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Caesarean Section (planned)

Can I request a caesarean?

A caesarean section is usually carried out when a normal vaginal birth could put you or your unborn baby at risk. It is is major surgery, therefore pregnant women are not immediately entitled to a caesarean section if they do not have any physical or mental need for it.
At Kingston Hospital NHS Foundation Trust, we recognise pregnancy and childbirth may be an anxious time for parents-to-be and we want to address any concerns you may have. In addition to the support provided by our midwives and obstetricians (senior maternity doctors) and the information available at antenatal classes, we have produced a leaflet, based on the latest clinical evidence, to ensure consistent information for women who are considering a caesarean section by choice, rather than for an obstetric or medical reason.

This leaflet and further information will also be discussed with you by your midwife or obstetrician.

 

How to best prepare for a planned caesarean?

The following infornation will help prepare you for your planned caesarean section. It also provides information on what you can do after your baby is born to help speed your recovery. 

Appointments you will have

  • Consultation with your Obstetrician

You will see an obstetrician who will provide you information regarding your caesarean section, including the risks and benefits to you and your baby.  They will also be able to answer any questions you might have and may formally consent you for the operation.  Your caesarean section will be planned for 39 weeks of pregnancy onwards, unless there is a medical or obstetric reason for it to be performed earlier.

  • Consultation with your Anaesthetist

You will see an anaesthetist who will discuss with you your options for anaesthetic during your caesarean section.  In most cases, a spinal anaesthetic is used which allows you to be awake during the birth of your baby and is both safe for you and your baby.

  • Pre-assessment Clinic Appointment

You will see a midwife at your pre-assessment clinic appointment usually around 38 weeks of pregnancy.  This is a routine antenatal check-up during which a blood test will be taken to check your iron levels and blood group.  They will also take routine swabs from your nose, throat and groin to test for MRSA, if this has not already been done in your pregnancy.  If there is a problem with the blood or swab results, you will be contacted before you come in for your caesarean section.

Your midwife will also measure your legs for surgical stockings, which help to reduce the risk of blood clots in your legs after your caesarean section.  You will also be provided with Ranitidine tablets that help to reduce the levels of acid in your stomach, which you will need to take before your operation.

 

On the night before Your Caesarean

We advise that you eat and drink normally until midnight before your caesarean section. From midnight until 6am on the day of your operation, your diet will be restricted and you will be asked to take one of your Ranitidine tablets at 10pm on the night before your operation and 6am on the day of your operation.

As with all operations, we ask that you do not wear any make-up, nail varnish, false nails or jewellery, apart from a plain wedding ring which can be taped around your finger. If you wear contact lenses, you will be required to remove these before you go into theatre so it would be advisable to bring your glasses.

We advise that you do not shave or wax the hair in the bikini area within one week of your planned operation as it can increase the risk of infection after your operation. Routine hair removal is not required but should you wish to do this, clippers and depilatory cream are safe to use.

On the day of your caesarean

On the morning of your caesarean section, you will call the labour ward to confirm your time to attend (usually one hour prior you caesarean section).

We are not able to give an exact time for your caesarean as sometimes emergencies will need to take priority.  Please be patient while we manage these and we will endeavour to perform your caesarean section in a timely fashion as safely as is possible.

During Your Caesarean Section

We would like to make the birth of your baby a comfortable experience, one birthing partner can be with you and staff will introduce themselves and their role and will be able to answer any questions you may have.  To make it a more relaxing environment for you, we have a CD player and iPod docking station; please bring with you a CD or iPod should you wish to listen to music. You can also bring a camera with you into theatre.

You will usually be in theatre for about an hour in total:

  • The anaesthetist will make preparations for you to have your spinal anaesthetic to make you numb from the chest down (you will be able to stay awake ready to see your baby being born) 
  • Your midwife will then listen to the baby’s heart beat
  • When you are numb; your midwife will place a urinary catheter, a tube that goes into your bladder which will help to keep your bladder empty during the operation. 
  • A screen will then be put up so that the doctors can prepare for your operation.

Your baby will be born through a cut or ‘incision’ into your lower abdomen (tummy). You may feel some pulling or tugging sensations as your baby is born but you will not feel any pain. 

