April is ‘National Caesarean Month’, so when better a time for a post on c-sections! We are extraordinarily lucky to live in a country where c-sections are safely available, and available for free! For this post I’ll be looking at elective caesareans, where you choose to have one in advance, for whatever reason and the options that may be available to you. Some choices may vary from hospital to hospital, or have different risks attached due to your personal medical background, so do discuss any preferences with your healthcare team in advance.
So, what actually happens in a caesarean? An operation where you’re awake? That’s got to be scary right?! It doesn’t have to be, if you know what to expect.
Usually, you’ll come the hospital first thing in the morning, having not eaten or drunk since the previous evening. You’ll wait on the ward or delivery suite, where you’ll meet an obstetrician and midwife in advance, and they will chat you through everything you need to know about the procedure and ask you to sign a consent form. This would be a good point to reiterate any ‘special requests’ for your birth.
You will then essentially, be made to wait your turn, whilst the team prioritise the safest order for the babies to be born! (Taking into account what is going on throughout the unit.) Take something to entertain you and keep you relaxed- a funny series on Netflix or a comedy podcast should do the job!
You will need to wear a hospital gown for the birth, you can put this on backwards if you are keen to have skin to skin immediately following the birth. Your birth partner will change into ‘scrubs’, which are like comfy blue pyjamas and be asked to wear a stylish fabric hat, this helps keep the theatre sterile, to keep you safe from infection. Mum will have a cannula fitted into her hand, for fluids and other medicines as required.
In you go! Now, the next bit might seem strange! But everyone in the room will go around introducing themselves- this is part of a checklist for safe surgery, they haven’t all just met for the first time!
Who’s in there? It might seem like there’s a lot of people in the room, but they all have a role in keeping you and baby safe.
Anaesthetist and Anaesthetic Nurse- in my experience, Anaesthetists are all LOVELY! They are responsible for making you numb before surgery, and monitoring you throughout surgery, they will stand by your head during the birth.
Two Obstetricians- One doing the surgery and facilitating the birth, the other assisting. The lead surgeon is ‘in charge’ of the procedure, and both will be seated, usually behind a screen by your bump!
Midwife, at least two- one is ‘scrubbed’ (sterile, and will stand with the obstetricians to check, count and provide instruments, stitches etc.) The other will be there to support you, keep you informed of what is going on, and to support you with your baby after the birth.
Midwifery Assistant- to ‘scribe’ (write down) what is happening during the birth, double count instruments, swabs etc with the midwife, and pop in and out of theatre to fetch things/people.
Student Midwife/Medical Student- with your permission, they will shadow their assigned mentor and be there as addition support to you during the birth.
Paediatrician- in some instances a paediatrician may be present, depending on your medical circumstances or any concerns that arise during or following the birth.
So, after all those intros, you will receive a spinal anaesthetic, which goes into your back and makes you numb from the nipples down. The anaesthetist will use a cold spray to check it is working. You will have a blood pressure cuff on one arm, and some stickers, which can be put on your chest or back to monitor your heart.
With consent, your midwife will insert a catheter, to drain your urine during and following the birth.
Once you are comfortable and the anaesthetic has taken effect, the operation will begin. The atmosphere during the birth can be quiet and calm, or upbeat and relaxed, it’s totally up to you!
After baby is born, if all is well, they can be placed straight on mums chest, or taken and wrapped up by the midwife before being brought back over for a cuddle.
The process of safely birthing the placenta and stitching the uterus and skin back up can take much longer the ‘birth’ part! Usually around 30-40 minutes. Plenty of time for cuddles with your new baby!
After this you will be transferred to a ‘recovery’ room, where you will be closely monitored for the few hours after birth, whilst the anaesthetic wears off. If you are planning to breastfeed, you will be supported to do so at this point.
OK Let’s chat birth preferences!
Atmosphere of the room
Most hospitals will have the facility to play your choice of music throughout the birth. You can also bring earphones and an mp3 player if you prefer. You can play your hypnobirthing scripts, or any music that makes you feel calm and relaxed.
It is becoming more common for hospitals to be able to ‘dim’ the lighting of the theatre- with full lights on the operation area. This can help you feel relaxed and calm, and welcome your baby into a comforting area.
Photos, pictures or affirmations. You can bring in something to look at during the birth, to help maintain a sense of calm and make you feel confident and at ease.
The Birth
A ‘gentle’ caesarean. You can ask for the baby to be born more slowly, mimicking the process of a vaginal birth, squeezing fluid from the lungs, and allowing moulding of the head.
‘Delayed Cord Clamping’ can still occur during a c-section birth.
The screen can be lowered during the birth or straight after, so you can see your baby being born.
If you don’t know the sex of your baby, you can ask for your birth partner to see, or find out for yourself.
Baby can be put straight onto your chest for skin to skin cuddles, getting all of the benefits of this as with any other type of birth.
You might like to look into the option of Vaginal Seeding
More coming up on the risks and benefits, research, recovery and ‘emergency’ c-sections on the blog soon!
If you are interested in taking the next step to a positive birth, Positively Birthing Hypnobirthing and Antenatal Classes run throughout Surrey and SW London- areas including Surbiton, Esher, Teddington, Cobham, Twickenham, St Margarets, Thames Ditton, Molesey, Richmond, Wimbledon, Kingston, Sunbury, Epsom, Ewell, and beyond. All bookings can be made here.