There are situations where a scheduled c-section is the plan of birth for baby. It could be due to a medication complication such as placenta previa, or due to baby’s position being breech or transverse and the provider not being skilled in vaginal breech delivery. It could also have been your choice, whether due to you having a previous c-section, previous severe tear, or personal choice!
Having a scheduled c-section is a completely different experience from having an urgent or emergent c-section during labor or pregnancy. There are a few differenced between the two but the biggest is the energy and sense of urgency.
During a scheduled case, it is a calmer environment because there nothing going on with baby or you. It’s also calmer for you sometimes because you know when baby is coming!
Versus an unplanning c-section may be more chaotic or anxiety inducing because of either the health status of you or baby.
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Ok, let’s continue with our atricle…
What To Expect During Your Scheduled C-Section?
Here is what we are going to talk about in this article:
- Scheduled date and time of surgery
- No eating prior to surgery as determined by your hospital
- Special Body wash the night before*
- Arrive at the hospital at a set time with a routine protocol
- Meet with Surgeon, Anesthesia, and Nurses prior to surgery
- Surgery
- Recovery Room for 1-2 hours
Benefits of a schedule c-section:
1. Scheduled date and time of surgery
One of the biggest difference between an unplanned and scheduled c-section is you get to also PICK the day you meet your baby. (surgery schedule dependent)
For most cases its around 39 weeks, but may be earlier or later depending on individual situations. They will assign you a time of when to arrive to the hospital depending on which number c-section case you are.
This can take a lot of stress of you sometimes because you have a countdown of when baby will be here! No one will be texting you to ask when they will be here.
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2. No eating prior to surgery as determined by your hospital
With any surgery they require you to be NPO, or nothing by mouth, for a certain period of time prior to the surgery. Usually between 6-8 hours. This means no food or liquid! Some will say water is okay, but not always.
Most of our cases start at 7am, with an arrival time around 6am. This would be a nothing by mouth after midnight! This is the common timeline for most.
The reason for this is due to the risk of aspiration during surgery. In pregnancy we are at an increased risk of aspiration because of physiologic changes that occur to our gastrointestional system. Our digestion slows down and our sphincter at the bottom of our esophagus relaxes. Both of these changes increased the risk of aspiration.
This risk is not always able to be avoided during labor because we cannot control what you do before arriving in labor, but for scheduled cases this is something we can control!
3. Special Body wash the night before your scheduled C-section
Some hospitals will give you these special soaps and wipes to shower with the night before surgery.
They will give you exact instructions on how to use them on your abdomen and genital area.
This is to help lower the risk of infection from surgery by cleansing the skin of any bacteria or pathogens that could be on there.
They will also likely tell you all the rules of what you can and cannot wear, some include:
- makeup
- contacts
- metal in hair, hair pins or metal on hair beret
- lotions or perfume
- jewelry of any kind: earrings, rings, necklaces, nose rings, belly button piercing, genital piercing.
- If possible, no nail polish
- Some hair extensions (if metal is in them)
4. Arrive at the hospital at a set time with a routine protocol
When you arrive at the hospital the will have a set routine of what needs to occur before surgery:
- Check you into system and let everyone know you have arrived
- Walk you to your room, and give you your hospital gown, socks, and if you have a partner their bunny suit for surgery by your nurse. Your nurse may be the nurse for your entire surgery or just for the pre-op portion.
- Place your baby on the fetal monitor and place the contraction monitor on to see if any contractions are happening. This is usually for a minimum of 20 mins but sometimes longer depending on hospital policy.
- Place IV catheter in your arm or hand. Some hospitals will place 2 before surgery, and other will only require one. This also may be done before putting baby on the monitor.
- The Nurse and Birth Team will learn your birth wishes for the c-section of:
- Skin to skin
- Feeding choice
- Medication choice for baby
- Any birth wishes during c-section – see baby over drape or drop drape, clear drape
- If you have a playlist you would like to play
- Baby’s information if you have it – name etc.
- Doctor, Anesthesia, and sometimes the pediatrician will come in to consent for surgery and/or discuss plan of care for you and baby
- Once everyone agrees and is ready, you will be wheeled or walked back to the OR. Your partner will wait outside the OR till your are prepped.
- Once inside the OR they will first place the spinal anesthesia. This can be a stressful part for a lot because of the the thought of a spinal. The nurse will provide support during placement. Once the spinal is in, you will be laid back and some sort of cushion placed under one side of you to prevent the uterus putting pressure on the great vessels in the back.
- The nurse in the OR will then place the foley catheter in your bladder (you should be numb so will not feel this) and then will prep the abdomen to sterilize it for surgery.
- Doctors will come in and place the drape and get set up for surgery, they will do a test to make sure the abdomen area is fully numb. They will pinch the belly with an instrument and ask if you feel anything. Most of them you you feel nothing. If you do feel something, SPEAK UP!
