Caesarean birth: planned and emergency, what to expect

A caesarean is major abdominal surgery, and it is also a very common way to have a baby. Here is what happens, step by step.

Why they’re done

The NHS says a caesarean may be planned or done in an emergency if it’s thought a vaginal birth is too risky. Planned caesareans are usually scheduled from the 39th week. Reasons include a breech baby, a low-lying placenta (placenta praevia), pre-eclampsia, certain infections, the baby not getting enough oxygen and nutrients, or labour not progressing or heavy bleeding. Some people ask for a caesarean without a medical reason. The NHS says staff will explain the benefits and risks, and you should be offered a chance to discuss anxieties about birth. If you still don’t want a vaginal birth, you should be offered a planned caesarean. If your doctor won’t perform it, they should refer you to one who will. For how urgent categories work, see planned c-sections and what happens if you go into spontaneous labour.

Before

The NHS says you’ll need to stop eating and drinking a few hours before, and will be told when. At a pre-op appointment the week before, you’ll have a blood test to check for anaemia. NHS 111 Wales also lists medicines before the operation (such as antibiotics and anti-sickness medicine) and consent.

In theatre

Anaesthetic: usually a spinal or epidural, which numbs the lower half of your body while you stay awake. General anaesthetic is used in some cases.
The operation: a cut of 10 to 20cm is made in your tummy and womb, and your baby is delivered through it and shown to you soon after. You’re given oxytocin to help your womb contract and reduce blood loss. The whole procedure usually takes around 40 to 50 minutes.
Your birth partner: with a spinal or epidural they can be with you. With a general anaesthetic they would not normally be present.

After

You’ll usually go to a recovery room straight after. Staff check on you every few hours, and offer painkillers, clot prevention, food and drink, and help with feeding. The catheter is usually removed around 12 to 18 hours after the operation. The NHS says recovery takes longer than after a vaginal birth, and most women go home 1 to 2 days after surgery if there are no complications, although NHS 111 Wales says the average stay is three to four days. You may need to avoid driving until your 6-week check. The scar fades over time. For wound care and getting back on your feet, see self-care tips for postpartum mothers.

Contact your midwife or GP straight away if you have severe pain, heavy vaginal bleeding, a wound that becomes more red, painful or swollen or has pus or foul-smelling discharge, a cough or shortness of breath, or swelling or pain in your lower leg. Use NHS 111 if you can’t reach them.

Skin-to-skin

Ask your team about skin-to-skin after a caesarean, and put it in your birth plan. Your unit will tell you what to expect.

Next time

The NHS says most women can safely have a vaginal birth next time, possibly with extra monitoring. See VBAC.

Questions people ask

Will I be awake?

Usually, yes. The NHS says a spinal or epidural is the usual option, and a general anaesthetic is used in some cases.

Can my partner come with me?

With a spinal or epidural, the NHS says your birth partner can be with you. With a general anaesthetic, not normally.

How long does the operation take?

Around 40 to 50 minutes, according to the NHS.

When can I drive again?

The NHS says you may need to avoid driving until your 6-week postnatal check. Check with your insurer and your GP.