c-section guide

Your Obstetrician informed you that your baby will be delivered by Caesarean Section, also called a C-section. We can imagine that you have questions regarding this procedure. This leaflet relates to the planned C- Section and provides you with information about the preoperative preparations, the actual surgery, the different types of anesthesia and postoperative care.

A C- section is an operation in which your baby is delivered through an incision in your abdomen and the uterus. The procedure is preferably done with regional anesthesia (spinal block) and rarely with general anesthesia.

All jewelry, hair pins, and contact lenses must be removed before the surgery, as well as nail polish and make-up. A hospital gown will be given. The clothes you brought for the baby will be laid ready in the baby room and will be given to the baby. The baby’s heart rate will be monitored again before the surgery begins. Shortly before the operation you will be transported in your hospital bed to the theatre. Your partner may accompany you and remain with you during the operation to support you.

An IV will be placed in your arm so that fluids, medicines and, if required, blood can quickly be administered. The benefit of a spinal block is that you are fully awake and alert so you can actively participate in the birth of your baby. Moreover, your baby is not affected by the anesthetic drugs. The spinal block temporarily numbs your entire lower body, including your legs. To receive the spinal block, you will be asked to sit up on the operation table with your head and back bent forwards. The skin on your back will be disinfected and a local anesthetic will be injected to freeze the spot where the spinal needle will be inserted. The anesthetist will insert the spinal needle between two vertebrae and inject the anesthetic drug in the right spot to ensure that you will be pain-free during the operation. The needle is then removed. You will notice the effects immediately. In exceptional cases, regional anesthesia cannot be administered and the operation must be performed under general anesthesia. Your doctor will explain the procedure.

For your comfort, you will be given a urinary catheter. This is a thin silicon tube that is passed through the urethra into the bladder so the urine can drain directly into an attached bag.

The doctor starts the operation by making a horizontal incision in the skin right above the pubic bone, followed by cutting through the abdominal wall and the uterus. Once the uterus has been opened, a lot of amniotic fluid is evacuated. The doctor lifts the baby out. The umbilical cord is clamped and cut, and the placenta and membranes are removed. All of this takes about 10 minutes. Stitching up the uterus and all the layers that were cut during the surgery takes longer than the actual birth of your baby (about 30 minutes). Sometimes the doctor leaves a drain behind in the wound to remove any accumulation of fluid or blood under the incision.

Many babies born by C- Section have trouble breathing initially. Therefore oxygen may be administered. Next your baby will be examined. As soon as your child is in a stable condition, it will be placed in your arms to be cuddled. To prevent the baby’s body temperature from dropping, it will soon be placed in an incubator and taken to the ward. Once you are back on the ward and your baby’s condition is stable, the baby will stay with you in your room day and night. If you wish to breastfeed, you can start immediately.

Your blood pressure, heart rate, blood loss and urine production will be monitored regularly. The doctor will visit you every morning. You may have pain from the incision and/or uterine contractions. Pain medication is administered in different forms, such as injections, suppositories and/or tablets. The urinary catheter will be left in place for one day. While you are admitted, you will be given an injection in your leg to prevent thrombosis. The incision is generally repaired on the inside using dissolvable stitches. Bowel function will gradually return one day after surgery. Your abdomen may feel bloated and you may experience some cramping. Usually you will be allowed to go home 3 days after surgery.

Before you leave the hospital, an appointment for a postnatal checkup will be made. A common complaint of women who have had a C-section is tiredness. This can last quite a while, sometimes even months. This is normal! After all, you just had a major operation, so be patient with the tiredness and accept the help of family and friends!