Welcome to the operating room! Do not expect to see something like a “movie” setting with a lot of noisy devices, tubes, tools and exchange of dramatic lines in a formal environment!
Once you are given the anaesthesia and you are placed on the operating table, your legs will be fixed to the table with a belt and the table will be tilted slightly to the left. This is done in order to avoid compression of some veins and to prevent you from nausea; fixing of your legs ensures that your legs will not fall off the table while you are lying in this position. After the baby has been taken out, the table will be fixed back in a horizontal position and the surgery will be completed.
Your abdomen will be thoroughly disinfected – two or three times, depending on the solution applied, and your body will be covered with sterile operating linen. The lower end of the operating linen will be lifted or a special stand (screen) will be used to make sure that you do not have direct visibility to the surgical sterile field. Reflector lights do not allow mirror reflection of the operation!
Anesthesia has already started to take effect and now you do not have sensitivity and your body in numb from your diaphragm down to your toes. Do not worry that the operation will start before the anesthesia “has started to work”– the anesthesiologist and the surgeon will make all necessary tests to see if the anesthesia is working properly. The anesthesiologist and the midwife will be by your side, so if you have any questions or complaints you may refer to them. Your face will be covered by an oxygen mask to help oxygen better saturate in your blood (the baby’s blood, correspondingly). Oxygen has no smell – if there is some, it may be due to the treatment of the oxygen mask with a disinfectant.
Usually, surgery delivery is performed under regional anesthesia; however, in some particular cases we can use general anesthesia. Regional anesthesia makes you feel no pain and dulls your sensitivity in the surgery area; the feeling is similar to a touch, pressure and some pulling, but not pain. Except in some rare cases, requiring the use of general anesthesia, during your Cesarean section you will be conscious and able to hear all the conversations of the operating team and the sounds of the medical instruments, as well as to talk to the anesthesiologist who will be constantly taking care for you.
You will be able to hear the first cry of your baby! However, do not necessarily expect to hear a loud baby’s cry. Some newborns do cry as if they want the whole world to hear and see that they were born, other newborns just cry quietly and start to breathe normally.
In the past, Caesarean section was performed with a long vertical incision, starting from the woman’s navel and down to her pubic bone. Now, this technique is applied only in some special cases and the usual practice is much more discreet – the incision is made in the lower part of the abdomen, a bit below the bikini-line, exactly where we expect your baby’s head to be positioned.
Normally, the muscles of the anterior abdominal wall are not cut through; instead, they are pulled away and later restored with a few minor stitches to their usual position. The baby is taken out from the mother’s uterus with little effort, i.e. the process is highly similar to a normal labour and the baby’s passing through the natural birth routes.
Childbirth happens in the beginning of the operation – around the 5thminute. What happens then with the baby and when you will see your baby? We will tell you in a while. Now a few words about what happens during all these “long minutes” while you are still lying on the operating table. After the childbirth the placenta also needs to be “born”- to be taken out – it has already fulfilled its functions in the uterus. In a normal delivery, due to the hormone oxytocin, the placental separation from the uterus walls happens naturally within a few minutes after the delivery. When a Caesarean section is performed, this process is simulated by the surgeon with the use of a small dose of oxytocin, in the form of intravenous application, which stimulates the easier and complete separation of the placenta.
After removal of the placenta and cleansing of uterine cavity all the tissue layers are restored one by one. Sometimes, this procedure takes time – in cases of some bleeding, old adhesions that cause complications during removal of cysts, small myomas, etc. We know how impatient you are to leave the operating room, but the careful performance of this stage of the surgery is a key factor for your normal post-surgery recovery, as well as for the normal course of your next pregnancy. An aesthetic seam is not always possible – sometimes single layer sutures are preferable for better wound drainage.
At that time your relatives may already have become acquainted with your baby and should be awaiting the final stage of the surgery.