What happens during a C-section?

DEAR DOCTOR K:

My doctor says she is going to have to deliver my baby by C-section. What will happen during this procedure?

DEAR READER:

A cesarean delivery, or C-section, is surgery to deliver a baby through the abdomen. It may be scheduled in advance when a woman cannot or should not deliver the baby through the vagina. A C-section may also be performed if continuing with labor or delivery becomes risky to the mother or baby. Finally, a cesarean may be done as an emergency procedure if there is immediate risk to a mother or baby.

Women undergoing a scheduled C-section should not eat or drink for several hours before surgery. You will take antacids because stomach juices can — rarely — be regurgitated up into a woman’s throat, and then leak down into her lungs during surgery. If you take antacids, the juices contain much less acid.

Just before surgery, an intravenous line (IV) is placed into a vein. It will deliver medications and fluids. It can also provide a blood transfusion during surgery if needed.

A flexible tube is inserted into your bladder to drain urine. Your abdomen and pubic area are washed with an antiseptic or antibacterial soap.

Regional anesthesia is usually used for C-sections. You are awake and alert during the baby’s birth. However, the anesthesia will make you numb from the waist down. You can breathe naturally on your own. (You will also be given an oxygen mask to use as needed.) General anesthesia may be used for some emergency C-sections, but your C-section will not be done on an emergency basis.

Your partner or a friend can be with you during a C-section if you have regional anesthesia. That’s not usually the case if you have general anesthesia.

To begin, the doctor will make a low, horizontal incision in the abdomen at or just above the pubic hairline. A vertical incision may be used in an emergency situation.

Next, the uterus is opened. The incision is usually horizontal and low in the uterus. A vertical incision is often used to perform a pre-term cesarean delivery.

The bag of waters is broken. The baby is delivered. The umbilical cord is clamped and cut. You will get an antibiotic just after delivery to reduce the risk of infection.

The time from the beginning of surgery to delivery of the baby generally is less than 10 minutes. It can take another 30 to 40 minutes to remove the placenta and close the uterus and abdomen with stitches or staples.

C-sections have been performed for several thousand years. However, it is only in the past 150 years or so — since the development of anesthesia — that they have been performed with some frequency. If studies show that the baby is just not going to be able to come out through the birth canal, C-section can be lifesaving, for both baby and mother.

Scheduled C-sections, like yours, almost always are uneventful. You and the baby should do fine.