Caesarean Section
Caesarean Delivery
Birth by Caesarean section is common, safe and often life-saving. It is a valid mode of delivery and, while not without risks, it has played a critical role in improving outcomes for both mothers and babies worldwide.
Every baby can be born by Caesarean section; the same cannot always be said of vaginal birth. This operation has saved countless lives and remains one of the most important advances in modern obstetrics.
Whether a Caesarean section is appropriate in your individual case, however, is a separate question.
In this practice, requests for an elective Caesarean are discussed carefully and decisions are usually finalised at the 37-week visit. By that stage, the relevant clinical facts are clearer. This is a private, pro-choice practice, and no patient will ever be coerced into a procedure without her explicit consent.
When Is a Caesarean Necessary?
There are clear medical indications for Caesarean delivery, including (but not limited to) :
- Fetal distress
- Severe prematurity
- Abnormal fetal position (such as transverse lie)
- Two or more previous Caesarean sections
- A very large baby
- A contracted pelvis
A Caesarean may be:
- Elective (planned) – usually scheduled within 7 to 10 days of the due date
- Emergency (unplanned) – performed during labour or following an acute event
Preparation for an Elective Caesarean
Preparation is similar to that for other abdominal surgery. The same pre-operative checklist applies.
You should have nothing to eat or drink from midnight and arrive at the hospital at 06:00 for a morning procedure. An intravenous line will be inserted and routine medication administered. A urinary catheter is usually placed.
In theatre, your partner remains nearby while the anaesthesiologist administers a spinal anaesthetic. This is done with you seated on the theatre bed and usually takes only a few minutes to work. Once you are comfortable and the sterile draping is complete, your partner is invited to join you and is welcome to remain for the entire procedure.
The spinal anaesthetic is carefully tested before surgery begins. You will feel pressure and movement, but not pain. If there is any excessive sensation, conversion to a general anaesthetic remains an option.
The Procedure
A horizontal incision is made in the lower abdomen, usually along the bikini line. Blood vessels are sealed as the surgery progresses.
The muscle layers are gently separated rather than cut. The lining of the abdomen (peritoneum) is opened, and a protective retractor may be inserted to improve visibility and safety. The bladder is carefully moved out of the way.
A small horizontal incision is made in the lower segment of the uterus. The baby is then delivered, often with the assistance of a specially shaped instrument designed to fit the baby’s head. Breech babies are delivered in a controlled and safe manner.
Whenever possible, the umbilical cord is allowed to pulse briefly before being clamped. Babies are generally allowed to establish breathing naturally, with minimal suction. After a brief check by the midwife, your baby is brought back to you. Breastfeeding in theatre is encouraged, and we aim to keep mother, baby and partner together throughout the procedure.
The placenta is delivered, and medication is given to help the uterus contract, reducing blood loss. The uterus is sutured in two layers. If sterilisation has been authorised, it is performed at this stage.
The abdominal layers are then closed carefully. A local anaesthetic pain catheter may be placed to assist with postoperative comfort. The skin is closed with hidden, absorbable sutures to promote neat healing. A Comfeel dressing is applied and should remain in place for approximately three weeks, as it supports optimal scar healing.
After Surgery
Sensation gradually returns as the spinal wears off. Pain relief is prescribed and can be requested as needed.
Most medical aids cover three nights in hospital after a Caesarean section, although discharge after two nights may be possible if recovery is uncomplicated and both mother and baby are well.
Caesarean delivery is a carefully considered, respectful and supported process in this practice. Our goal is always the safe arrival of your baby and your wellbeing throughout the journey.