C-Section Births: What to Expect & Practical Suggestions

I hope this feels a helpful article to read, there is so much information and options available to you. I am not a medical professional, I do not give medical advice or tell you what you should or shouldn’t do. I want you to feel empowered to make your own choices and decisions that feel right for your family and to be aware of the options available. I want you to trust your instincts and be led by them, to feel supported and informed. You are the expert of your baby and your body. This article has been written based on experiences that I have witnessed and supported. Every birth experience is unique and if you’d like to share your experience with me I can add more information to evolve this in to a helpful guide for other mothers.

I never intended this to be so lengthy!!

Before Theatre:

For a planned Caesarean Section at East Surrey Hospital you’ll arrive and prepare for surgery on the Ante Natal Day Unit (ANDU): Rusper. You can find this on the hospital’s virtual tour so you can see what to expect.

This part of your journey can feel really long, you are not permitted to eat or drink. There’s sometimes a lot of waiting around. Whilst waiting with families I support, I like to offer a gentle foot massage for swollen ankles or a distracting game of uno and to make sure Dad has the opportunity to eat something in the Three Arches Restaurant whilst I stay with the birthing person.

If you can, now is a good time to express 3-5ml colostrum for baby’s first feed, so their sterile gut isn’t disrupted by the preventative IV antibiotics you receive.

It’s also important to be prepared, that for planned surgical births, emergency situations may take priority, this could mean you end up waiting all day or even asked to come back the following day. This can of course feel very disappointing.

Once the team are ready for you, with little notice it can suddenly feel a rush to get you in to theatre. You can ask for a couple of minutes to slow things down. Take a moment to pause, and take 3 deep breaths; you’re going to meet your baby very soon.

You will be asked to sign a document giving your consent.

The hospital provide scrubs and crocs to birth partners (the shoes are typically the wrong size and rarely a pair, so you may want to purchase a new pair ahead of time). Partners typically remove all clothing down to underwear and put the scrubs over the top.

Remove all clothing, jewellery and you will be given a surgical gown to wear. if you put one on like a coat and a second to cover your front this makes it easier to expose your chest for immediate skin to skin contact.

All your belongings are moved to the maternity recovery area.

What to take to theatre:

-a nappy,

-a hat for baby,

-a camera,

-90 minute playlist,

-a few drops of your a relaxing essential oil on a cloth

A cannula will be fitted in to your non-dominant hand and a catheter inserted to drain urine from bladder, you can ask for this to be done privately and discreetly. You deserve to be treated with dignity.

In Theatre

Having the courage to advocate for yourself is vital when it comes to a positive birth experience. Knowing what you want and asking for it makes you feel in control. The many women who experience birth trauma report that they didn’t feel heard, supported, respected or felt out of control and that decisions were being made without their input.

YOU ARE THE MOST IMPORTANT PERSON IN THE ROOM.

Make this experience your own by considering the following:

• Atmosphere: ask for lights to be dimmed, for a special playlist to be played, ask for talking to be kept to a minimum; this is the start of your baby’s life, their very first moment on earth, it doesn’t have to be to the soundtrack of the anaesthetist discussing last night’s episode of Traitors. Stay in control by voicing what you want.

• Visuals: do you want the drapes lowered, a grounding photo to connect with, an affirmation to remind you of your strength, you can ask for someone to capture photos or a video that you can watch when you feel ready.

• Bonding; you can request immediate skin to skin contact.

• Medical Procedures; you can request delayed cord clamping, typically for at least 30 seconds –2 minutes, is safe and beneficial for most newborns, increasing iron stores and reducing anemia risk. Umbilical cord milking (UCM) is a technique where the cord is gently squeezed towards the baby after birth to rapidly transfer extra blood, oxygen, and stem cells from the placenta, acting as a faster version of delayed cord clamping (DCC) though some studies show increased risk of brain bleeds. You can also request a lotus birth where the placenta is left attached to the baby and left to detach on baby’s terms. Baby’s first breath signal’s their start of their Independent journey away from their mother.

• Active Involvement; can they talk through what’s happening

• Support: there may feel a lot of people in the room; at least two doctors, including a consultant or registrar to perform the surgery, the anaesthetist and nurse, your midwife, a paediatrician, theatre nurse, your partner, yourself and last to arrive….your baby. With your permission there may also be medical students present.

At the time of writing this, I’m yet to support a c-section birth in person, as typically it’s only one partner permitted in the theatre alongside you (I would absolutely love to witness the birth of a baby so if you’re looking for a birth partner for your caesarean birth please hit the contact button!). You can decline students being present and ask for a second supporter instead.

Post Operative:

After surgery you will be moved to the maternity recovery area, where you will typically remain for an hour or two whilst being closely monitored. Baby will need feeding and need to have skin to skin on your naked chest for the next 72 hours. They’ll likely do a meconium poo at this time, so will need their first nappy change. Baby will be weighed, but you can ask for this to be delayed if skin to skin and feeding is a higher priority for you.

When your baby is weighed, take a photo of baby on the scales. This can be useful for tracking baby’s growth and mistakes have been made in the past when transcribing this data on to your notes that cause lots of unnecessary stress and worry.

Your baby will also be offered vitamin K for a rare disorder, this can be done in a single dose injection or oral drops. You have the option to accept or decline the offering by understanding and making your own informed decision.

-Chew gum to awaken the bowel after surgery (not available in the shops at East Surrey Hospital as it’s a gum-free hospital)

If planning to breastfeed:

-Ask for support from the midwives to give your expressed colostrum before latching for baby’s first feed.

