Caesarean section (planned)

Read our guide below to help you understand what to expect from a planned caesarean section

You can also download a PDF version of this patient information by following the link on the right.

Why have a caesarean birth?

In general, we recommend a caesarean if labour presents a risk or problem to you or your baby. The benefits are always balanced against the risks and your obstetrician and midwife will discuss your own needs with you,

Preparing for your caesarean in the antenatal clinic

You should get:

• a date and approximate time for your caesarean
• a copy of this information
• the completed consent form to keep in your maternity notes
• a pre-op assessment.

Admission to the ward

When we admit you to the ward on the day of your caesarean, we’ll welcome you and your partner show you to your to your bed. When you have settled in, we’ll show you the other facilities.

The midwife will:

• record your temperature, pulse and blood pressure
• listen to, or monitor, your baby’s heart rate.

One of the doctors and an anaesthetist will meet you before your operation. They can answer any questions you may have.

Type of anaesthetic

We usually recommend a spinal anaesthetic for caesareans, but you may need an epidural or general anaesthetic.

Before coming into hospital

To help reduce the risk of a wound infection following your surgery, we recommend that you:

• do not shave your pubic area for a week before your caesarean
• shower on the morning of your caesarean
• bring a dressing gown to keep warm before your caesarean.

Before going to theatre your midwife will complete a checklist. When you arrive on the ward please remove any contact lenses, all jewellery and nail varnish.

Going to theatre

You’ll be taken to theatre either in a wheelchair or walking accompanied by your partner and midwife. If you’re having an epidural or spinal anaesthetic, we allow your birth partner into theatre.

We can only permit one birth partner to come into theatre with you. We’ll ask them to change into theatre clothes.

If you’re having a general anaesthetic your partner cannot come into the operating theatre but can wait outside.

If there’s an emergency on the labour ward, we may need to delay your planned caesarean by a few hours. We’ll keep you informed if this happens.

Photographs are not allowed during the caesarean, but you may take a photo of your baby soon after birth.

The anaesthetic

In theatre, you’ll meet several members of staff who’ll ensure the smooth running of the caesarean section and care of your baby. You’ll have an intravenous drip put into your arm which will remain for 12 to 24 hours.

The spinal or epidural injection will be given in theatre.

The anaesthetist will ensure the anaesthetic is working effectively before your operation. You’ll be able to feel touch but not pain.

A catheter (tube) will be placed into your bladder to keep it empty which we usually remove later that day.

The operation

We’ll place a screen across your chest so you cannot see anything and complete a surgical checklist before the operation starts. The caesarean will take about 45 minutes.

The surgeon will make an incision (cut) 15 to 22 cm long in the lower part of the abdomen in the bikini line area. This is where your baby is born.

As your baby is born, you’ll feel pushing on your tummy. At your request, we can lower the screen to let you see the birth.

After the birth

If the baby is well and there’s no excessive bleeding, we’ll offer delayed cord clamping. We’ll then dry and wrap the baby and give them to you. If you wish to have your baby skin-to-skin during this time, tell your midwife and anaesthetist know in advance so they can position the monitoring equipment away from where the baby will be against your skin.

If you’ve had a general anaesthetic

We’ll take your baby to your birth partner while we close your wound. We do this in layers by either a stitch with beads on either side, a dissolving stitch or metal staples.

You may have a tube in the wound area to allow drainage of excess fluid. We usually remove this after 24 hours.

Antibiotics and pain relief

We’ll give you an antibiotic into your drip during the operation to help prevent infection.
To help with pain relief, we give you a strong painkiller with your spinal or epidural anaesthetic.

You may also have a suppository placed into your bottom immediately after the operation. You’ll also have regular pain relief as needed after the birth.

After your caesarean

We’ll observe you for some time after your caesarean in the recovery area and offer you pain relief. Your baby and partner will usually be with you.

We’ll then transfer to the ward and monitor you closely during the first 24 hours. You’ll feel tired so rest is essential. You’ll normally be able to eat and drink following your caesarean.

Moving around

It’s important to move around as soon as possible and drink plenty of fluids to prevent blood
clots forming in the legs.

We may also give you heparin injections or compression stockings to prevent thrombosis (clots).

How long will I need to stay in hospital?

This depends on a number of factors but an average stay would be 1 to 2 days. One of the obstetric team doctors will see you before you leave to discuss any questions you may have, including recommended mode of birth in future pregnancies and contraception choices.

If this is your first caesarean, we recommend a vaginal birth for the majority of women giving birth next time.

Wound care

It’s important to keep the wound clean and dry. The dressing is usually removed after 5 days.

We remove your skin stitches on day 5 if they’re not dissolvable, either whilst still in hospital or by the community midwife if you’re at home.

As your wound heals you may notice numbness which is normal.

To help yourself you should:

• always wash your hands before and after touching your wound or dressing
• shower instead of having a bath
• not rub soap, shower gels, or talcum powder directly onto the healing wound
• pat the wound dry with a clean towel or a piece of clean kitchen roll kept just for this purpose
• wear loose-fitting underwear to prevent rubbing the wound.

Your baby

We encourage skin-to-skin contact for all mothers as soon as practically possible following birth. The midwife will weigh and check your baby before you transfer to the ward.

When you’re both ready to transfer to the ward after the operation, we’ll place your baby in your arms for the journey. The midwife will assist you in finding a comfortable position to hold your baby.

What if my baby is unwell?

Sometimes babies may be unwell or premature and need special attention or monitoring. If this is the case, the paediatrician will discuss this with you and your partner as soon as possible. We always try to ensure you can hold your baby before they’re taken to
the Neonatal Unit if necessary.

If the baby is premature or unwell this may not be possible. Initially, you can visit the baby in the Neonatal Unit very soon after your return to the ward.

Risks associated with caesarean section

Most caesarean births are straight forward. But with any surgical operation there’s an element of risk depending on the reason for your caesarean section.

In general, the risks include:

• excessive bleeding during the operation, which may require a further procedure and blood transfusion
• injury to the structures near to the womb (ureters, bladder or bowel)
• difficult surgery because of scar tissue from a previous caesarean section or surgery
• infection in the wound on your abdomen, the uterus (womb) or bladder
• clots in the legs or lungs after the operation.

There’s also a higher risk of complications in your next pregnancy.

Risks to your baby include:

• minor breathing difficulty at birth caused by lung fluid
• accidental laceration (cut).

Going home

Your community midwife may visit you intermittently up to around your 10th postnatal day. They’ll agree visiting days with you. If necessary, we can extend midwifery visiting.

You should:

• rest as much as you can at home as you may still feel quite tired
• do your postnatal exercises – see our postnatal guide
• avoid lifting heavy objects or sit-ups which might strain your abdominal muscles.
• check with your insurance company before driving to confirm that you’re insured
• avoid sexual intercourse until vaginal bleeding after birth has settled and your wound feels comfortable. This is likely to be 6 weeks.

Make an appointment with your GP for your postnatal check 6 to 8 weeks after the birth of your baby. This check will include:

• a general examination
• a possible cervical smear or a blood test to check your haemoglobin (iron) level
• advice on contraception.

Please discuss any other concerns you may still have. If there have been any complications, your GP or obstetrician may have arranged a hospital appointment for you.

If you need anything else

This page explains some of the most common side-effects that some women may experience. However, it isn’t comprehensive.

If you experience other side-effects, want to ask anything else related to your treatment or you need a translation or transcript of the PDF leaflet, please speak to your community midwife.

Reducing associated healthcare infections

Find out how you can help to reduce healthcare associated infections when visiting hospital