Caesareans can be ‘elective’ (planned) or done as an emergency.
If you choose to have a caesarean or it is recommended upfront it is called an ‘‘elective’ caesarean.
If complications happen and your baby is in distress during labour, we may perform an emergency caesarean section.
There are different forms of anaesthesia available for a caesarean section. For the operation, you can either to go to sleep, known as general anaesthetic, or stay awake, known as spinal or epidural anaesthetic.
Elective (planned) caesarean
For some pregnant women and people, we may recommend birth by elective caesarean. This could be due to a pre-existing medical problem, your previous pregnancy history or because an obstetric complication develops during your pregnancy.
We will discuss the reasons for recommending an elective caesarean with you. We will also go through the benefits and risks of the procedure.
If you would like to request a Caesarean for non-medical reasons, please tell us early in pregnancy.
If you have had a caesarean before, we will discuss your options for vaginal birth after caesarean (VBAC) or an elective caesarean.
What to expect
Elective caesareans are usually done at 39 weeks of pregnancy. If your elective caesarean is done earlier than this, you may need to have steroid injections to prepare your baby for an earlier birth.
We will give you a pre-operative appointment to check your health and go through your anaesthetic options and surgery risks. This is also an opportunity to ask more questions.
On the day of your surgery, you will usually be expected to arrive in the morning. There are regularly two or three elective caesareans each day at all our maternity units. You may have to wait a while if there are emergencies on the labour ward.
When we are ready, we will take you into theatre to meet the team and to have your anaesthetic.
You can have one birth partner with you during the operation. You can also bring in your own music to listen to during the procedure.
We will make sure that your elective caesarean is as individualised and special as possible. Please let us know if you have any extra requests.
After your baby is born you can have skin to skin, if this is something you would like to do.
Emergency caesarean section
Around 15% of pregnant women and people will need an emergency caesarean section. All our maternity units have specialist theatres for this purpose.
When you would need an emergency caesarean section
Emergency caesareans can be:
Category 1: immediate threat to the life of the birth person or baby
In this case surgery would be performed within 30 minutes of the decision being made.
The most common reason for a category 1 emergency C-section is a concern about the wellbeing of your baby e.g., baby is showing signs of distress or is not coping, and birth is not imminent. Other, rarer, reasons are heavy bleeding or if you suddenly become very unwell.
Category 2: the birth person or baby are showing signs of compromise which aren’t immediately life threatening
In this case surgery would be performed within 75 minutes of the decision being made.
The most common reason for a category 2 C-section would be that labour has slowed or stopped, and interventions to encourage progress have been unsuccessful. A very long labour may not be safe for you or your baby; your baby may be becoming distressed and there is an increased chance you may bleed more heavily after birth.
What to expect
The obstetrician should discuss the decision about needing an emergency caesarean section with you. You should understand the reason it is being recommended, be told what will happen, and given information about the risks and side effects of the operation.
We will ask you to consent to the operation; this will usually be a written signature on a consent form. In extreme emergencies we will ask you to verbally consent and sign the consent form afterwards.
Your midwife will stay with you. If you have not had a general anaesthetic, they will explain the different things that are happening during the operation.
One birth partner can come into theatre with you after you have had your anaesthetic. Please note that if you need to have a general anaesthetic your birth partner cannot come into theatre, and they will have to wait for you in recovery. Once surgery has started, your baby is usually born within 15 minutes.
A neonatal doctor will be there when your baby is born to check them and provide immediate care if it’s needed. If your baby is well, we will return them to you as soon as possible. We encourage skin to skin for you and your partner in theatre if this is possible and part of your birth plan.
Recovery after caesarean section
After your surgery, a nurse in the recovery area will care for you. You will stay in recovery for about 2 hours. Your birth partner can stay with you, but we do not allow other visitors to this area.
The obstetrician will also talk to you about the operation and answer any questions you may have.
When the recovery nurse thinks you are ready, you will be moved to the postnatal ward.
Most people will have a straightforward recovery following their C-section and can go home within 48 hours. We will encourage you to get up and move around as early as you possible after your anaesthetic has worn off. This is to support your recovery.
If you have had an emergency caesarean, you will usually stay on the ward for at least 2 days.
If you had planned a vaginal birth and feel upset or disappointed after your caesarean section, it’s important to talk about how you feel. Talk to us to find out more about what happened and why.
Before you go home, we will talk to you about the effect of your surgery on your future pregnancies.
Recovering at home
Recovery after a caesarean section takes longer than after a vaginal birth. You may need extra help in the first few days and weeks with your own and your baby’s care.
If you have any concerns during your recovery, please speak to your midwife or GP.