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caesarean section

Procedure where a baby is delivered by cutting through the front wall of the abdomen to open the womb. Find out more about this procedure at NHS Direct

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Planned (Elective) Caesarean section

This page gives you more information about elective caesarean sections.

A caesarean section is ‘elective’ if it is planned in advance.

                                    Maternity theatre caesarean

Elective caesarean section Show [+]Hide [-]

There are situations where the safest option for you or your baby is to have a planned caesarean section. As this involves major surgery, it will only be recommended to you for clinical need. Your baby is delivered by cutting through your abdomen and then into your uterus. The cut is made across your abdomen, just below your bikini line. The scar is usually hidden in your pubic hair.

If you are expecting twins, triplets or more, it is more likely that you will be advised to have a caesarean section. This will depend on how pregnancy progresses, the position of your babies and whether they share a placenta.

Whenever a caesarean is suggested, your doctor will explain why it is advised and any possible side effects.

They will ask for your written consent for the procedure; please do not hesitate to ask questions. An elective caesarean section takes place after 39 weeks unless an earlier delivery is clinically indicated.

Elective caesarean section for maternal request

If your pregnancy is progressing well and there are no medical concerns, you may still wish to request or discuss having an elective caesarean section. As the risks of caesarean section are greater than those for a successful vaginal birth, decisions on whether a caesarean section can be offered are made after a full discussion of the risks and benefits in each case.

The pre-admission clinic

Designed to avoid admission the night before your operation, the clinic staff will complete a health check list, review your consent to make sure you are able to ask any questions you might have and also to take blood tests where neccessary. You will be given an appointment to attend when the date for your caesarean section is booked. If you are less than 39 weeks you may be offered two steroid injections 24 hours apart to help in maturing the baby's lungs.

You will be given antacid tablets called Ranitidine. One tablet is taken at 10.00pm the night before your operation and the second tablet is taken at 7.00am on the morning of your operation. You will be advised not to eat for six hours before the start of the operation. You can continue to drink clear fluids, not fizzy, up until the time of the operation.

What to expect on the dayShow [+]Hide [-]

On the day of your surgery please come to maternity reception at the time you have been given. You will be taken to the Enhanced Recovery room which is on delivery suite. Bring your maternity notes notes with you. Please have a shower and remove all make-up and jewellery.

On admission you will be shown to your bedside and a check made on you and your baby. The obstetrician who will perform the operation and the anaesthetist will visit you. There will be lots of opportunity to ask questions. You will have been told that your operation is planned for the morning or the afternoon. this time is provisional and may sometimes need to be changed due to the clinical needs of others.  Your midwife will keep you informed.

You are able to drink clear fluids up until the time of the operation

The birth of your baby

The midwife will take you to the operating theatre and your birthing partner will be taken to the changing room and asked to change into theatre clothes. Your birthing partner will then to be invited into theatre to support you.  

The correct position for you on the operating bed varies, but it is usual to tilt the bed so your left side is downwards.This keeps the weight of your baby off the middle of your back, until the baby is born. You will be offered a dose of antibiotics through a drip which is usually given before the operation starts.

The baby is born near the beginning of the operation and you will be in theatre for around 50 minutes

Spinal anaesthetic

Most (96 in every 100) caesarean sections are carried out using a spinal anaesthetic as this is usually the safest option for you and your baby. You will be awake and aware of what is happening. You and your partner can see and hold your baby immediately after the birth.

After a spinal anaesthetic, one in every 100 women have a headache but in only about half of these women it is due to the spinal anaesthetic. Your midwife will be able to help you with this and if it persists will arrange a review with one of the anaesthetists.

General anaesthetic

Very rarely, the shape of your spine would make a spinal anaesthetic difficult or occasionally a spinal may not provide enough pain relief. In this case, a general anaesthetic is used.

Side effects of a caesarean section

A small number of women will have problems during or after a caesarean section. The most common problems are:

  • one in every 100 women will have bleeding from the womb and need to return to theatre to stop this. A small number will need a blood transfusion.
  • one in every 100 women will have a wound infection. For this reason all women are offered antibiotics at the time to reduce this risk.
  • one in every 100 babies sustain a small cut as the operation is being carried out. Every effort is made to avoid this and it is rarely serious. 
  • Having a caesarean section increases the chances of developing blood clot in the legs or chest. To minimise the risk you will  be given a course of injections of heparin (a drug to thin your blood) after the operation.

After the birth of your baby or babiesShow [+]Hide [-]

Often you will be moved to the Enhanced Recovery area of the delivery suite for a few hours before transfer to the postnatal ward. In Enhanced Recovery your birthing partner is welcome to stay and you can have other visitors from 14:00 until 15:30 and then again from 18:00 until 19:30 if you wish. You have a call button to use if you or your baby needs attention and your midwife will support you to feed your baby.

We would encourage you to get up as soon as the feeling in your legs is back to normal. The midwife will help you to the shower when you feel ready. The catheter will be removed once you are up and about. One or two days is the average length of stay but you may stay longer or leave earlier. Often after surgery you will be given a course of heparin injections for up to six weeks. This is to help prevent blood clots forming in your legs. You will be able to give these injections yourself and we will show you how to do this. If you feel unable to do this we can teach your partner or a member of your family.

The stitch in your abdomen is usually a continuous thread with beads at each ends. That is removed six to 10 days after the operation. Your community midwife will do this for you.

You will also receive a booklet with advice on postnatal exercises but if you would like any further information, please ask to speak to one of our physiotherapists.

More informationShow [+]Hide [-]

You can get more information about caesarean sections from:

  • Maternity Assessment Unit
  • tel: 0191 282 5746
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