Having a Cesarean Section Delivery
A cesarean section, or c-section, is an alternative method to a vaginal delivery. It is a surgical procedure done in the hospital OB operating room. During a c-section an incision is made in the mother’s abdomen, just below the pubic line, and then through the uterus to remove the baby. The incision is usual between 4-8″ in length. Nearly one in three women in the U.S. deliver their babies by C-section, either for elective reasons, or because of a risk to mother or child. It is a safe and reliable method of delivering your baby but most times requires a bit longer recovery for the mother.
Scheduling a Cesarean Section
The American College of Obstetricians and Gynecologists insists that, unless there is a complication of pregnancy, deliveries should be scheduled within one week of the due date. This 39 week rule has been around for a while. It has been gaining traction in recent years. Now, more and more organizations, including hospitals and insurance companies, and even some states, insist that scheduled deliveries can NOT happen before 39 weeks.
The due date is 40 weeks 0 days.
The 39 week rule is designed to protect babies from complications of early term delivery. Babies born after induction or cesarean section before 39 weeks have more complications, admissions to intensive care units, and even mortality, when compared to those born after 39 weeks. Babies born after the natural onset of labor do better than those induced at term, after 37 weeks. There is plenty of Good medical evidence to support these claims.
Practically, this means that when we schedule your cesarean section or induction we need to do it on or after 39 weeks 0 days. There are many pregnancy, medical and patient specific reasons which influence picking a date between 39 and 42 weeks. Very few women should be pregnant two weeks past their due date.
For cesarean section we typically do not schedule cesarean sections on Saturday or Sunday. We try to schedule the cesarean section between 8 and 9 am. The date must work for many parties: the patient and family, surgeon/obstetrician, family practice doctor, hospital and operating room schedule.
Once we set the date and time, there is a process to make sure arrangements are made and questions are answered.
What to Expect the Day Of
After arriving at the hospital, patients meet the labor floor staff, including the nurse, resident, the attending, and sometimes a medical student. You will be shown to your permanent room and given a gown to change into once you have made yourself comfortable. The staff will then review the course of the pregnancy, your medical history, and document things in the electronic health record. There will be some paperwork to go through as well before things get started.
We begin monitoring the uterus with two hockey-puck sized devices. One puck is a microphone, to listen to the baby, and the other puck is a used to measure contractions. You will have a NST (fetal non-stress test) done and possibly be a brief ultrasound at your bedside to confirmed the baby’s position. An intravenous line (IV) will be started and you will meet with your doctor and anesthesiologist to review the plan for the procedure.
Your partner will be allowed to be in the operating room with you! They are required to wear protective clothing over their normal clothes – it’s best that they plan to wear something that will fit comfortably under the operating room suit. Once the operating room and staff are ready, Mom will be given a very fashionable hair net and walked back to the operating room.
Once in the operating room you will be seated on the table to place your pain medication, either an epidural or a spinal block. If you were already laboring you may have already had an epidural placed. You will then lay back on the table for the operation to begin. Your partner will be allowed to stand next to you but there will be a drape up over your stomach so that you won’t be able to see the surgery.
From the time surgery begins until baby is pulled out only takes a couple minutes. When baby is out, and cleaned up, they will bring him/her up for you to see and kiss, etc. before it leaves with the pediatric team for evaluations and cleaning. Your partner will then be able to leave with baby and your surgery will finish.
After surgery you will be brought back to the original suite where you checked in. Your baby and your partner will meet you there and you will be able to bond with your new baby. Visitors will only be allowed in once you are ready and within the permitted hospital visitation hours.
Typical hospital recovery time for a c-section is 3-5 days depending on how you are doing. Your doctors and nurses will be visiting you regularly as will the pediatricians to check on your baby.
Going Home After a C-Section
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