- Then at this time they will do what is called a Time out. This is a procedure done for all surgeries, even emergency ones, to ensure we have the correct patient, performing the correct surgery, and everyone is aware of any risk factors for both you and baby. Everyone will introduce themselves so we know who is in the room
- This is when your partner is brought into the room and surgery begins!
- Surgery can take anywhere from 30-60mins on average, but baby is usually born within the first 5-10mins. You should only feel pressure or some tugging during the procedure, if you feel pain at all speak out to anesthesia.
- Once baby is out, they can do delayed cord clamping if baby allows per their hospital policy. Important to discuss this option during a prenatal appt if you want it.
- They will then either drop the drape for you to see baby, hold baby up over the drape, hand baby directly to you(hospital dependent) or hand baby off to the baby team to be checked out first.
- While they are suturing the uterus and the other layers of your body, you usually will have the option to do skin-to-skin in the OR. This looks different in each hospital, asking prenatally what this looks like and how long their policy allows for skin-to-skin can be helpful for planning. Sometime you will not feel great while they are suturing up the uterus or other layers and you may not want to do skin-to-skin, and thats okay!
- They will either leave baby skin to skin with you the rest of surgery and then you will transfer to the recovery together, or at some point they will take baby out of the OR to do their first assessment in the recovery room until you join them. Some partners choose to stay behind or go with baby. If partner plans to go with baby, asking if you can have another support person to switch out so you are not alone in the OR.
- Once they are done closing the last layer, the skin, they will clean you up and take you to the recovery room. They will likely do a fundal assessment and check vaginal bleeding before leaving the OR. You should still be numb, but it will feel like a lot of pressure.
5. Recovery Room for 1-2 hours
Where you go for recovery is hospital dependent, some hospitals you will recover in the labor and delivery room you checked into. While other hospital it will be in a PACU unit, Post-Anesthesia Care Unit. This may be specific for just Labor and Delivery or be the one for the entire hospital. Knowing where you will go after surgery can be helpful for planning. This is a questions I would recommend asking during the pre-op or when you check in!
They will monitor your pain level, vital signs, and vaginal/incision bleeding during the recovery phase. You will stay in the recovery room for at least 1-2 hours depending on your status and hospital policy.
In most hospitals, baby will be with your during the entire recovery portion. Great time to do skin to skin and get that first feeding in with baby! Medications and assessments can wait till you return from the OR if you are wanting to be apart of them. If baby is not with you during recovery, it can be helpful to ask for a breast pump to start stimulating the breast if you are planning to breastfeed!
Once recovery is complete, you will move to your postpartum room!
Benefits of Scheduled C-section
There are risks and benefits with everything we do! Major benefits of having a scheduled vs unplanned:
- Planning: you know exactly when baby is coming (unless you go into labor before this date)
- If you have other children, it makes planning for babysitting easier
- You can tell friends and family when baby is coming so they don’t keep asking
- You have a set date in your head to prepare for
- Usually a more relaxed and calm experience
- The feeling of urgency isn’t a factor when it is scheduled versus unplanned. Everyone in the room is usually calmer and it can feel less chaotic in the OR room
- More control over birth options
- You have time to ask for all the birth options you are wanting: such as skin to skin, delayed cord clamping, or maybe having a birth playlist playing in the OR. You can research and ask your providers prior to the surgery as well as when you check in to remind everyone of what you are wanting.
- You can sometimes choose the provider who will be doing the surgery
- Fully rested (as much as you can be at 39 weeks)
- You get a full night of rest prior to the surgery, if sleep isn’t an issue for you during pregnancy, so you go into caring for your baby and recovery well rested!
- Recovery is usually easier versus having a unplanned c-section after laboring
Questions to Ask
Questions to help you prepare for your Scheduled C-section:
- Who will be performing the surgery? You can request the surgeon usually and the date!
- Anesthesia method? Usually it is a spinal, but some may offer a spinal epidural option
- What type of drape will you have? Your hospital may have clear drapes for you to see baby being born, or have regular drapes with a window they can pull down, or a regular drape they will pull down during the surgery for you to see baby
- Can I do skin to skin in the OR, and what does that look like? Skin to skin may be immediate or it will be after the pediatrician sees baby. Some hospitals are doing immediate where you would pull the baby to your own chest.
- Can you do delayed cord clamping? and for how long? More Hospitals are doing delayed cord clamping for 30-60 seconds on babies now!
- Where will baby go after birth? Do they stay in the OR room or go to a recovery area? This can be helpful to plan for support. If baby does not stay in the room with you, maybe you can have someone to either go with baby while your partner stay with you in the OR, or you can have your partner go with baby and someone else switches out to support you.
- Will baby be in the recovery room with me? If they will not be in the recovery room, can you pump while in recovery if choosing to breastfeed
- What method will they use to close the incision (if important to you)? Some providers will use sutures, staples, or surgical glue.
- Options during the surgery? Can you play your own music/playlist
Conclusion
Having a scheduled c-section can be a great options, and sometimes the only option. It can be helpful to know what to expect going into it, especially if you are a planner!