Preparing for an elective c-section

It’s quite a strange experience knowing exactly when you’ll meet your baby. And like everything to do with motherhood, it can be a rollercoaster of emotions.

Whilst nothing ever fully prepares you for motherhood (however baby arrives!) being forewarned is forearmed and all that. So here’s some information on what to expect when having an elective c-section.

  • You will be nil by mouth for a period of time before the procedure and your healthcare team will advise you of this. It can be anywhere from 9pm – 2am the night before and you’ll be given anti-sickness drugs to take.
  • You’ll be asked to arrive first thing, but other people will be booked in the same day and you won’t find out the “running order” until you’re there. And it’s quite a fluid list because the theatre teams have to accommodate emergencies throughout the day, so be prepared for a potentially long wait. Make sure you take lots of things to entertain yourself and know that on odd occasions they don’t manage to get through everyone that day. 
  • You’ll walk yourself down to theatre in your gown which can feel like an odd/emotional experience for many. In normal circumstances your partner would typically be with you until this point and then given scrubs to change into whilst the team sort out your spinal or epidural (which will numb your lower half). However, Covid-19 has changed things and some partners are being asked to wait in the car park until mom is being prepped for theatre, so be prepared to wait on your own. 
  • There will be lots of people in the theatre and this is perfectly normal. They’ll explain to you who they are and what they’re doing.
  • You’ll have a catheter inserted, IV fluids to keep you hydrated and you’ll typically be tilted on your left hand side to reduce the risk of your blood pressure dropping.
  • A screen will be placed across you so you can’t see the operation being done. It only takes c. 5-10 mins to get baby out, but the whole procedure is more like 40-60 mins. Whilst you won’t / shouldn’t feel any pain, you may well feel movement – so pushing or tugging sensations. Some women have described it as feeling like someone’s doing the washing up inside their abdomen.
  • Your scar will typically be 10-20cm long and across your bikini line, but it can sometimes be vertical below your belly button.
  • Baby will be lifted up for you to see immediately, but typically dried, checked/weighed and wrapped up before being given to you. You can typically ask for a photo or get your partner to take one at this point, but you might well be wrapped up in the moment so mention it to the team beforehand. Similarly speak to the team looking after you if you want to film the birth. 
  • Either you or your partner can and will be encouraged to have skin to skin with baby.
  • Delayed cord clamping doesn’t always happen, so please say in advance if this is important to you.
  • You’ll be given an oxytocin injection to encourage your uterus to contract and to reduce blood loss. You’ll have dissolvable stitches in your uterus and the outside scar could have dissolvable ones or stitches and staples which might need to be removed a few days later. It differs according to the surgeon.
  • You’ll then be taken to recovery to have more skin to skin with baby, to potentially feed and to be monitored. You’ll be given pain relief, those completely unsexy compression stockings and blood thinning injections to minimise the risk of blood clots and you’ll be offered food and drink as you feel ready for it.
  • You will have a buzzer on the postnatal ward, so do use it for anything that you need. Particularly if your partner isn’t around. Don’t feel bad for pressing it!
  • It typically takes a few hours for the spinal to wear off. And your catheter will only be removed once you’re able to walk around.
  • Sitting up in bed is really hard. Use any available bed controls or ropes, think about log rolling (so rolling on your side rather than jack-knifing in half and using your arms to push you up). It can also help in any situation where you feel pulling around your skin to press gently against it.
  • Before you go home you’ll need to demonstrate that your pain is under control, that your bladder is functioning fine (so drink plenty and beware that they’ll typically want to measure how much urine you pass the first couple of times so don’t go without the bowl!) and that you feel fit and well to be discharged. Typically 24 hours min.
  • You will still bleed (lochia) after a c-section and it may take a few days for your bowels to start working again, particularly if you end up on iron tablets for blood loss. You might suffer from constipation & trapped wind. Stay hydrated (consider prune juice & peppermint tea too), eat sufficient fibre and get your feet higher than your knees when you do go for a poo. For info on other delightful things no-one told you about giving birth click here.
  • It’s normal for c-section babies to cough up mucous in the early days as it didn’t get pushed out of their lungs in the way it would in a vaginal delivery.
  • And sometimes breast-feeding can be a bit delayed, so get help and think about hand expressing beforehand.
  • Seek out as much help as you want/need whilst in hospital, don’t plan on driving yourself home and make sure that whoever’s taking you home has a car seat ready.

This post is long enough as it is, so click here for my thoughts on c-section recovery. And do comment / get in touch if there’s anything you’d add, particularly in light of births during Covid-19.

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