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Caesarean Birth Description

More and more babies are being born by caesarean section and despite what you usually hear, the main reason for more caesarean sections is that doctors and hospitals are using more unnecessary interventions in childbirth that interrupt the hormonal orchestra and ultimately lead to more caesarean sections.

Caesarean sections have very serious long-term effects on your reproductive health (including future pregnancies) and on your baby’s short- and long-term health. You should have enough information to be sure that it is the right choice for you. What happens during a caesarean depends on whether the operation was planned (elective) or unplanned (emergency).

If you are having a planned caesarean
In this case you will have a check-up before the operation where you can ask all the questions you have about the procedure. This check-up will be with either the surgeon who will be performing the operation or with the anaesthetist, or both. This is a good time to ask your doctors about whether they offer gentle or family-centred caesarean section care, to plan and document your wishes. Once you have been given information about how the operation will look, its risks and benefits and have the opportunity to ask any questions, you will sign an informed consent form agreeing to the operation.

If you are having an unplanned caesarean
The operating team will request all the necessary blood tests quickly after you make decision to have the operation. The time from the decision to the operation is usually around thirty minutes, sometimes longer depending on the hospital and the number of patients they have that day, or shorter if your case is very urgent. If you ate that day don’t worry, you will be monitored and the chances of complications is very low.

If you are having a planned caesarean
On the day of the operation
You will be told not to eat or drink from at least midnight the night before your operation. When you arrive at the hospital you will be given a hospital gown to put on and depending on the hospital you
might get started on IV fluids, antibiotics and anti-nausea medication before getting anaesthesia. Caesareans are usually done in regional anaesthesia, so you are awake to see your baby being born but don’t feel any pain – the only thing you feel is a blunt feeling of being touched in the area where the operation is being done. If you want to be put under general anaesthesia (fully asleep), speak to your anaesthesiologist. Once you are given anaesthesia, a catheter will be inserted to empty your bladder. Depending on the hospital, your partner and doula may be present.
During the procedure
You will lie down on the operating table and a cloth screen will be put in front of your head so you can’t see the operation being done if you are awake. You can ask for a clear screen if you want to see your baby being born, or ask for the screen to be lowered as the baby is born so you can see her as soon as she is born. The surgeons will make a 15 cm cut on your lower belly through all layers of skin, fat and muscle to your uterus. The cut is usually just above your bikini-line or just above your symphysis bone. The baby is born through the cut and you may feel some tugging or moving at this part of the operation.
Once baby is born the surgeon will lift her up so you can see her, and ideally you will be able to spend your first few minutes in skin to skin contact. The surgeon will then stitch your uterus with dissolvable stitches, using a different material to close the final layer on your skin. Your baby will be checked-over and a midwife or nurse should help you start breastfeeding in the operating theatre or immediately afterwards in recovery. In total, a caesarean section with no complications takes 40-50 minutes from start to end.

What happens afterwards?
After the operation you are moved to a recovery room where your vital signs are monitored closely by nurses and midwives. Usually you stay there for a few hours or so as your anaesthesia wears off. You will be offered pain medication for any discomfort and injections to reduce the risk of blood clots. You will also be given light liquids and pain medication for the post-operative period will be planned. The catheter will be removed a few hours after the operation. You should be able to have baby with you and to breastfeed after the operation.

The Golden Hour After Caesarean Birth
The golden hour can happen after a caesarean birth, and mum or dad can usually hold the baby skin to skin in the operating theatre. The hospital staff will give you a cloth to wrap around yourself and baby to keep you both warm. Babies who have skin to skin contact - even with another parent or loved one - cry less and more easily start breastfeeding than babies who are wrapped and left in their cots after caesarean birth. It can be normal to feel nauseous or groggy after a caesarean, if this is the case a midwife or nurse should help you with your first breastfeed and be with you while you hold your baby, just in case.

What makes a gentle caesarean different?
During a gentle caesarean, the operating theatre staff work to include as many physiological aspects of birth into your caesarean experience. This can mean different things for different situations and hospitals, but some of the main ideas are summarised in this illustration. In some hospitals, it is even possible for you to pull your baby onto your chest by yourself after it is born. This is done by giving you long sterile gloves and lowering the drape, with theatre staff helping you to lift the baby onto your chest.

Gentle Caesarean 2Gentle Caesarean 2