What happens during a caesarean birth?

By Kaz Cooke
From the latest edition
of Up the Duff

What happens during a caesarean birth?

During a standard caesarean, you may have the top half of your pubic hair trimmed or shaved, and then you’ll be put on a hospital trolley and wheeled off to the operating room. In this very brightly lit room all the medical staff will wear the usual shower caps, face masks and protective smocks, and so will your support person, who can usu­ally be with you.

An intravenous (IV) drip will be put into your arm, then you’ll be given an epidural injection or a spinal-block injection – or a combination of both – by the anaesthetist. (These are described in the book in the Medical Pain Relief section in Week 32.) This will totally numb the lower half of your body. As well as numbing all sensation in the abdomen, an epidural or a spinal block for a caesarean may also affect the nerves in the legs, making them feel very heavy or numb, and nerves in the bladder, so you’ll probably have a catheter inserted in your bladder because you won’t know when you’re weeing.

A screen will be put up between you and your tummy, but a mirror can be angled for you to watch the operation if you’re that way inclined. A nurse or doctor will swab the lower part of your stomach with antiseptic. Your obstetrician will make an incision just above your pubic hairline, usually horizontal and about 10 centimetres long. Then the obstetrician will cut through the layers of fat and muscle to the uterus wall, cut open the uterus and pull the baby out. You may have some sensation of pulling or pressure. There’s a slim chance with an epidural that you’ll still feel pain. If the incision hurts, or anything else hurts, say so loudly and quickly. Your surgical team will have extra anaesthetic ready to give you straight away.

It all happens very quickly: the baby is generally born 5 – 10 minutes after the first incision. The baby will be shown to you and then will be fully examined by a paediatrician standing by in the room. The baby might also have mucus sucked from its tiny airways.

You might be too preoccupied to notice or remember what happens next, but usually you’ll hear some gurgling, slurping noises when the amniotic fluid is suctioned out. The placenta and membranes, and the swabs, are removed, then you are stitched up. This can take quite a while because it’s not just one row of stitches – it’s seven different wounds to be sewn, including layers of skin, fat, muscle and the inner and outer walls of the uterus.

Again, you probably won’t notice this bit as you’ll be too busy MEETING YOUR BABY!

There’s more in-depth and helpful advice in the book Up the Duff: The Real Guide to Pregnancy.