What is a planned or elective caesarean?

A caesarean section (C-section) is an operation to deliver a baby through a cut in your tummy.

Caesarean sections may be planned before the birth. This is known as an elective caesarean. This may happen if there are pregnancy complications that prevent your baby being born by vaginal birth. In some cases, an elective caesarean is requested by the mother.

There are some important things to think about if you plan to or want to have a caesarean.

Why have a planned caesarean?

About 3 out of every 5 caesarean births in Australia are planned (elective).

Sometimes health problems or pregnancy complications mean that a caesarean birth would be safer than a vaginal birth.

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

• you have already had one or more caesarean sections
• your baby is in an abnormal position (such as bottom or feet first, or lying sideways)
• you are carrying more than one baby (for example, a twin pregnancy)
• your placenta is covering all or part the cervix (the opening to the uterus) - this is called placenta praevia
• you have a health problem, such as a heart problem, high blood pressure or fibroids (growths in the uterus)
• you have an infection that could be passed to your baby during a vaginal birth
• you or your baby have other medical complications

Some women may prefer a caesarean section to a vaginal birth for non-medical reasons. There are some risks and benefits to this decision for both mother and baby. It can also affect future pregnancies.

You have a right to be involved in making decisions about the type of birth you will have. If you are having a planned caesarean section, talk with your doctor about the risks and benefits.

A caesarean section is major surgery. Complications are rare but can be serious. It is important to make an informed decision. So, make sure you ask questions and discuss concerns with your doctor and midwife.

How do I prepare for a planned caesarean?

Your doctor or midwife will arrange any tests and medical reviews that may be needed before your surgery. You will be asked 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, planned caesarean sections are often done at around 39 weeks. If there are problems or if you are having multiple babies (for example, twins), your caesarean may be done earlier than this.

Remember to take a bag for your stay in hospital, containing the things you and your baby will need. If you would like to take photos of the birth, ask your doctor whether it is OK for your partner or support person to bring a camera.

What will happen before a caesarean?

You will need to stop eating and drinking for about 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. You will be fitted with compression stockings on your legs. These help to reduce the risk of blood clots in your legs.

You will then be prepared for the anaesthetic. Many women having an elective caesarean will have an epidural anaesthetic or spinal block.

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. This will likely be removed once sensation returns to your legs and you can sit out of bed and walk.

What happens during and after a caesarean?

A screen is usually put across your chest so you cannot see what is happening. Some doctors now offer a ‘maternal assisted caesarean section’ so mothers can help deliver their baby. This is under the guidance of the doctor and is not always possible.

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

If your baby is well, it is a good idea for you or your partner or support person to hold them straight away 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 assist you to do so once 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 if I go into labour first?

About 1 in 10 women whose planned caesareans are scheduled for 39 weeks will go into labour first. That means their waters break or their contractions start. 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.