Giving birth: Cesarean birth

In a Cesarean birth, your baby is born through an incision (surgical cut) in your abdomen. The surgery takes about an hour. Your baby is born five to 10 minutes after the surgery begins. The rest of the time is needed to remove the placenta and repair the incisions. A Cesarean birth can happen with any pregnancy.

Planned Cesarean birth

You may have a planned Cesarean birth. This means that you and your health care provider know before your labor begins that this is the way your baby will be born. A Cesarean birth might be planned if:

• you've previously had a Cesarean
• you've had complications in a previous birth
• your baby is breech (your baby's buttocks and/or feet are closest to the cervix)
• you have placenta previa (the placenta is covering some or all of the cervix).

If you know you will be having a Cesarean, talk with your health care provider about the reason. Ask all of your questions and raise all of the concerns you have. Consider asking your husband, partner, family member, or a friend to come to that visit.

Unplanned Cesarean birth

You may have an unplanned, emergency Cesarean. This might happen because of your baby's position, size or health, or because of your own health. A decision for an unplanned Cesarean birth can occur over several hours or happen quickly.

If it happens quickly, you may not feel that you've had enough time to ask questions or adjust to this new idea. In an emergency, you may be prepped for surgery quickly and be unconscious during the birth. It is important to talk with your health care provider after the surgery so that your questions can be answered and your feelings addressed.

What to expect during your Cesarean birth

• You will need to sign a surgery consent form.
• Your nurse and other staff will prepare you for surgery.
• Your heart rate will be monitored.
• Your vital signs will be checked.
• An IV will be started if you don’t already have one.
• Blood will be drawn to check for anemia and to type your blood. Blood typing is done in case you need a transfusion.
• Your pubic hair will be clipped.
• A small tube, called a catheter, will be placed in your bladder to drain urine.
• You may be given an antacid to drink.
• An anesthesia department staff member will discuss the best anesthesia choice for you and your baby. The type of anesthesia depends on the reason for the Cesarean birth.
• With general anesthesia, you will be unconscious during the surgery and birth of your baby. With a spinal or epidural, you will be awake but numb from your breasts to your feet. You may be unable to move your legs. (See Anesthesia Medicine for Cesarean Birth for more information.)
• You will be moved to an operating room.
• You will be placed on a narrow bed with a safety strap placed across your legs.
• A blood pressure cuff will be put on one arm.
• A clip will be placed on your finger to monitor the amount of oxygen in your blood.
• Patches will be placed on your chest to monitor your breathing and heart rate.
• You will breathe oxygen through a mask.
• Sterile drapes will be placed on your abdomen and legs.
• The anesthesia staff and your health care provider will make sure that you are numb or unconscious before starting surgery.
• Your husband, partner, family member or labor companion is welcome at the birth. He or she will change into scrub clothes and must not touch any of the surgical drapes, gowns or any of the instruments. This is to protect you and your baby from infection.

  Your labor companion can sit on a stool behind your head. There will be a cloth screen across your abdomen to help keep the surgery area sterile. Although some operating rooms have mirrors, neither you nor your labor companion will see the actual surgery.

• The incision on your skin will probably be a lowtransverse, or bikini, incision. It is horizontal and across the upper edge of your pubic hairline.
• The incision on your uterus will probably also be low-transverse. If not, it will be a vertical, or midline, incision. Your health care provider will tell you which type of incision was made on your uterus. This is important to know for future pregnancies.
• When your baby is lifted out and the umbilical cord cut, you may feel pressure at the top of your uterus. Your health care provider may lift your baby over the cloth screen so that you can see, or may place your baby directly in a heated warmer. A nurse will examine your baby.
• Your baby's Apgar score will be assessed.
• If your baby is premature or has special needs, she may go to a special nursery.
• If your baby is in a special care nursery or a newborn intensive care unit, you may be taken there to see your baby before you are settled into your room.
• If your baby has to be moved to another hospital for special care, you may be able to see and touch your baby before she is transported. This depends on whether you are awake and well enough before she leaves.

  You will be kept informed of your baby's progress. (Talk with your doctor to see if you will be discharged from the hospital early to go to the other hospital to see your baby.)

• Identification bracelets will be placed on your baby's ankle and/or wrist, your wrist, and your labor companion's wrist.
• You and your labor companion will probably be able to touch and hold your baby and take pictures. It will be hard for you to hold your baby while you are on the operating table.
• Your baby will be taken to a nursery or your birthing room. Your partner can go with your baby.
• After your incisions are closed, you will be taken to a recovery area. Later, you will go to your room.