Caesarean section - How a caesarean section is performed

Your caesarean section will usually be performed under a regional anaesthetic (epidural or spinal anaesthetic). This numbs the lower part of your body, but means you will be awake during your operation.

This is safer for you and your baby compared to a general anaesthetic, where you are put to sleep. A small amount of caesarean sections are performed under general anaesthetic, usually if a regional anaesthetic is not possible.

Read more about anaesthesia and an epidural.

Before the procedure

Before the procedure, you should have:

a blood test – to check for anaemia and to keep a sample of your blood, in case it's needed
antibiotics – to reduce your risk of developing an infection after the operation
if required, medication to help prevent low blood pressure during the operation – either ephedrine or phenylephrine
antacids – medication to reduce acidity in your stomach
anti-emetics – medication to prevent nausea and vomiting

Antacids and anti-emetics are used in case you need a general anaesthetic, because there may be a risk of food or drink entering the airway (aspiration). Read more about the risks of a caesarean section.

You will also need to have a catheter (tube) inserted into your bladder to empty it. This is because, with a regional anaesthetic, you will not be able to tell if your bladder is full and needs emptying.

The procedure

A caesarean section usually takes 40-50 minutes.

A screen will usually be placed across your tummy (abdomen) during the procedure, so you don't have to watch the operation being done. However, you can choose to have the screen lowered to see your baby being born. You won't see yourself, just the baby being lifted up.

During the procedure, the operating table will be tilted sideways to an angle of at least 15 degrees. This moves your womb and baby to one side, so it takes the pressure off your womb and large blood vessels in your back, reducing your chance of getting low blood pressure and feeling sick during the operation. The bed is usually levelled once your baby has been delivered.

A horizontal cut will be made to your lower abdomen, at the top of your pubic bone – this is often described as your bikini line. This allows another horizontal incision to be made in the wall of your womb, so your baby can be delivered. The low incision will cause you less pain afterwards and looks better than a vertical scar.

Once your baby has been delivered through the incision made in your womb, you should be given an injection of the hormone oxytocin. This encourages your womb to contract and reduces blood loss. The placenta soon separates and is also removed. The wall of your womb and abdomen will be closed with stitches that will safely dissolve.

The cut in your skin will be closed by either:

stitches that will safely dissolve at a later stage
stitches that will be removed at a later date – usually after five days
staples that will be removed at a later date – usually after five days

In some cases, it may be possible to use skin glue to close the wound, although this is rare. You may want to ask your hospital team which method they plan to use.

Your healthcare team will encourage you to have skin-to-skin contact with your baby as soon as possible.

After the procedure

You will usually be moved from the operating room to a recovery room. Once you have recovered from the anaesthetic, the medical staff will make sure you are well, and then continue to observe you every few hours. They will perform some tests, such as checking:

your heart rate
your blood pressure
whether you have any drowsiness or pain

You will be offered a combination of painkillers – usually paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and stronger painkillers, such as morphine.

If you are recovering well, you should be able to eat or drink normally.

You may want to begin breastfeeding your baby, and the medical staff can offer support to help you begin.

Read more about the first few days of breastfeeding.

Anaesthetic: Anaesthetic is a drug used to either numb a part of the body (local) or to put a patient to sleep (general) during surgery.
Epidural: An epidural is an anaesthetic injection given into the epidural space that surrounds the spinal cord, especially during labour, to numb the lower half of the body.
Local anaesthetic: A local anaesthetic is a drug that is injected by needle or applied as a cream. It causes a loss of feeling in a specific area of the body.
Spine: The spine supports the skeleton and surrounds and protects the delicate spinal cord and nerves. It is made up of 33 bones called the vertebrae.