How a Cesarean is Performed

When you find out that you're going to be having a planned c-section, you feel a lot of different emotions. I remember very well being told by my doctor that I'd need to have a planned cesarean after having two unmedicated vaginal births. I was freaking out! It got me thinking that if I'm a nurse and I wondered how a cesarean is performed, maybe you wonder too.


In my free class, I'll teach you what you should pack for the hospital, how to make a cesarean birth plan and how to start planning for your recovery!

The good news is that since my first cesarean twenty years ago, I've spent most of my career teaching and supporting women like you to feel prepared for their c-section, do let's go!

How is a cesarean performed?

The nice thing about a planned c-section is that you've got time to prepare for the operating room environment. It can be cold, loud and busy but if you know all of that ahead of time you'll understand that it's normal. A lot of my patients who hadn't prepared by taking a prenatal class specifically about cesarean were anxious.

Why is the operating room so cold?

The operating room is kept cold on purpose to discourage the growth of bacteria. Bacteria loves a warm environment, so keeping the surgical suites cold means we're trying to keep you safe from a life-threatening infection. A lot of nurses will bring a blanket from the blanket warmer to make the experience better for you.

Why is the operating room so loud?

 You may notice that operating room is echoing with voices and it's true! We've gotta blame it on bacteria again: we keep very little equipment in the room because any surface can carry the potential of bacteria. So that's why the room feels so....not cozy.

When you have a c-section, there's a good chance that there'll be six or seven health professionals in the room with you and when we start talking in that hollow room it sounds loud.

Finally, with all of the monitors beeping, instruments clanging and other equipment in the room it can be overwhelming. 

Why is the operating room so busy?

Remember how I told you that there'd be about six or seven health professionals in the room when your c-section is performed? Everyone there has a specific job to keep you and your baby safe and healthy. If you're having more than one baby, there may even be more people in the room with you!

There's a lot of activity among operating room staff and they do it all while staying sterile to limit the risk of infections. Anyone who works in the operating room has had to take extra education and certification to be in there (like me!).


Step 1) The spinal medication

There's a good chance that you'll have a spinal for your planned c-section. This allows you to remain awake for your baby's birth, but you'll be frozen from the breasts to your toes.

In the operating room, the anaesthetist will place the medication in your lower back as you sit on the side of a narrow table, with the nurse giving you a big hug from the front. Once the spinal is placed, you'll feel it working quickly so you'll be laid back on the table with everyone's help.

At this point, you'll probably get a warm blanket.


Step 2) Preparing you for your cesarean

Once you're safely laying on the table, your doctor will place a catheter in your urethra to catch your urine in a bag for the next 24 hours. This is because you won't be able to walk to the bathroom for some hours, and don't worry- you won't feel it because you'll be frozen. You probably won't even notice that it's even happening!

Once the catheter's in place, your doctor will wash your tummy with a really strong cleaner and then place sterile drapes around the area that your baby will born from. This is because- you guessed it!- bacteria. Bacteria that lives on your skin can cause infections if it gets into the incision, so we do everything possible to stop that from happening. Unfortunately, some hospitals still don't have clear drapes that you can see your baby's birth through.

While this is all happening, you may hear nurses counting sponges- this is to make sure we know exactly how many sponges were used at the end of the surgery, to make sure none where left inside of you. We count a lot during surgery!

Once you've been cleaned and draped your doctor will wash his hands with a sterile solution and put on a gown. This is when your birth partner can come into the room. 

From the time you walked into the operating room until now, it's been about 15 minutes.


Step 3) Performing your cesarean

It's go-time! All of the preparations are complete and it's time for the doctor to make incisions through several layers of your skin and tissues. Before they start the surgery, they'll pinch your tummy to make sure you don't feel anything.

Just another 15 minutes or so, until you meet your newborn! Once you reach this stage, you may feel:

  • relaxed and ready
  • anxious
  • sleepy from the medications

When the doctor is ready to deliver the baby through the incision you may feel:

  • pressure
  • tugging
  • pulling
  • pushing

This can all make you feel shaky, nauseous and even short of breath. If you're feeling any of these things during your cesarean, it's important to let the anaesthetist know. 

After the baby is born, all of the fluid is suctioned away and the doctor starts the work of stitching all of those layers back up with dissolvable stitches. While they're doing that, you and your partner will probably be holding your new baby and getting to know one another. At the skin layer, you'll probably receive staples or glue to close the c section scar and a dressing will be placed over it.

You'll go back to your room and continue to be monitored there while you bond with your fresh newborn.

Now that you know how a cesarean is performed, you can focus your attention on preparing your mind and body for your birth and recovery! Not sure how?

Take my free course to learn my insider tips for rocking your cesarean 

> Book a call with me to learn how I can be your very own cesarean birth coach and give you private prenatal classes, so you can feel prepared for your birth, rather than like a helpless bystander. 

> Read some of my articles about cesarean on the MamaSoup Blog

Good luck and I hope you learned enough about how a cesarean is performed to help ease your anxiety so you can have a positive birth experience!

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Joanne Ilaqua - CEO of MamaSoup

Hey there, I’m Joanne.

I’ve spent about 20 years serving women as a nurse, doula and Lamaze educator. I have 4 kids and I know firsthand how lonely and isolating motherhood can be, so I created MamaSoup. I'm mostly known for my love of red wine, spontaneously singing and my confidence in being my true self on social media. When I’m not busy building women up, you can catch me taking Instagram stories of my bulldog Ruby, watching The Handmaid’s Tale, playing MUber (Mom Uber) to my kids or vacationing in my favourite town: Cabo San Lucas, Mexico.

I love serving the world by providing a space for moms to connect and support each other. In my opinion, moms are the backbone of communities because they are (literally) raising the future!

As the founder and CEO of MamaSoup, I’ve been featured on CHEX TV Morning Show, KawarthaNOW, Economic Development- The City of Kawartha Lakes and MyKawartha.

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