Cesarean Section: What to Expect

If you are giving birth by cesarean section, whether planned or not, the process will start in an operating room, where you will usually receive spinal or epidural anesthesia to make you completely numb below the level of your ribs. Your partner or support person may be asked to wait outside the operating room while the spinal or epidural is being set up, but in most instances he or she can return to the room to support you during the surgery. If an epidural catheter (tube) is already in place when the decision for surgery is made, the level of anesthesia will be increased so that you are completely numb.

In the rare instance when a cesarean section needs to be performed very quickly, you may be given general anesthesia (which makes you unconscious), because it is faster than making you numb with a spinal or epidural. General anesthesia is also used in the rare instances when an adequate level of anesthesia is not obtained with a spinal or epidural.

For most cesarean sections, your belly will be scrubbed and your pubic hair clipped, and often you will be given a dose of antibiotics during the procedure to reduce the risk of infection. In addition, a small tube (catheter) will be placed in your bladder to keep it empty during the procedure. A drape will be placed between your chest and the lower part of your body to create a sterile area for the operation. The drape also prevents you from seeing the surgery as it happens. Sometimes the drape is close to your neck, but you can turn your head to the side if it makes you feel claustrophobic. Your arms are likely to be taped down at your sides. You will have an IV inserted, and devices will be attached to your skin to monitor your vital signs. In most hospitals, if you do not have general anesthesia a support person or partner can be present during the surgery, staying at the head of the bed, next to your head, behind the

drape.

After the anesthesia has taken effect, the surgeon will usually make a horizontal incision in your skin, low down near the pubic bone—the “bikini cut.” (Vertical cuts are now reserved for special situations.) The surgeon will then cut through the uterine muscle and ease your baby out. The incision on the skin is not always in the same direction (horizontal or vertical) as the incision on the uterus. The type of incision that goes through the uterine muscle will determine whether you should consider a vaginal delivery if you give birth again. (For more information, see Vaginal Birth After Cesarean (VBAC) or Repeat Cesarean?)

I looked up at my husband. There he was, looking quite ridiculous in his blue scrubs and hairnet. He was standing slightly, just enough to see over the draped curtain. His eyes [were] intently staring. I can’t even be certain he blinked. When the doctor announced the birth of our daughter, there was no need for him to say it. I saw it on my husband’s face, the birth of his daughter. His eyes widened at first, almost as if someone had stomped on his toe, then he began to cry. The look on his face was amazement, pride, love. I saw the birth of our daughter that day, too … through the eyes of my husband. It was beautiful.

The surgeon will clamp and cut the umbilical cord and hand your baby to a nurse or other attendant who will suction your baby’s nose and mouth if needed and assess the baby’s breathing. Once the baby is breathing normally and has been bundled into a warm blanket, your partner can hold your baby and you can welcome your child even as the doctor removes the placenta, sews up the incision, and closes the skin with sutures or staples. Your provider can save the baby’s cord blood and the placenta if you like. The entire procedure usually takes about an hour.