- A period of fasting from all food and fluids. Your obstetrician and/or Anaesthetist will advise you as to how long this will be in your case
- Removal of make-up, nail polish and jewellery (wedding bands may be taped)
- Clipping of your pubic hair near the site of the operation
- Showering/bathing and changing into a hospital gown
- Insertion of an IV infusion
- Insertion of the epidural or spinal
- Pre-operative medication such as an antacid
- Insertion of a urinary catheter
- Special stockings and/or medication to prevent blood clots in the legs
- Antibiotics to prevent infection
Labour and Birth
Elective/planned caesarean birth
About elective caesarean birth
Caesarean birth is a major surgical operation in which the baby or babies are delivered through a surgical cut in the mother’s abdomen and uterus. It is usually performed under epidural, but spinal or general anaesthetics are also used. About 1 in 3 births in Australia are caesarean births, with around half of these being elective or planned caesareans. Elective or planned caesarean birth is scheduled ahead of time and usually occurs without the mother first experiencing labour. Planned caesarean birth may also be called repeat elective caesarean birth when, for example, the last birth was a caesarean and the current pregnancy results also in a planned caesarean birth. Of Australian women who had a previous caesarean section, in 2008, 83.2% had a further caesarean for the birth of their next child.
What are the reasons for choosing a planned caesarean birth?
There are many reasons why women choose a planned caesarean birth. Sometimes a vaginal birth is not possible or the risks of attempting vaginal birth outweigh the risks of planned caesarean birth. The timing of planned caesarean birth is another consideration. It is a complex decision that will depend on many different considerations such as your age, your past and present medical and obstetric history, your preferences and how many children you wish to have in the future. Some of the obstetric and medical reasons for choosing a planned caesarean birth include:
- Low lying placenta (e.g. placenta praevia)
- Failed ECV for a breech baby, footling breech
- Multiple pregnancy
- Transverse or oblique lie of the baby
- Previous uterine surgery
- Certain maternal medical or obstetric conditions or illnesses
- Certain fetal conditions or illnesses
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What are the benefits and risks of planned caesarean birth?
When considering your birth options, the benefits and risks of planned caesarean birth should be first discussed with your obstetrician. As for all surgical procedures, written consent is required in addition to the verbal informed consent discussion. In general, caesarean births are safe for both mother and baby, however, all surgery carries some risk, such as, haemorrhage, thromboembolism (blood clots), infection, the risk of damage to other organs during the surgery and risks associated with anaesthetics. Caesarean birth also carries additional specific risks for both mother and baby and these should be discussed with your obstetrician.
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What can you expect from a caesarean birth?
Your obstetrician and booking hospital will provide you detailed information on what your planned caesarean birth will involve, but in general, these are some things you can expect in hospital:
- You will be admitted to your hospital as per your hospital’s guidelines and admission procedures at the allocated time. Please bring your Antenatal Card or Summary and any other paperwork required.
- Your Anaesthetist will usually visit you to discuss your anaesthesia for the procedure with you and gain your written consent
- Preparations for the caesarean birth may vary according to individual hospital protocols, by generally may include the following:
- Your birth partner will usually be present with you if you have an epidural or spinal and will be seated at the head of the operating room table. They too will wear appropriate operating room attire like the members of the Operating Team
- A midwife or registered nurse will be present as well as members of the Neonatal Team to receive the baby/babies
- The initial cut or incision is usually made across your abdomen just above the bikini line and you might be aware of some tugging and pushing sensations and hear some suctioning noises prior to the birth of the baby/babies
- The baby is born in a few minutes and your obstetrician may lift him/her up so you can see them
- The baby is usually taken to a resuscitation area where they are warmed and dried and examined by the Neonatal Team, after which they are wrapped and handed back to you and your partner
- The obstetrician will then deliver the placenta and membranes and they are examined for completeness
- Cord blood samples are drawn as usual
- Your obstetrician will complete the operation by suturing (stitching) your wound in layers. You may have dissolving sutures, non-dissolving sutures or staples, depending on your obstetrician’s preference
- After the caesarean birth you will usually go to a recovery area where you may breast feed your baby and then be transferred back to your room
You can find more information about planned caesarean birth in the Resources. Recovery from caesarean birth is covered in the next Section on Postnatal and Parenting.