Written By: Alyssa Emo DO/OB/GYN
Having a scheduled cesarean section? Here's what you can expect.
You will arrive to the hospital about 2 hours before your scheduled surgery. The labor floor can be a crazy place at times, so the scheduled time occasionally gets pushed back if there is an emergent need for the Family Birth Place operating room (OR). Luckily this is pretty uncommon.
You will be checked in and brought to your postpartum room. There the nurses will admit you, go over your medical history, plans for baby (feeding, vaccinations, etc.), and get your labs and IV started. You will meet your surgeon and your anesthesiologist and sign consent forms for the procedure. The nurses will clean your belly with wipes to prevent infection. If your baby is breech (bottom down), your surgeon will most likely double check with ultrasound that they are still in breech position.
I personally like listening to music in the OR. I ask my patients for their music preferences (some make a playlist for their surgery). Most of our surgeons are happy to play music if that makes the experience more comfortable for you, so feel free to ask before you head back to the OR.
When it's time, you will head to the OR with your nursing team. Your support person will wait outside initially. In the OR there will be your: surgeon and their assistant, anesthesiologist, a nurse for you, a nurse for baby, and a scrub tech. The anesthesiologist will place your spinal anesthesia (similar to an epidural but stronger). Once in place, it feels a bit like a pit crew. The nurses will place a catheter to drain your bladder, put massage devices on your calves, and wipe your belly with another solution to prevent infection.
Your surgeon, their assistant (typically another provider in our practice), and your baby's nurse will scrub and gown with the scrub tech. Once they are gowned and your prep is dry, a sterile blue drape is placed over your belly and it forms a curtain blocking your view. Then a safety time out occurs. We also double check that your anesthesia is adequate and you are comfortable. Once completed, it's time to invite your support person in (make sure they bring a camera) and get the birthday party started!
It usually takes very little time to deliver the baby. Once the baby is delivered, if the cord is long enough, we do a little "Lion King" moment where the drapes are dropped and you can see your little one. Sometimes the cord is too short, and so this happens after it is cut. We attempt to do delayed cord clamping for approximately a minute. We try to leave the cord longer so that your support person (or you!) can trim it (similar to cutting the cord in a vaginal delivery). The baby's nurse then brings them to the warmer to be assessed. If everything is good, baby is swaddled and you are able to hold them for a while.
While you are snuggling baby, your surgeon is delivering the placenta and then closing all the layers that were opened to deliver baby. This is what takes the most time during the surgery. The OR is not usually warm enough to keep baby with you for the rest of the surgery, so at some point your baby and support person will go to the post-op recovery area (PACU) with the baby nurse. No other family members or friends are allowed in this area. Everyone has different preferences, so I recommend discussing with your support person about if they can send pictures to friends and family, post on social media, factime, etc. while you are still in the OR. I know that I wanted to be present for facetime calls to family to introduce them to our little one!
Once all the layers are back together, we clean you off and place a bandage on the incision. Usually, incisions are closed with sutures that dissolve on their own. You may have extra glue on top or little bandage strips. Our team will move you (since those legs will still be quite numb) to another bed and bring you to the PACU. In PACU, you will be able to hold and (if you desire) breastfeed your baby. After 30 minutes of recovery, you will be brought back to your initial room.
The OR can be an intimidating place to be as a patient, so hopefully this helps give you an idea of what to expect prior to your big day.