When your baby is born:

  • If you wish, you can have the screen dropped so that you can see your baby. 
  • Your baby will then go to the midwife to be dried and weighed and then come to you for a cuddle. 
  • You may wish to have skin to skin at this point or you can have skin to skin after your caesarean section has been stitched. 

After your caesarean section

You will initially be taken to a shared recovery area after your caesarean section for a minimum of a couple hours.

You will be offered skin to skin contact with your baby regardless of your chosen method of feeding and will be given assistance to feed your baby should you require it. 

You may wish to book an amenity room, a single room, for £100 per night for your stay on the postnatal ward.  Your midwife will be able to discuss this with you, please note that this is subject to availability and will depend on your individual circumstances.

Visiting Times

Visiting times are 3pm until 8pm. Your partner and your own children may visit outside of these times. Please note that this only on the postnatal ward and is not for when you are in the recovery area on labour ward.  No children under the age of 16 may visit unless they are your own children. Your partner can stay overnight with you if you wish.  A reclining chair is provided but your partner must bring their own food and home comforts e.g. a blanket and pillow.

Getting back to normal after your caesarean section

It is important that you begin to eat and drink as soon as you feel able to after your caesarean section.  This will help your body to recover much faster after your surgery. 

  •  Prevent thrombosis or blood clots

When your spinal anaesthetic has worn off; staff will help you to get out of bed, being mobile helps to prevent thrombosis or blood clots. You will also need to wear your surgical stockings and you will be given blood thinning injections daily for seven days following your caesarean section.  
You should tell your midwife or doctor if you develop a cough or shortness of breath, or swelling and pain in your legs, so that they can make sure that these symptoms are not caused by a blood clot.

  • Looking after your bladder

When you are mobile, your catheter can be removed and you should measure the first void of urine in the jug/bowl provided. 
If you have any problems passing urine such as pain or leaking, even when you are at home, please inform your midwife or doctor.

  • Prevent pain

You will be prescribed regular pain killers to take in hospital.  Please make sure you have a supply of paracetamol and ibuprofen ready for when you go home, providing that you are not allergic to them or have been advised against taking them.

  • Looking after your wound

You should have a shower on the morning after your caesarean section and get your wound dressing wet.  You can take off the dressing in the shower, wash the wound and dry it gently with a clean towel.  Your midwife will check the wound for you and if everything is normal, the wound will be left to air dry without a dressing.

You should take a daily shower to keep the wound clean and dry.  You should wear loose fitting cotton underwear that are big enough to pull up above the wound so that it does not rub. You may notice some bruising and a loss of feeling/sensation in the area around the scar.  This is normal after a caesarean section and should not be permanent.
If you notice any redness, oozing, offensive smell from the wound or you feel feverish (going hot and cold or you have a temperature) you should tell your midwife or doctor. 

  • Observe your bleeding

You may bleed vaginally after your caesarean for up to six weeks.  You should change your maternity pads frequently, every 3-4 hours and make sure that you wash your hands both before and after going to the toilet and changing your pads. 
You should tell your midwife or doctor if your vaginal bleeding increases, you are passing clots or it becomes irregular or painful.

After you go home

You will be visited at home by one of the community midwifery team on the day after you go home from hospital.  They will check both you and your baby and help you with feeding if you require it. Staff will then make another appointment to see you and your baby depending on your individual circumstances. Staff will then make another appointment to see you and your baby depending on your individual circumstances.
If you have any concerns or questions please let them know.  

 

You will be discharged from the community midwives from 10 days after the birth of your baby, at which point, your health visitor will take over your baby’s care.  However we can visit up to 28 days should you or your baby require it.  You will usually hear from the health visitor at around 10 to 14 days after the birth of your baby and they will monitor your baby’s progress up until school age.

You should make an appointment to see your GP at 6 weeks after the birth of your baby.  This appointment is a routine general wellness check and will also give you an opportunity to discuss contraception and future smear tests.

When Can I Drive?

You must check with your insurance company when you will be covered to drive after your caesarean.  When you do decide to start driving again, you must be absolutely sure that you would be able to do an emergency stop.  Most women feel ready at 6 weeks after their caesarean section, however, if you feel that you are ready to drive before 6 weeks, some insurance companies may ask for a letter from your GP to say that you are fit to drive.

 

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