A C-section is major abdominal surgery. A planned (elective) C-section is usually done 10 to 14 days before the due date. The ‘normal’ term of pregnancy is 37 to 40 weeks which is one of the reasons why many doctors advocate having the operation earlier than the due date which is closer to 40 weeks. Of course many couples are quite happy that the pregnancy will be over somewhat sooner.
What you can expect during the procedure
A C-section takes about 30 minutes. Closing up the wound takes far longer, and you may be in the theatre and recovery area for a full hour. The procedure depends a little on whether the operation is an emergency or elective, but usually includes the following steps.
An anaesthetist will check your health, allergies and other related matters, either just before the operation or earlier in the ward. Your pubic hair will be shaved as a cautionary measure against infection, and a catheter will be inserted. An intravenous infusion is inserted into a vein in your arm before the procedure begins, to give fluids and medication.
2. In the theatre
You’ll be wheeled into theatre, and your abdomen will be swabbed with a disinfectant; the catheter and ‘drip’ will be inserted at this stage. In a general anaesthetic C-section, the gynaecologist, who will be assisted by another doctor and nurses, will be poised to start surgery. A horizontal incision of about 10cm is made just above or at the pubic hair line, and all layers below are cut. The amniotic fluid and blood is suctioned off. Your baby is lifted out by hand or with forceps, and the placenta is removed after an injection to make the uterus contract strongly to detach the placenta and prevent postpartum bleeding. The inner lining of the womb is then scraped to ensure no pieces of placenta remain.
3. Closing up
The layers of the wound are then stitched and the last layer either has stitches which don’t need to be removed or stitches for removal a week later.
How anaesthesia works
Spinal anaesthesia is far safer for baby and for you. It also allows for a greater feeling of involvement with the birth as you’re awake. It also makes recovery quicker, as you don’t have the after-effects of general anaesthesia. The procedure isn’t painful, apart from an initial injection. The operation will only proceed once total numbing of the abdominal area, right up to just below the breasts, is assured.
Women commonly report that they don’t experience pain during the C-section, but do notice some tugging type sensations.