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Elective Caesarean Section “What to Expect on the Day of Delivery” By Midwife Zoe

With one-third of women in Australia giving birth by caesarean section, I thought it only necessary to have a blog on “What to Expect on the day of Delivery” for the women who are booked in for an Elective Caesarean Section.

Some women may find the process of a caesarean section causes them to become very anxious and worried about the unknown. So let’s try and take away some of that fear.

We cover the caesarean section, both emergency and elective, in our antenatal classes in more depth than this blog. If you are having an elective caesarean section it may be a great idea to purchase the classes so that you can become fully prepared for the birth of your baby.

Caesarean delivery is a surgical procedure used to deliver your baby. This may be performed for various reasons (which I will not go into today).

On average, the caesarean section can usually be done in less than an hour. In most cases, your partner or friend can stay with you in the operating theatre for the procedure.

WHAT TO EXPECT

At Home – You might be asked to shower with antibacterial soap the night before, and the morning of, the caesarean section. This helps reduce the risk of infection. If you regularly shave your pubic hair, do not do it the day of the operation. The midwife who will prepare you for theatre will see if you need the area trimmed with an electric razor and will do it for you on the day.

At the Hospital – Before your caesarean section, a tube called an “indwelling catheter” will be placed into your bladder to collect your urine. This is because after your operation you will not be up out of bed for a while, so you will, therefore, be unable to empty your bladder yourself. The catheter will ensure your bladder remains empty and comfortable for the required bed rest time after your operation. You will also have an IV link inserted into a vein in your hand or arm to give access for IV fluids and medication. The midwife will also put some circulation stockings on you. These are called TEDS and will stay on your legs for your entire stay in hospital (minus showering times). This helps prevent clots from forming in your legs, which is a common risk factor after major surgery. Lastly, you (and your support person) will be given a gown to put on.

Anaesthesia – Most caesarean sections are done under a regional anaesthesia (spinal or epidural), which numbs only the lower part of your body allowing you to remain awake during the procedure. The most common choice is a spinal block, in which pain medication is injected directly into the sac surrounding your spinal cord. Another option might be epidural anaesthesia, in which pain medication is injected into your lower back outside the sac that surrounds your spinal cord. In an emergency, however, a general anaesthetic is sometimes needed. All your anaesthetic options will be discussed with you by an anaesthetist before your caesarean section.

Incision – The surgery involves a horizontal incision made across your bikini line in the lower abdomen to expose the uterus. Another incision is then made in the uterus to allow removal of the baby and the placenta. If you would like to know more about the incisions make sure you ask your Obstetrician.

Delivery – If you have epidural or spinal anaesthesia you will likely feel some movement as the doctor gently removes the baby from your uterus but you shouldn’t feel pain. The doctor will clamp and cut the umbilical cord, and the midwife will take the baby to the paediatrician, who will be in the theatre as part of the delivery team, for a quick check before bringing the baby straight to you for some skin-to-skin contact. The placenta will be removed from your uterus and the incisions will be closed with sutures that will dissolve, whilst you spend your first minutes cuddling with your new baby.

NB: Make sure you check with the hospital you are booked in with to have your baby about their policy of skin-to-skin contact with your baby at the caesarean birth. Every hospital is different, and although each hospital should be working towards allowing this opportunity, it is not always the case that skin-to-skin contact will happen in the operating theatre.

AFTER THE PROCEDURE

After a caesarean section, most mothers and babies stay in the hospital for about three to five days. The most important thing is to control pain as the anaesthesia wears off. This will usually be done with either oral medication or a patient-controlled medication through the IV line in your arm.

After your caesarean section, you will be monitored closely by the midwives. You will have very regular observations taken, including your blood pressure, pulse, temperature and respiration rate. You will be reviewed by a medical officer at any time the midwife feels this is necessary, and usually daily by your obstetrician while in the hospital.

Soon after your caesarean section, you’ll be encouraged to get up and walk. Most women will stay in bed for only 8-12 hours after a caesarean section, but then the midwife will get you up for a shower. Moving around can speed your recovery and help prevent constipation and potentially dangerous blood clots.

While you’re in the hospital, your health care team will monitor your incision for signs of infection. They’ll also monitor your movement, how much fluid you’re drinking, and bladder and bowel function.

Discomfort near the caesarean section incision can make breastfeeding somewhat awkward. With help, however, you’ll be able to start breastfeeding soon after the caesarean section. Your midwife or the hospital’s lactation consultant will teach you how to position yourself and support your baby so that you’re comfortable, and you should always ask for this assistance if it is not offered and you feel you need the support.

Remember that trying to breastfeed when you’re in pain might make the process more difficult. Your health care team will select medications for your post-surgical pain with breastfeeding in mind, and these will be safe for you and your baby.

If you have any questions leading up to your elective caesarean section, make sure you ask your midwife or obstetrician so that you feel well informed for this important step in your journey into motherhood.

Following on from this blog, in the near future I will create a blog about “Postnatal Care Following Caesarean Section”, so be sure you lookout for it.

Zoe

(This article contains general information only and is not intended to replace advice from a qualified health professional. All information is written from the experience and knowledge of the person writing the post).