.
Things to know about your C-section
How to prepare: If you’re having a scheduled C-section, do not eat for at least eight hours before your procedure. You may have clear fluids (water, tea or coffee without milk) for up to two hours before your procedure. Talk to your doctor about what medications to take the day before/day of your surgery.
How long it takes: The average time in the operating room is 1.5-2 hours.
How long you’ll be in the hospital: If you have other children, arrange for a flexible caretaker. You will likely have a two- or three-day stay.
The recovery: Take it easy during your C-section recovery process, as much as possible. We’ll work with you to discuss pain relief options, how long to avoid sex and physical activity, and more.
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