Planned or elective caesarean

A caesarean section (C-section) is an operation allowing your baby to be born through a cut in your abdomen (tummy) and uterus (womb).

Caesarean sections may be planned before your labour starts. This is known as an elective caesarean. You may have an elective caesarean if:

• you choose to have a caesarean birth rather than a vaginal birth
• your doctor recommends you have a caesarean birth

Around 2 in every 5 babies are born by caesarean.

Your doctor might recommend a planned or elective caesarean if:

• you have previously had a caesarean
• your baby is in a breech position (bottom first) or transverse position (lying sideways)
• you are carrying a twin pregnancy and the first twin is in a breech position
• you have placenta praevia (when your placenta covers the opening to your uterus)
• you or your baby have other medical problems

You may prefer a caesarean to a vaginal birth for non-medical reasons. Having a caesarean for non-medical reasons has risks and benefits for:

• you
• your baby
• your future pregnancies

If you request to have a caesarean birth for a non-medical reason, your doctor or midwife will explain to you the benefits and risks of all birth options. This will allow you to make an informed choice.

In Australia you have the right to make a shared decision with your doctor.

Your doctor or midwife will arrange any tests, such as blood tests, that you need before your surgery. Your doctor will also explain the risks of the operation and ask you to sign a consent form.

The timing of your caesarean birth will depend on:

• your health
• your baby's health
• the caesarean team's schedule

You will usually have your planned caesarean section at 39 weeks of pregnancy or later. If there are problems in your pregnancy or if you are having multiple babies, you may have your caesarean earlier.

Your doctor will discuss with you the most appropriate anaesthetic for your situation. They will explain the risks and benefits of each type of anaesthetic so that you can make an informed decision.

Remember to take a bag for your stay in hospital. It should have all the things you and your baby may need.

If you would like to record the birth, ask your doctor if it's okay for your support person to take photos or videos.

Before the surgery:

• your pubic hair may be shaved
• your abdomen will be cleaned with antiseptic wash
• your health team will measure your legs to fit you with compression stockings. These help to reduce the risk of blood clots in your legs.

You will then have an anaesthetic. Most people who have an elective caesarean will choose an epidural or spinal anaesthetic.

After you have an anaesthetic, you will have an intravenous (IV) line put into your arm to give you fluids and medicines. A doctor will also place a catheter (a thin flexible tube) into your bladder so your urine (wee) can drain freely.

Once you can get out of bed and walk, your healthcare team will take the catheter out.

Usually, you can have one support person, such as your partner, with you in the operating room. Your support person can help you with emotional support as well as communicating between you and your healthcare team.

Your support person will be given scrubs and a theatre hat to wear. They must wear closed in shoes.

If you need to have a general anaesthetic your partner will not be in the operating room because you will be asleep.

A screen is usually hung across your chest so you cannot see what is happening during the operation. Some doctors offer a 'maternal assisted caesarean section'. This means that the screen is removed so you can see what is happening for part of the operation.

After the operation, you will be cared for in the recovery room until you are ready for the postnatal ward. If you choose to breastfeed, your midwife may be able to help you once you are in the recovery room.

You will stay in bed until your epidural or spinal anaesthetic wears off. Your midwife will help you to get out of bed, which usually happens in the first 1 to 2 days.

You will usually stay in hospital for 3 to 5 days after a caesarean. You will be given pain relief medicines and may be given blood thinner medicines. A midwife will check on you regularly during this time.

Remember that you will need time to recover after a caesarean. If possible, plan to have plenty of help at home after your surgery.

After your baby is born, your doctor will hand them to the midwife or paediatrician who will clean away the amniotic fluid and check their condition.

If your baby is well, you or your support person will be able to have skin-to-skin contact with your baby while you are still on the operating table. Skin-to-skin contact keeps the baby warm and helps with bonding.

Many women go into labour before their planned caesarean. If this happens, you will have an emergency rather than a planned caesarean.

If you are booked to have a planned caesarean and you go into labour, call your hospital's maternity unit immediately.

If you are unhappy with your care, you should start by asking to speak with the person in charge of your care team. Each hospital has a process to manage complaints and make sure that you are satisfied with the outcome.

If you don't feel that you have resolved your concerns, there are organisations in each state where you can make a formal complaint.

Read more about your healthcare rights and how to make a formal complaint.

The Royal Australian College of Obstetricians and Gynaecologists has a detailed information sheet about caesarean section.

The Royal Women's Hospital has a web page all about caesarean birth.

Languages other than English

Health Translations Victoria has factsheets in multiple languages, including:

• managing your pain following a caesarean
• going home after a caesarean birth
• anaesthetic medicines used during a caesarean