Caesarean Birth

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In the UK about 30 percent of pregnant women and people will experience a caesarean birth. This means the surgical birth of your baby through a cut in your stomach and womb.

Around 50 percent of these will be planned – we call this an elective caesarean birth. The reasons to plan a caesarean birth are varied and can include:

Choice of the birthing person
Previous caesarean births or surgery to your womb
Your baby being in a breech position – where the baby’s bottom comes first instead of the head
Your baby being in a transverse position where the baby lies across your womb
A multiple birth (more than one baby) if your first twin is not head down
If there are concerns about where your placenta (afterbirth) is situated
Concerns for the health of either you or your baby

Some are unplanned; this is sometimes known as an emergency caesarean birth. This might occur if labour is not progressing and all other options have been explored or if there are concerns for you or your baby’s wellbeing.

Although a caesarean birth may not be what you were hoping or planning for, it can be a positive birth experience.

What to expect

A caesarean birth happens in theatre and you will notice lots of equipment and a lot of staff. They will all introduce themselves to you and provide plenty of reassurance. Your midwife will stay with you and you can expect to see two doctors, an anaesthetist, a theatre nurse, a neonatologist, and theatre assistants. They are an expert team and will take great care of you, your partner and baby.

Casesarean birth caregivers

Doctors/Obstetricians

This is a doctor who specialises in care during pregnancy, labour and after birth. They will be the person that performs the Caesarean.

Anaesthetist

Anaesthetists are specialist doctors who provide anaesthesia to patients for operations and procedures. The anaesthetist will administer your spinal injection to stop you feeling pain before the Caesarean takes place.

Midwife

Midwives provide care to you and your family throughtout your pregancy, labour and during the period after a baby’s birth. The midwife looking after you will be present at your Caesarean birth to offer support and aftercare.

Neonatologist

A neonatologist specialises in premature babies or newborns with high-risk or complex halth conditions. a neonatologist will be present should your baby need and extra care after birth.

Theatre Nurse

A theatre nurse acts as an assistant fdor the doctor performing your caesarean and the rest of the medical team. They also provide an essential link between health care providers, doctors and patients.

Theatre Assistants

Theatre assistants assit the doctor performing your Caesarean. They ensure that all aspects of theatre run safely, smoothly and on time. They also keep theatre equipment in good working condition.

Download casesarean birth caregivers infographic as PDF

An intravenous drip in the back of your hand will keep you hydrated and give any medications needed. You will also have a catheter, which is a small tube, placed in your bladder. This keeps your bladder empty for surgery. Once surgery has begun, the birth of your baby is quite quick – about 10 minutes. In most instances, the baby is placed skin-to-skin with you or your partner while you wait for the operation to finish.

Anaesthetic

The anaesthetist will be with you for the duration of your birth, monitoring you and ensuring you are pain-free and comfortable. The aim is to use an epidural/spinal anaesthetic so you can stay awake to meet your baby and your partner can be with you.

A general anaesthetic may be needed for some emergencies if there are medical reasons why a regional anaesthetic isn’t suitable for you or if you prefer to be asleep.

Your choices for a caesarean birth

When planning a caesarean birth, we can discuss your birth wishes and preferences. It is worth discussing these during your pregnancy whilst completing your personalised care and support plan.

A Gentle Caesarean Birth

Consider ways to personalise your birth as you welcome your baby.This could include things like:

Your choice of music playing
Lowering the drapes so that you see the birth of your baby
Asking your partner to reveal the sex of your baby
Delayed cord clamping
Asking your partner to cut the cord
Skin-to-skin contact with you

Birth Partner role

In most circumstances, your birthing partner will be able to accompany you to theatre for the birth. They will need to change their clothes, wear theatre scrubsand will usually be given theatre shoes or shoe covers and a hat.

They will be sitting next to you so you can experience your baby’s birth together. The only time your birth partner would not be able to be there is if you need a general anaesthetic – where you are put to sleep for the surgery. In this situation, they would remain on the labour ward being supported by the staff.

Tips for a gentle caesarean birth

Consider ways to personalise your birth as you welcome your baby, this could include things like:

Asking your partner to cut the cord

Your choice of music playing in theatre

Asking your partner to reveal the sex of your baby

Lowering the drapes so that you can see the birth of your baby

If your planning on breastfeeding most babys can be fed in the operating room or shortly after in recovery.

Focus on your breathing and relaxation techniques before and throughout to stay calm

Skin to skin contact with you as soon as possible

Delayed cord clamping

Note the elements of a gentle caesarean birth that most appeal to you, then speak to your midwife and find out which of these options are possible in your hospital.

Download tips for a gentle caesarean birth infographic as PDF

Immediately after birth

Around 30-40 minutes after the birth of your baby, you will be moved to the ward to recover and for regular observations in the first few hours. Timings are different for everyone but you will be encouraged to begin moving around as soon as possible. When you are able to do so, your catheter will be removed.

You’ll be offered water first, followed by some food. When you’re able to drink fluids, your drip will be stopped. If it’s no longer needed for fluids or medications, it will be removed.

Early days

If your caesarean birth was straightforward, you can expect to go home between 24 and 48 hours later.

Before you leave you will be given advice on how to care for your wound and stitches, when you can remove the dressing and activities you should avoid whilst you recover.

You will be sent home with medication to control any pain or discomfort. It’s important to keep yourself as comfortable as possible so you can rest and recover, including wearing loose, comfortable clothing and underwear.

Any medication that you are given will be safe to use if you have chosen to breastfeed your baby. Your community midwife will visit regularly to ensure you are recovering well. You may need extra support whilst you recover, especially if you have other small children to care for.

You should only resume driving, carrying heavy items and formal exercise when you are fully recovered.This may take up to six weeks.

What does this mean for possible future pregnancies and births?

Having already had a caesarean, in any future pregnancies you’re at a slightly increased risk of your placenta attaching to the scar tissue from before. This risk increases with the more caesarean births you have.

75 percent of those who have had one caesarean will go on to have a vaginal birth in their next pregnancy. If you have given birth vaginally before your first caesarean, this increases to 90 percent.

Now that there’s a scar on your womb, there is a 0.5 percent chance this can separate or tear in a subsequent labour. This is less likely if you go into labour naturally than if you are induced.

Experiencing a caesarean birth, whether planned or unplanned may seem like a medical procedure where choice is limited.
However, the maternity team will work in partnership with you to make your birth experience as personalised as possible. Speak with your midwife about what is important to you.

Explanation point

Term	Description
Breech	hen your baby is bottom or feet first in your uterus
Transverse	If your baby is lying sideways across the Placenta
Placenta	A circular organ that attaches to the lining of your womb (uterus) and connects to your baby through the umbilical cord.
Theatre	A room in a hospital in which surgical operations are performed.
Intravenous drip	Having an intravenous (IV) infusion or ‘drip’ means you can have fluid or medicine straight into your veins rather than having to swallow it.
General anaesthetic	Medicines are used to send you to sleep, so you're unaware of the surgery.
Regional anaesthetic	Only the area of the body that would feel pain is numbed, allowing the patient to have the procedure while awake.
Theatre scrubs	Special clothing made of materials that are easy to clean with harsh chemicals, meaning they are sterilized and less likely to bring germs and infection into the theatre environment.
Induced	An induced labour is one that's started artificially. Contractions can be started by inserting a tablet (pessary) or gel into your vagina, or a hormone drip to speed up the labour process.