Caesarian Section

What needs to be done quickly when you come to theatre for an unplanned (non-elective) caesarian operation.

If you are having a planned (elective) Caesarian the same things are done but in a much more leisurely manner

If it is unplanned it may all may seem overwhelming to you, with people milling about, but this is what is happening (not necessarily in this order).

While all of this is happening to you, other people are getting other things ready. The person who will be passing instruments and equipment to the surgeon is setting out on trolleys everything likely to be needed, so that it is ready to hand. They count and check with another person how many instruments, swabs, stitches they have, so that during the operation they can keep track, and ensure that you don't leave theatre with more than you came in with! These two people may just seem to be chatting, but they are counting out loud to each other.

The paediatrician (baby doctor) will come in, prepare and check the resuscitation equipment, in case your baby needs help after it is born.

We use suction equipment during the operation and check it before we start. This makes a hissing noise.

There is a lot to be done, if it has all to be done quickly, it must seem like everyone is scurrying around in a chaotic fashion. But it is organised chaos, and very necessary. We do check and cross check, that it is all done before we start.

In addition to all this, at least four people will be "scrubbing up" and putting on sterile clothes. They will be:

  1. The person in charge of the instruments as mentioned previously, she or he will have scrubbed up first, and everybody else has to avoid touching this person as they move around.
  2. The surgeon
  3. Another doctor or midwife to assist the surgeon
  4. The midwife who will take the baby to the paediatician, and assist with the resuscitation of the baby if necessary.

Other people who may be in theatre

Even though birth by Caesarian Section is not without risks and is marginally not as safe as a normal birth, everything that is being done to and for you is being done to make the operative birth of your baby as safe for you and your baby as possible.

If you are having an epidural or spinal anaesthetic the anaesthetist will check very carefully that you will not feel any pain during the operation, though it will be explained that you will feel the movements of the baby being delivered through the incision in your abdomen. Many anaesthetists check the effectiveness of the numbness of your abdomen by rubbing a block of ice over your abdomen and possibly your breasts. Research has shown that the ice is a better method of ascertaining a complete numbness that using a pinprick. The anaesthetist will explain exactly what s/he is doing and that if you have chosen an epidural or spinal anaesthetic it is very occasionally necessary to give you a general anaesthetic i.e. put you to sleep. Please do not hesitate to ask the anaesthetist or surgeon any questions you wish.

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