This leaflet explains what will happen on the day of your caesarean birth, from the morning before you arrive at hospital until after your baby is born.
Eating and drinking before your operation
Following the fasting instructions is very important, they are designed to keep you safe during your anaesthetic. If you do not follow them, we may need to postpone your operation.
| When your operation is scheduled | Spinal or epidural anaesthesia | General anaesthesia |
|---|---|---|
| When your operation is scheduled Morning operation | Spinal or epidural anaesthesia Eat and drink normally until midnight. Clear fluids only after midnight. Stop clear fluids at 6:30am the morning of your operation. You can have sips of water in hospital if your anaesthetist agrees it is safe for you to do so. | General anaesthesia Eat and drink normally until midnight. Clear fluids only after midnight. Stop clear fluids at 6:30am. |
| When your operation is scheduled Afternoon operation | Spinal or epidural anaesthesia Eat and drink normally until 6am. Clear fluids only after 6am. Stop clear fluids at 10am on the day of your operation. You can have sips of water in hospital if your anaesthetist agrees it is safe for you to do so. | General anaesthesia Eat and drink normally until 6am. Clear fluids only after 6am. Stop clear fluids at 10am. |
What are clear fluids:
Clear fluids are water, diluted squash (without pulp), black tea or black coffee with or without sugar. You are not allowed to have milk or milky drinks, fruit juice, anything fizzy or carbonated, or anything that you cannot see through.
Showering before your operation
We advise that you shower or bathe with soap either the night before or the morning of your surgery to reduce the risk of infection.
The morning before you arrive at hospital
You will usually be given omeprazole tablets to take at home. These tablets help reduce the acid in your stomach and help prevent you from feeling sick after your anaesthetic. If you cannot take omeprazole, an alternative medication will be provided, and you will be given separate instructions.
How to take your omeprazole tablets:
If you are on the morning list:
- Take two 20 milligram tablets the evening before your surgery at 10pm.
- Take two 20 milligram tablets the morning of your surgery at 6am.
If you are on the afternoon list:
- Take two 20 milligram tablets in the morning at 6am.
- Take two 20 milligram tablets at midday at 12pm.
When you arrive at the hospital
You will usually be admitted to hospital on the day of your planned caesarean birth to Sara Ward. Your midwife will tell you when to arrive and details will be on MyChart.
What to remove and wear
Please remove all jewellery, including body piercings, where possible. If you are unable to remove jewellery or piercings, please tell your midwife and doctors. It is best to leave valuables at home or with your birth partner on the day.
You will be asked to put on a hospital identity band and a red allergy band if you have any known allergies. You will be helped to change into a hospital gown and put on compression stockings (sometimes called TEDs). These stockings help to reduce the chance of a blood clot developing in your legs.
We recommend that you bring a dressing gown, jumper or cardigan to wear over the gown to keep you warm. It is important to keep warm as your baby's temperature will be affected by your temperature during skin-to-skin.
Meeting the team
The midwife, surgeon and anaesthetist will come and see you before your birth to confirm your birth plan and answer any questions you may have.
Going to theatre
Just before going to theatre, you will be asked to remove your underwear. If you have not brought a dressing gown, a second hospital gown will be provided to help keep you warm and covered. You will normally walk to theatre with your birth partner and your midwife.
Your birth partner will be shown where to change into theatre clothes (scrubs) and will be provided with shoe covers and a white hat to wear. They should keep any valuables in their pocket. They can bring a phone or camera into theatre to take photos of you, your birth partner and your baby. Video recording is not allowed in theatre. Please also note that no photos or video should be taken of staff in theatre.
Your belongings will be placed in the recovery area where you will be transferred to after the birth. This is generally a secure area, but your bags will be unattended, please do not leave any valuables in them.
Who will be in theatre
There are many people who work in the operating theatre, including the anaesthetist and their assistant, obstetrician and their assistant, the scrub nurse, the theatre nurse, the theatre support worker, the midwife, the midwifery support worker, and in certain circumstances a baby (neonatal) doctor. Additionally, there may be students present as this is a teaching hospital. If you do not wish to have any students involved in your care, please let us know in advance.
The WHO Safety check
When you arrive in the theatre and before the anaesthetist starts, the medical team will perform a check of your name, personal details, confirm the operation you are expecting and check your consent form. This is called the "WHO Safety Check" and is an important safety procedure. There will be other times during the procedure when the team will pause and perform safety checks or confirm details.
