About half of women who have a Caesarean section know that they will be having one in advance.
We explain why you might need a planned or ‘elective’ Caesarean and what happens.
Reasons for elective Caesarean include:
- The baby is thought to be too big to go through the pelvis.
- Placenta praevia.
- Severe pre-eclampsia.
- Baby in an awkward position (such as breech or lying crosswise) and attempts to turn the baby have failed.
- Mother’s request (doctors can refuse this if there is no clinical complication).
- If the mother is HIV positive.
- Any other complication that may affect the mother’s or baby’s health.
Check your local hospital for its policy. If you are booked in for an elective caesarean, you’ll know your baby’s birthday in advance. Usually you go into hospital the day of the operation.
What happens
On the day, you will have a drip put into your arm. A catheter (drainage tube) will be used to empty your bladder and the top centimetre of your pubic hair is shaved off. Monitors will be placed on your chest to record your heartbeat and you are likely to be given a spinal or epidural anaesthetic. Very few planned caesareans are now carried out under a general anaesthetic.
The birth of your baby is quite quick. A screen is put up so that you cannot see the actual operation taking place, but the baby is lifted up for you to see as soon as he or she is born. You may feel some tugging and pulling and hear odd sounds from the machinery used to suck out the fluid and seal the cut. Once the baby is born, the wound is stitched up – and this process can take a lot longer than the birth. The wound is closed with clips or a running stitch just below skin level.
Spinal and epidural – what’s the difference?
Both these are injections into your back, and both have a numbing effect. An epidural can be ‘topped up’ and last for many hours, but it does take 20 minutes or so to set up. When speed is needed – for instance, for an emergency caesarean section – a spinal can be used instead. This is a single injection that gives pain relief for about 30-60 minutes, depending on the dose.
Once a Caesarean...?
It used to be said that ‘once a caesarean always a caesarean’ but this is no longer so. VBAC stands for ‘vaginal birth after caesarean’. Many women who have a caesarean with one baby go on to have a vaginal birth the next time. It often depends on the reason for the caesarean last time. If your last baby was breech but this one is head down, then you would probably have a vaginal birth without a problem. You can have an epidural for pain relief and your labour will be carefully monitored. If you had a section last time, talk over the options with your midwife or doctor.
Breastfeeding after a Caesarean
If you have had a caesarean, you might need help with holding your baby for the first few feeds. Use a pillow on your tummy to cushion your wound and spread the weight of the baby. Try different feeding positions, such as tucking the baby under your arm in a ‘rugby ball’ position.
Life after a Caesarean
C-section recovery tips




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