Sometimes Caesarean births are not planned and known as Unplanned (Emergency) Caesarean Sections.
There are different reasons that Doctors (Obstetrician's - doctors that specialise in childbirth) recommend this for. Usually there is concern about the health of you or your baby or it may be that you go into labour before a planned caesarean birth.
What Happens when you need an unplanned Caesarean Birth
There are different types of Unplanned (Emergency) Caesareans Births - most are Category 2 which means we usually aim to get baby born within 75 minutes from the decision. Sometimes we need to move more quickly and do a Category 1 Caesarean and get baby born within 30 minutes from the decision. This is usually due to concerns for you or your baby's safety. Sometimes there is a need to do a Category 3 Caesarean which means the is a need carry out the birth by Caesarean but timing of it is made case-by-case.
You will be talked through the risks and benefits of having an unplanned Caesarean Section by the Obstetrician and asked to sign a consent form. You will then be seen by an Anaesthetist. A Caesarean Section can usually be performed under a spinal or epidural Anaesthetic (if you already have had one). The Anaesthetist will discuss this with you and any possible complications of having an anaesthetic. You will usually be awake so you can see your baby and have 'skin-to-skin' contact as soon as your baby is born.
You will be taken through to theatre by your midwife who will be present throughout. Usually your birth partners will stay in the Delivery Suite room for a short time while the Anaesthetist sorts out your anaesthetic. Occasionally you may have to have a General Anaesthetic (be put to sleep) for the birth. In these cases your birth partner will stay in the Delivery Suite room and a member of our team will update them during the birth. There will be additional theatre staff to help care for you, each with a different role and a Neonatal Doctor or Advanced Neonatal Nurse will be present when your baby is born.
When your anaesthetic is effective (they will do some checks to ensure you cannot feel any pain) your main birth partner will be able to come into theatre. A screen will be placed across your body so you cannot see what's being done - the doctors/nurses will let you know what's happening. The midwife will insert a catheter (tube into your bladder to drain your urine) if you do not already have one in. The Obstetrician will then make a horizontal cut across your lower tummy and womb so your baby can be born and then they will take time afterwards to repair each layer in your tummy whilst you spend time with your baby.
A theatre nurse and midwife will be with you during this time, we will be doing routine monitoring but also helping you feed your baby and continue skin to skin contact. Your partner can stay with you in theatre recovery.
As long as you are feeling well you will be able to have a drink whilst in recovery
Returning to the ward
On return to the ward your observations will continue and support offered by the maternity ward staff.
You usually return to the post-op bay for the first 6 hours after transfer up to the ward.
After this time your catheter and intravenous drip will be removed and you will be moved into your own room (depending on availability).
Your partner is able to stay with you the whole of your stay in the side rooms, and there are some pull out beds available for their use.
All side rooms have an en-suite bathroom for your use. Your baby will remain with you at all times during your stay. There is feeding support available from staff on the ward at all times so please ask for any help and support as needed.
As the majority of the ward is side rooms sometimes it can be difficult to locate a member of staff so please press your buzzer if required and someone will come to you.
We can arrange (if suitable) for you to self-medicate basic pain relief whilst on the ward and this can often avoid any delay in you having pain relief when you need it.
Three meals a day are provided for all patients and toast is always readily available. There is a drinks station on the ward where patients can help themselves to drinks and any snacks available. Partners can bring snacks in with them and also have access to the café in the main building. If you need any food outside of meal times please ask ward staff.
You may still feel very exhausted and overwhelmed especially if you have had a long labour or had any complications. Sometimes people feel like they understand everything that happened to them, sometimes people have more questions and need time to process it. It's helpful to speak to your midwife on the Maternity Ward about how you are feeling and they may be able to explain what was happening during labour and your birth to give you a better understanding. You may benefit from the Obstetrician's coming to discuss this with you, so please ask your midwife if you think this would help you. If you need more time before you do this we can arrange a debrief appointment for you a few months after your birth.
When you are ready for discharge the ward midwife will run through your discharge leaflets and give you a list of contact numbers.
Your baby will have had a first check in the baby clinic by a paediatrician or midwife prior to discharge. Any appointments or follow up needed from this will be arranged prior to your discharge.
You will be sent home with any medication required and this will include injections to help prevent blood clots, which you will be taught to self-medicate.
You will also be advised to wear your support stockings for six weeks after surgery.
A community or your continuity midwife will visit you at home the day after your discharge.
More information:
You can find out more about what happens during a Caesarean birth, the recovery period and what your options for your next birth may be here:
Birth after previous caesarean | RCOG
If you have another baby and have had one Caesarean Section already we have a Birth After Caesarean Clinic which is run by one of our specialist midwives who can talk through your options for your next birth. Even if you feel you might know what you prefer it is important to get all the information about both options to help you make an informed choice.