What to Expect When You’re Expecting a Cesarean

Let me begin by saying: this is my experience. I have been blessed with smooth cesareans and zero unforeseen complications. Please know that I, in no way, disregard any mothers who have had different, more turbulent experiences. And I, in no way, want to set the expectation that this is how it will go for all mothers. We all are unique in His plan. I am thankful every day that this was my experience, and my heart is with anyone who hasn’t had the same. I see you, momma.

Sometimes cesareans are calmly planned and scheduled ahead of time. Sometimes cesareans are on-the-spot and emergent. I, myself, have experienced both. I know they can be scary, sometimes even gut-wrenching dreadful. And I know they can be the complete opposite of most mommas’ dreamy birth plan. But with my experiences, I’m here to shed some light on what to expect and hopefully ease a bit of your nerves. I promise the experience is still so beautiful!

If You’re Cesarean is Planned

If you’re cesarean is planned ahead of time, for whatever medical reason your doctor has decided, your doctor will send you home with a packet of instructions and a bottle of surgical soap. You’ll be instructed to begin fasting at least 12 hours prior to your scheduled surgery time. A lack of food may slow down your baby’s movement, so don’t panic if you feel a slight decrease. Just continue to count your kicks and if for any reason your gut tells you it’s time to worry, go straight to your nearest emergency department.

You’ll need to shower twice with the surgical soap your doctor provided. Instructions are simple: wet your body neck to toes, lather your skin with the soap, allow it to sit for 3-5 minutes, and then rinse. You’ll do this once the night before your scheduled cesarean, and once the morning of, prior to heading to the hospital. I also suggest washing your hair before your big entrance! It has typically taken me a few days to be able to comfortably raise my hands behind my head without pulling on my very sore abdomen.

The medical staff will ask you to arrive at the hospital roughly two hours prior to your surgery. When you get to the hospital, the nurses will get you stripped down to just your hospital gown and some cozy hospital socks. They’ll get baby on the heartbeat monitor, run an IV to begin fluids, and have you complete all of your forms – including the birth certificate info! Unfortunately this doesn’t take long, and much of your two-hour window is sitting around and getting hydrated before the big hoorah.

Your obstetrician should check in with you to answer any questions you may have about what’s to come. The anesthesiologist should also stop by to talk about your medical history and his plan of action for the day.

Both Planned and Emergent

When it’s time to deliver that sweet bundle in your belly, you’ll actually head back to the operating room alone. As you walk to the OR, whoever is accompanying you during the cesarean will change into scrubs and prepare for their entrance as well.

Once in the OR, you’ll climb onto the operating table. You’ll turn your back towards the doctor, and hunch your back over as far as possible with the protruding belly you’ll soon miss. The anesthesiologist will first apply numbing medication to your spine, and then the grand spinal tap needle. In my opinion, you don’t feel much of the needle. I think the nerves overcome any pain you’d normally feel. Really, the hardest part is keeping your body from shaking in order to aid the doctor’s accuracy. Rather than pain, the medication in your back will feel more like a burning, fiery sensation. Once the needle is removed and the site bandaged, the doctors will lay you down as quickly as possible.

They’ll keep the IV already placed in your arm running. They’ll add oxygen tubes, a blood pressure cuff, and a pulse monitor. The nurse will also then place a catheter in, as the spinal tap or epidural you’ll receive will block all bladder control. And a blue panel will be hung just below your neck to block your view of the doctor’s work. Slowly, you’ll lose the ability to move your legs and wiggle your toes, but your arms, your neck, and your face will remain totally in control. Before surgery begins, the doctor will check to ensure you’re completely numb.

This is when your OR partner will join you. The doctors will come in, they’ll review every surgical item placed in the operating room. You’ll hear them call out an entire lineup of numbers – this is so they can track all of the equipment that should remain in the room once surgery is over and you’re all closed up.

Then, it’s time to get that baby out! You shouldn’t feel any pain when they begin to open your belly. But they’ll warn you that you will feel tugging and pushing during the procedure. And you will. It’s a little uncomfortable. The movements make it difficult to breathe deeply, sort of like when your toddler climbs on your chest and takes a big plop down. Your face may itch and feel very warm during the procedure, which is normal. And the rush of adrenaline your body is feeling may leave you light-headed or dizzy. Over the course of my three cesareans I’ve been told by the doctors that all of these feelings are normal. But tell your team how you’re feeling so they can ensure your blood pressure and heart rate remains steady. And reassure you to stay calm!

In my experiences, all three of my babies were out of my belly within 25 minutes of the start of my surgery. In fact, getting the baby out happens quicker than the second half of the procedure.

When they pull baby out, they’ll show you your sweet babe over the blue curtain that blocks your view. And they’ll quickly take the baby over to the newborn care bed. This bed will be perfectly adjacent to your head, so baby should be fully in your view while the nurses do their part. If all is well, they’ll wrap that beautiful baby up and allow your OR partner to hold them and bring them near you. The craziest part? Your partner is allowed to take pictures of the entire experience!

The doctors will continue to work on closing you up. For me, this process has taken about 30 minutes from the time the baby is removed. Once you’re completely closed, whether you’re stapled, stitched, or glued, the doctors will let you know that all has been completed. They’ll remove the oxygen tubes and all of the connected wires. They’ll take down the blue curtain. And they’ll place baby in a wheeled bassinet for transport. Then they’ll need to move you from the operating table to a common hospital bed. Remember – the effects of your spinal tap/epidural are still heavily in place. So a team of nurses will gather around your body, all hands on deck. Collectively, they’ll lift you and move you to the bed that you will recover on until you are released to head home.

After your cesarean is completed, you and your new baby bundle will spend the first hour or two of post-op in the recovery unit. Don’t be surprised if this room is shared with other new moms and freshly delivered babies! Here they will continue to monitor your vitals, give you your first dose of pain medication, and help you care for your newborn while the grogginess of the surgical medications wear off. But most importantly, they will help you get baby latched on for the very first time for their very first feeding. This is when your partner can go update your family and friends on the status of you and baby. Family members will only be allowed to visit in pairs of two while you are in the recovery unit.

After an hour or so, you and your baby will finally be wheeled to the room in which you will stay until discharge. During the first 12 to 18 hours you’ll be in your bed, adjusting to the pain medications and regaining feeling and movement of your legs and feet. You’ll have your first meal in many many hours! And once the nurse is sure you have fully recovered from the numbness, you’ll have to make that very dreadful move: getting up.

Recovery

Over the next 48 hours, getting up and out of the bed, using the restroom, showering, and caring for your baby will be the challenges you’ll have to overcome in order to be discharged. Every few hours a nurse will come in, check baby’s feeding schedule and diaper fills. The nurse will push on your belly, checking your belly’s insides for proper healing. You’ll be asked to take few slow laps around the hospital floor to encourage some movement. And you’ll stick to a pain relief schedule. Let me be clear – beat the pain. Take your medications on schedule, even if you’re not feeling any discomfort. Because if you wait long enough, the pain of your incision turns to fire within minutes. And you can’t care for you sweet baby if you haven’t cared for yourself momma!

The pediatrician will assess baby, and hospital staff will take them for a hearing screening, their first bath, and one vaccine if you choose.

Postpartum will begin, family and friends will visit, and you momma, will have accomplished the greatest thing you may just ever do.

The entire experience is one huge whirlwind. You’ll feel nervous and afraid, you’ll feel strong and victorious. You’ll hurt, you’ll love, and at moments you won’t feel anything at all. You’ll feel tired, but also so lively. You’ll struggle. But most of all, you’ll overcome. Because that’s what moms do – both rookies and veterans!