During your caesarean birth under spinal anaesthesia
Before your birth, the anaesthetist will start your anaesthesia. They will first ask to place a tube (called a cannula) into a vein, usually in your hand, wrist or arm. They will attach monitoring equipment to check your heart rate, oxygen levels and blood pressure.
The anaesthetist will site either your spinal anaesthetic, epidural or combined spinal-epidural. See Information to help you decide about your choice of anaesthesia for caesarean birth for more information. Once your anaesthesia is working, your midwife will insert a tube (catheter) into your bladder to keep it empty during the operation and while you are unable to stand after the birth.
You can have music of your choice playing during the birth. A small curtain (sterile drape) will separate you and your birth partner from the medical team undertaking the surgery. The anaesthetist will stay with you throughout the surgery to ensure you are comfortable and safe.
Your midwife will be preparing for the arrival of your baby and will contact a neonatal doctor to attend the birth if this is part of your birth plan.
Before surgery starts
Before the surgery begins, you will be given an antibiotic through the tube in your vein (cannula). Antibiotics are routinely given with a caesarean birth to reduce the chance of infection.
During the operation
Once the anaesthetist has confirmed the anaesthetic is working, the obstetrician will make a small horizontal cut (incision) in your skin above your pubic bone. This is sometimes called a "bikini cut" because it sits where a bikini would sit.
During the operation you may feel pulling and pressure, but you should not feel pain. It has been described as feeling like "someone doing the washing-up in my stomach". The anaesthetist will monitor you throughout the operation. If you feel uncomfortable or sick, let them know and they will discuss your options with you.
The time it takes for your baby to be born from the start of the operation is variable, depending on how much surgery you have had previously.
As your baby is born
Once your baby is born, cord clamping will be delayed for one minute so that your baby receives additional blood from the placenta and cord. This increases their oxygen-carrying blood cells (haemoglobin) and iron stores.
At this point, so that you can meet your baby, the obstetrician will usually hold the baby above the sterile drape or lower the drape if this is what you have planned. Your baby will then be passed to the midwife who will dry them and support you with skin-to-skin contact if that is what you have planned. A baby (neonatal) doctor may also be present.
If your baby is very small or unwell, they might need to go straight to the neonatal intensive care unit (NICU) or special care baby unit (SCBU). Otherwise, you or your birth partner can hold your baby while the afterbirth (placenta) is being delivered, and your womb (uterus) is being stitched (sutured).
After your baby is born
Immediately after the birth, a medication (an artificial version of the hormone oxytocin) is put into your drip to help your womb (uterus) contract. This will continue for four hours after the birth. You will also be given other medications to help with your recovery, including anti-sickness medications and pain relief (which may include a suppository if you do not have an allergy to this medication).
During your caesarean birth under general anaesthesia
Your birth partner can come to theatre with you but will need to leave the room when you go off to sleep.
Before you go to sleep, the anaesthetist will place a tube (called a cannula) into a vein and attach monitoring equipment to check your heart rate, oxygen levels and blood pressure.
You will be offered a catheter and cleaning of your skin before you go off to sleep. This reduces the time you are asleep before your baby is born.
You will be asked to breathe oxygen through a clear plastic face mask. The anaesthetist will then give you the medication to make you sleep. The medication in the vein might feel cold as you go off to sleep. As you go off to sleep, the anaesthetist's assistant will gently apply pressure on the front of your neck. This helps to stop stomach contents from coming up and potentially entering your lungs. Once you are asleep, a breathing tube will be placed in your throat to keep your airway open during the operation.
Once the anaesthetist is happy you are asleep, the operation will begin with the same small horizontal cut (incision) above your pubic bone as for spinal anaesthesia.
Once your baby is born, cord clamping will be delayed for one minute, the same as for spinal anaesthesia. A baby (neonatal) doctor will be present to check your baby. You will be given the same medications after the birth to help with your recovery.
You will wake up as soon as the operation is done. Most people remember waking up in the recovery room.
More information
If you have any questions about what happens on the day of your caesarean birth, please speak to your midwife.
For information about the benefits and risks of caesarean birth and anaesthesia, please see the leaflets Benefits and Risks of Caesarean Birth and Information to help you decide about your choice of anaesthesia for caesarean birth.
For more information about anaesthesia for caesarean birth, visit:
It provides independent, evidence-based information written by a multidisciplinary group of doctors, midwives, and parents.
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