Nearly one in four babies in Britain is delivered by caesarean. So whether it's a last minute decision, or it's been planned for months making sure you're ready for a c-section is wise. Even if you plan to have a natural birth it’s worth knowing why you may need a caesarean and what it involves.
There are two types of caesareans: elective and emergency, or alternatively, planned and unplanned.
And while some will need to have a planned caesarean for medical reasons (such as a previous c-section), for many it’s not a case of thinking ahead – a caesarean will be an emergency measure.
But don’t panic – you can have a calm and straightforward birth just like a natural delivery.
Elective caesarean: How to prepare
‘Elective’ doesn’t mean you’re too posh to push! It simply means the caesarean is planned, normally because it’s safer for either mum or baby. This can happen, for example, if the placenta is across the cervix (you have placenta praevia) , or with multiple pregnancies.
It’s obviously easier to prepare for an elective caesarean. “You know when and how your baby is going to arrive, so you can plan for the extra support you will need,” says Mervi Jokinen of the Royal College of Midwives.
As with any operation, you may experience some discomfort afterwards, which may make sleeping more difficult, so it’s worth getting a good night’s sleep before you go into hospital. And good general health is likely to help boost your recovery.
Emergency caesarean: How to prepare
‘Emergency’ doesn’t mean giving birth in A&E. Complications that can lead to an emergency caesarean include your baby being in distress, labour failing to progress or the umbilical cord prolapsing.
Even if you have no intention of going under the knife, realising that it may become a necessary option can be helpful. Research shows that women who are most rigid in their attitudes to labour are those who feel most cheated if things don’t go as they had hoped. “The women most traumatised by emergency caesareans are those who feel they weren’t included in the decision-making process, or didn’t understand what was happening,” cautions Mervi. “So ask questions during your labour.”
The operation
Once a caesarean is agreed upon, you’ll have to sign a consent form and put on a pair of surgical stockings to reduce the risk of blood clots. You’ll have a drip put into the back of your hand and a catheter installed to drain your bladder (it has to be emptied as it’s very close to where the incision will be made).
Pain relief
You’ll need pain relief. This will be a spinal block or epidural, which you may already have in place if you’re in established labour.
In rare cases a general anaesthetic has to be given. If it is, your birth partner is unlikely to be able to come with you into theatre.
Be aware that there may be quite a crowd in there. Apart from the obstetrician performing the operation, there will be a theatre assistant, an anaesthetist plus assistant, and one or more midwives. There may also be a scrub nurse, up to two further nurses or midwives and a paediatrician.
The delivery
Inside the theatre you’ll be laid down with a big light above you. A screen will be set up so you can’t see your tummy. The obstetrician will then prepare to deliver your baby through an incision made into your abdomen. Most incisions are made below the bikini line as it leaves the most discreet scar and is generally safest for future pregnancies.
“If you’ve had an epidural or spinal block, you may be aware of the obstetrician tugging a bit, but you won’t feel any pain,” reassures Mervi. “In fact, once the operation begins, the baby is delivered normally in about five minutes from start to finish.”
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