-Immediately after birth your body needs nipple stimulation & your baby needs your body to regulate their temperature, breathing, heartbeat and to access colostrum from your breasts.

Some women may need to be moved to the high dependancy unit (HDU) where you will be continuously monitored. These two bays have a pull out bed for partners to be able stay with your more comfortably.

If your baby is unwell, they may be admitted to the neonatal unit (NICU) for special care, this can be a very difficult and distressing time to manage. My hope is that after reading this article you booked an initial chat and know that gentle doula support is available to help you at this time. The current set up at the hospital is that your bed is on Olive Bay on the Burstow Ward, for mothers who don’t have their baby with them but you have access at any time to see your baby for connection, feeding and monitoring.

The Postnatal Ward: Burstow Ward

Private rooms are available for a fee but cannot be booked in advance.

You will be frequently told to “get some rest” which for most is frankly impossible. The first 24 hours are the longest hours of your life that fly by in minutes! You’re now on a cycle of every 3 hours feeding and resettling, observations, interruptions and pain management.

Tips:

-Ask for the Infant Feeding Team.

-Tie a dressing gown belt to the end of the bed to assist in sitting up.

-Arrange for an overnight supporter for advocacy and support.

-Use your call bell!! Midwives are busy people and may need reminding that you asked for pain relief an hour ago! Don’t be afraid to “be a bother”

-Focus on warm, soft, nutritious & easily-digestible food.

-Book a cranial osteopath

-If separated from your baby, request a breast pump to stimulate your breasts to make milk. This is vital for your long term breastmilk production.

If formula feeding, there are no facilities to make up formula or wash and sterilise equipment. It’s best to buy the ready made formula and decant it in to the sterifeed bottles & teats which are available on the ward. Initial feeds will be 30–60 ml (1–2 oz) of formula every 2–3 hours, there is a fridge to store opened bottles of formula or expressed milk. Always label them.

Once opened, ready made formula is usually good for up to 48 hours in the fridge. At room temperature it’s good for 2 hours. Once a feed has started discard any leftover formula in the bottle once within 1 hour, as bacteria can grow.

Once you’re mobile and able to walk you will be able to have your catheter removed. Disposable underwear is so useful at this time. For your first visit to the toilet place a container in the toilet bowl, so it can be recorded how much you passed.

The cannula in your hand is annoying and uncomfortable and will be removed once the medical team are happy that you are stable and confidence that you won’t require IV medication.

Stronger pain relief options are available if you’re struggling with pain. You will be discharged once you feel you’re able to manage the pain at home with paracetemol and ibruprofen.

Someone should also come round to perform a hearing test on baby. It’s not uncommon for baby’s to fail this due to fluid in their ears from birth and you’ll be invited to a follow up appointment in a few weeks.

Newborn jaundice is a very common, usually harmless condition causing yellowing of the skin and eyes in newborns due to high bilirubin levels, typically appearing 2–3 days after birth and resolving within 2 weeks. It arises because a baby’s developing liver cannot yet efficiently process broken-down red blood cells. While often harmless, it requires medical attention if it appears within 24 hours, persists, or reaches high levels, requiring treatment like phototherapy. Constant breastfeeding and exposure to sunlight also helps baby flush out those excess cells.

Packing the bag

Do not under estimate the importance of your partner’s comfort. To be able to support you properly they need food and sleep. A neck pillow, comfy clothing, toothbrush. If you partner is snoring, they will be asked to go home!

A notepad and pen are two of the most important tools I have in my bag when supporting new mothers on the postnatal ward overnight. You will be interrupted a lot and bombarded with questions that make you feel like a rabbit caught in headlights! Your brain likely won’t have the capacity to feel in control - this isn’t because you’re doing it wrong, it’s because biologically after birth your brain PHYSICALLY changes to ensure all your attention is focused on your baby.

-which breast did i last feed from?

-what time did I open this bottle of formula?

-when did I last pee?

-have you done your menu choices?

-when will I be due more pain relief?

-how many dirty/wet nappies have there been?

You will get asked a lot of questions, at a time when I you should be able to just be connecting with your baby, landing from the experience of birth.

An eyemask, earplugs, a nice essential oils scent, a bendy straw, fairy lights. Consider all of your senses, you need to boost your oxytocin so everything around you needs to give you “ahhhhh” vibes. Your temperature can be difficult to maintain so a cosy blanket, hot water, face cloths and fan are all useful tools to have on hand.

It’s a lot to manage by yourself. As an overnight supporter of women staying in hospital on that first night with your baby, it’s hugely humbling for me to be able to block out all of the noise around you and protect your space. To slow things down and to advocate for your needs.

Transitioning to Home

You may feel desperate to get back to your home comforts and it can be difficult to appreciate the ease of the adjustable hospital bed, the available feeding support, accessibility to stronger pain relief when you’re feeling unsettled in a ward that’s noisy, unfamiliar where you’re frequently disturbed. I get it!

Allow yourself more time to do things when you’re at home, such as getting to the toilet. You’ll still be on a 2-3 hour cycle of meeting your baby’s needs whilst trying to recover yourself. Take it slow and learn to welcome any help that’s offered. Having a postnatal plan to manage food, support, household needs and visitors is incredibly useful and something I often help families to consider.

After the constant midwifery care throughout pregnancy it can sometimes feel like you’re just being left. Having a doula ensures you have a familiar supporter providing a continuity of care throughout pregnancy, birth in to your postnatal period for as long as you feel necessary. As a postnatal doula I typically support families up until baby’s first birthday or as soon as mum feel ready.

Phew! That must be a lot to take in, it was a lot to write, and not how I first intended this blog post to be. If you have any questions or comments please get in touch.