Elective Caesarean Section - Your questions answered

A caesarean section is a surgical operation to deliver the baby from the uterus (womb) through an incision in the lower part of the abdominal wall (tummy). "Elective" means that this is planned in advance for a specific date, and it is not being carried out in an emergency.

Common reasons for caesarean include abnormal position of the baby (e.g. breech), previous caesarean sections or difficulties with previous labours.

You will usually be given a date in clinic. It is important to note, however, that this date might occasionally need to be changed at short notice if there are unforeseen circumstances or emergencies. We understand that this can be very inconvenient and will only make such a change if absolutely necessary. Any such change in date should not affect the health of you or your baby.

You will be asked to go to either the antenatal clinic or ward 17 in the afternoon the day before your operation.

You will be met by a midwife and you will also meet a doctor and an anaesthetist. A general examination will be carried out and routine blood tests will be checked to make sure that you are fit for the operation. You will also be given Enoxaparin, a small injection which reduces the chance of developing blood clots.

Assuming all is well, you will be able to go home again that day with a time to come back the following day for the operation. You will be given tablets to take that evening, and again on the morning of the operation, to reduce stomach acid and reflux.

After you come in you will be asked to change into a hospital gown, and to remove any jewellery, body piercings and make-up. A plain wedding band can be kept on and tape will be applied to make this safe. You will be asked to wear a pair of special stockings to reduce the risk of blood clots.

A urinary catheter is inserted into your bladder; this empties your bladder and keeps it out of the way while the operation is in progress.  This may be done on the ward or in the operating room after your anaesthetic is working.

One person of your choice is invited to accompany you into the operating room. Most caesareans are carried out using a spinal anaesthetic; this involves an injection into your back that makes you numb from the waist down and you will therefore be awake for the birth of your baby. This method is usually better than a general anaesthetic (when you are asleep) for both mother and baby. Occasionally, however, a general anaesthetic may be required for medical reasons and, if that is the case, the person accompanying you would not be able to be present in theatre.

Once you are ready and the skin has been cleaned the caesarean section will be performed. An incision (usually horizontal) is made into the lower part of the uterus and the baby and placenta are delivered. The baby will be reviewed by paediatric staff and then given to you or your partner as soon as possible after delivery. The uterus and skin are then stitched closed with dissolving sutures. If all is well with you and your baby we would encourage you to have skin to skin contact with your baby whilst your sutures are being put in.

This operation is usually straightforward but, as with all operations, there are some risks. These include bleeding, infection, wound scarring, blood clots in the legs or lungs, and damage to the bladder, bowel or blood vessels.

You will be taken back to the ward to recuperate. Pain relief medication, which is specifically chosen to be safe for use in breast feeding, is offered.

The approximate length of stay in Ward 17 after caesarean section is 2-3 days: some people may wish to go home sooner, and others may need to stay longer. Visiting is limited strictly to two visitors at one time to allow you to recover from your operation.

You will need the Enoxaparin injections 9blood thinners) for at least 5 days after the operation and the community midwives will give you this if you are discharged before finishing the course. A longer course is sometimes needed and you would be encouraged to give this to yourself if at all possible.

If you have any questions or concerns during your stay please do not hesitate to ask staff. We are here to help.

Borders General Hospital

Switchboard: 01896 826000

Labour ward: 01896 826897

Ward 17: 01896 826017

Visiting times (Ward 17)

2:30pm - 4:30pm

6:30pm - 8:00pm