What to expect in your elective C-section
Short on time? Then the key things to know are:
- Elective C sections can be for a range of reasons including placenta praevia, twin births, a breech baby or personal choice
- A caesarian birth typically takes one hour from start to finish - it may take longer if it isn’t your first C section
- The sensation in your lower limbs will return later in the day or the next morning - this is when your catheter will be removed
- You will be prescribed regular pain relief after your caesarean section and will be able to eat and drink normally immediately
- You may be prescribed blood-thinning injections in your postnatal period for ten days to help reduce the risk of deep vein thrombosis and clots in your lungs
What to expect in your caesarean birth
Caesarean births, or caesarean sections, are a surgical procedure that delivers your baby through an incision in your abdomen.
This procedure may be elective or planned; meaning that this type of birth has been planned by you and your obstetrician at some point in your pregnancy. This can be for a wide range of reasons including having had a previous caesarean birth, having a low lying placenta or placenta praevia, a twin pregnancy, a breech baby, or through personal choice.
The procedure may also be necessary due to an ‘emergency’ in the pregnancy or labour. This can include an abnormal heart rate pattern of your baby, your labour not progressing in the right direction, or abnormal bleeding.
Why would some women elect to have a caesarean birth?
Today there are an increasing number of women who are choosing to elect for a cesarean section birth, with no medical or obstetric indication.
This decision is always personal but may be because you are concerned about complications that surround having a vaginal birth, such as perineal tearing, the need for an instrumental delivery, fear of childbirth, or long term complications such as pelvic floor prolapse.
If this is you, it is important that you reach your decision after reading an information leaflet on caesarean births, to ensure you are aware of the surgical risks of having a caesarean birth, the recovery process, and impact on future pregnancies.
The Royal College of Obstetricians and Gynaecologists (RCOG) have published a concise and informative leaflet to help assist you with this decision.
How long does a caesarean birth take?
A caesarean birth usually takes under one hour, from the start of the surgical procedure to the very end when the dressing is applied to your abdominal wound.
In some cases, a caesarean birth may take longer - especially if this isn’t your first caesarean birth - due to the presence of tissue scarring that can be found from your previous surgery, or if there is predicted difficulty such as a placenta praevia. In addition, it will depend on who is performing the procedure and their surgical experience for how long the procedure can take.
What will also take time is the anaesthesia or pain relief that is administered to you, through either a spinal or combined epidural-spinal anaesthesia.
A spinal anaesthesia is where a single injection of local anaesthetic is inserted into the lower spine, numbing the body from the waist down. A combined spinal-epidural (CSE) anaesthesia is slightly different and involves a larger needle and the insertion of a small catheter or plastic tube. This allows for additional doses of pain relief, lasting longer than a spinal anaesthesia. The CSE may be indicated if your caesarean section is predicted to be complicated and potentially a longer operating time. With both anaesthetics you will remain awake during the birth, allowing you to hold your baby straight away.
In addition, some preparation will also need to be carried out such as the insertion of an indwelling catheter or small plastic balloon into your bladder before commencing which ensures your bladder remains empty throughout the procedure, placing pneumatic stockings on your legs to help massage and reduce the risk of clots, and general setting up of the surgical theatre.
This means that both you and your birth partner are usually in the operating theatre for more than an hour.
What is the recovery like?
If it is your first caesarean birth, you usually recover quickly given it is the first surgical procedure performed on your abdomen. Either later in the day when the sensation feeling in your lower limbs has returned or the following morning, you will be able to mobilise from your bed to the bathroom. In addition, your catheter will be removed and your bladder will be checked for its function.
You will be prescribed regular pain relief after your caesarean section, and it is important that you take this to help minimise the pain. This will ensure that you feel able to mobilise which is really important for your recovery.
If your caesarean birth was done as an ‘emergency’ this can sometimes mean you experience more pain in your recovery. However, overall your recovery tends to be similar.
The bleeding that occurs after the delivery of a baby (termed lochia) tends to be less following a caesarean birth, and will usually resolve by week two.
You can eat and drink normally following your caesarean birth, unless you were told otherwise. You generally will pass flatus (or wind) in the first 24 hours and open your bowels in the first 48 hours. Sometimes you may feel constipated after your caesarean birth and this can be a combination of both limited movement and the pain relief medication causing this.
You may be prescribed blood-thinning injections in your postnatal period for ten days to help reduce the risk of deep vein thrombosis and clots in your lungs. It is important you follow these instructions, as well as compression stockings, to help reduce this risk.
Caesarean section births can be as special as vaginal births. If you plan to have a caesarean birth or end up with an emergency caesarean birth, you will be well supported throughout the delivery and your recovery.
Looking for support with your elective C section? Book an appointment with one of our private midwives at a time that suits you to get specialist advice with any concerns.
Miss Jess McMicking, Naytal Lead Medical Advisor
Miss Jess McMicking is a consultant obstetrician and gynaecologist with a wealth of experience in both the NHS and private practice.