Labour & Delivery

Elective Caesarean Section: What to Expect

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Going into pregnancy, I assumed when it was time for the baby to make her grand entrance, there would be pushing and shoving involved. However, due to a complicated medical history, a natural birth was too risky for me. I was gutted at first. But I have complete faith in my doctor. I heeded her advice and proceeded to have two more births via planned Caesarean section since then. I have come to realise that it isn’t necessarily a negative experience, especially if you know what to expect and how to prepare.

Photo credit: Studiointhewild

Before surgery

  • Put together a bedside kit – wet wipes, lanolin cream for cracked nipples, a straw bottle for water, snacks, etc.
  • Prepare some granny panties for after surgery. Look for the kind that goes over your belly button, so the waistband does not rub on the incision wound (Uniqlo has some excellent high rise briefs).
  • Have a long shower as you will be immobile for at least 24 hours after surgery.
  • Approximately two hours before surgery, a  nurse will come into your room to shave your pubic area and give an enema to clear your bowels.

You will be wheeled down to the operation theatre (OT)  to prepare for surgery. Your support person/husband will be taken to another room to wait.

Preparation for Surgery

  • For planned Caesarean births, a spinal anaesthetic is most commonly used (don’t Google if you’re squeamish). You will be asked to sit on your bed and hug a pillow. The anaesthetist will then insert the needle in your spine.
  • A urinary catheter will be inserted (sounds painful, but since you’re numb from the waist down, you won’t feel a thing).

In my opinion, this is the worst part, not because of the pain, but of how scared and alone you will feel in an unfamiliar room as the surgical team bustle about preparing for the surgery. Stay strong and think of your baby whom you will meet in a few minutes.

You will then get transferred to the operating room. Your support person/husband will be allowed to sit by your side.

  • Your abdomen will be cleaned with antiseptic and a screen will be placed over your chest so you can’t see the surgery.
  • As the surgery is underway, you will feel intense tugging sensations but no actual pain.
  • Once your baby is born, he/she will be brought to you for a short moment. Make sure you get in a quick picture! Your baby will then be taken to the nursery, together with your support person/husband.
  • Your doctor will proceed to remove your placenta and stitch you up.
Photo credit: Babycenter.com

Immediately after surgery

  • You will be wheeled to the recovery area and be put under heaters as you may feel very cold post-surgery.
  • Every few minutes, a nurse will press on your abdomen and observe the blood flow (from your vagina) to check if the uterus is contracting well.

If there are no complications, you will be taken to your room where you will soon be able to meet your baby properly.

  • For at least 24 hours, an IV needle will be stuck to the back of your hand. This will make holding your baby a little awkward. Ask the nurse or family members to help you position the baby.
  • Due to the pain of the incision site, afterpains from uterus contracting and lack of full mobility due to anaesthesia, breastfeeding will be uncomfortable. Do request for a visit from the lactation consultant to help you.
  • Bring a nursing pillow and some scarves that you can roll up to prop baby’s head up.

Day After Surgery

  • There is no way to predict when your body will start producing milk – during my first two Caesareans, milk production kicked in within 12 hours. However, with my third baby, I had to sign the consent allowing nurses to feed her with formula. The milk only started coming in when we got home.
  • The spinal anaesthesia and catheter are usually removed the day after. You will be asked to walk around – yes it will hurt – and you will shuffle around with a hunch for the next few days.
  • You will begin to bloat even worse than when you were pregnant. This is because of IV fluids pumped into your body during and after surgery. But don’t worry, it will go away within two weeks.

At home

If all is well, you will be allowed to go home after three or four nights.

  • Allow baby to suckle often (even when there’s no milk) to stimulate milk production (demand=supply).
  • Be careful with how you move. When getting up from a lying position, roll on your side with knees bent then slowly push yourself into sitting position with your hand in order to protect the wound.
  • As per my doctor’s recommendation, I cleaned the wound with alcohol swabs and replaced the dressing whenever it got wet with Opsite Post Op Dressing.
  • Your scar may freak you out now but it will fade over time, especially if you gently massage with scar gel diligently.
  • You can begin postnatal massage sessions though you will not be allowed to lie on your front. Your masseuse will not massage or ‘tungku‘ (traditional Malay hot compress) the stomach area till about two weeks post-surgery.
  • Some doctors may tell you not to consume herbs such as ginseng after surgery. Do check with your doctor as to which herbs are safe for post-surgery recovery.

Some people view elective C-sections as the easier method of birth. It is not! You were cut open in a major surgery, don’t expect to bounce back immediately. Even if you are not in pain, rest as much as you can, enlist the help of your village and make sure you carry nothing heavier than your baby.

Note: Tips above are based on the author’s own experience. If unsure, always speak to your gynaecologist. 

Life before little humans involved hanging out with beautiful people and styling models for television commercials and photo shoots. Now, Su Ning can often be found at the park with a trio of girls dressed in various shades of pink.