Planned or elective caesarean

What is a planned or elective caesarean?

A caesarean section (C-section) is an operation where your baby is born through a cut on your abdomen (tummy) and uterus (womb).

Caesarean sections may be planned before the birth. This is known as an elective caesarean. In some cases, you may prefer an elective caesarean, or your doctor may recommend a caesarean section before you go into labour.

Why have a planned caesarean?

Your doctor might recommend a planned or elective caesarean section for the following reasons:

• you have already had multiple caesarean sections
• your baby is breech (presenting bottom first) or transverse (lying sideways)
• you are carrying a twin pregnancy and the first twin is breech
• your placenta covers all or part of your cervix (the opening to the uterus) - this is called placenta praevia
• you or your baby have other medical problems

You may prefer a caesarean section to a vaginal birth for non-medical reasons. This decision has risks and benefits for you, your baby and future pregnancies.

A caesarean section is considered a major surgery. Complications are rare but can be serious, so it’s important to make an informed decision. You have a right to make a shared decision with your doctor after discussing your preferences as well as the risks and benefits of the options.

How do I prepare for a planned caesarean?

Your doctor or midwife will arrange any tests and medical reviews that you need before your surgery. Your doctor will explain the operation and its risks to you. Your health team will ask you to sign a consent form for the operation.

The timing of your caesarean birth will depend on your health, your baby’s health and the caesarean team’s schedule. Where possible, you will have your planned caesarean section at 39 weeks or later. If there are problems in your pregnancy or if you are having multiple babies (for example, twins, triplets or more), you may have your caesarean earlier.

Your doctor will discuss the most appropriate anaesthetic for your situation (for example, epidural or general anaesthetic) and also explain the risks and benefits so that you can make an informed decision.

Remember to take a bag for your stay in hospital, with all the things you and your baby may need. If you would like to record the birth, ask your doctor if it is okay for your partner or support person to bring a camera or use their phone to take photos or videos.

What will happen before a caesarean?

You will need to stop eating and drinking 6 hours before the operation.

Before the surgery, your pubic hair may be shaved and your tummy will need to 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 prepare for the anaesthetic. Most people who have an elective caesarean will choose an epidural or spinal anaesthetic.

You will have intravenous (IV) lines put into your arm to give you fluids and medicines. A doctor will place a catheter (a thin flexible tube) into your bladder so your urine can drain freely. Once you can sit, get out of bed and walk, your health team will take the catheter out.

Can I have my support person with me?

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

If you need to have a general anaesthetic your partner will not be in the operating room. You will be unconscious during surgery, so you won’t be aware, move or feel pain.

What happens during and after a caesarean?

A screen is usually hung across your chest so you cannot see what is happening in the operation. Some doctors now offer a ‘maternal assisted caesarean section’ so you can be more involved with your baby’s birth. This is under the guidance of the doctor and means that the screen is removed so you see what is happening for part of the operation.

Your partner or support person can usually be with you during your planned caesarean birth. You will also usually have a midwife who stays with you. They will look after you and your baby in the operating theatre and recovery area.

If your baby is well, you or your partner or support person can hold them straight after the birth. Skin to skin contact keeps the baby warm and helps with bonding.

If you are choosing to breastfeed, your midwife may be able to help you to do so once you are in the recovery room.

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

What happens to my baby during a caesarean section?

After your baby is born the doctor will hand them to the midwife or paediatrician who will dry your baby from the amniotic fluid and check them.

If they are well, you will be able to hold your baby skin-to-skin while you are still in the operating room. If your baby is having trouble breathing or there are any other concerns, then the paediatrician will care for them in the operating room.

What happens if I go into labour first?

About 1 in 10 females whose planned caesareans are scheduled for 39 weeks will go into labour before their operation. If this happens, you will have an emergency rather than a planned caesarean.

Call your hospital's maternity unit or delivery suite immediately if you are booked to have a planned caesarean and you go into labour.

Who can I speak to if I am not happy with my healthcare?

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. Often, you can resolve your concerns by discussing directly with the people at the hospital where you received care.

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.

Resources and support

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.

Read more on recovery from caesarean birth, and how to care for yourself when you go home on the Mater Mother’s Hospital information page on caesarean birth.