A cesarean section surgery is an operation used to deliver a baby through an incision made in the mother's abdomen and uterus. It may be planned in advance or may become necessary during labor if a vaginal birth is not considered safe for the mother or baby. A planned cesarean is commonly scheduled around the 39th week when there is no medical reason to deliver earlier.
This guide explains what you can expect before delivery, including the reasons for a cesarean, pre-surgery appointments, tests, food and drink restrictions, anesthesia, hospital preparation, and important questions to ask your healthcare team.
What Is a Cesarean Section?
A cesarean section, also called a C-section, is a surgical method of delivering a baby. Instead of the baby passing through the birth canal, the doctor makes an opening through the abdomen and uterus and delivers the baby through this opening.
Cesarean delivery can be planned before labor begins, or it can be performed urgently when an unexpected problem develops during pregnancy or labor.
Although cesarean birth is a common procedure, it is still major abdominal surgery. Because of this, your healthcare team will carefully assess your health and your baby's condition before deciding whether it is the safest delivery option.
During a planned procedure, you will usually have time to meet the medical team, complete pre-operative checks, discuss anesthesia, and receive instructions about preparing for the day of delivery.
Why Might a Cesarean Be Recommended?
There are many possible reasons why a cesarean may be recommended. The decision depends on your pregnancy, your medical history, the baby's position, and other factors.
Some common reasons include:
Baby Is in a Breech Position
Normally, most babies move into a head-down position before delivery. If the baby remains feet-first or bottom-first, called a breech position, a cesarean may sometimes be recommended.
Your doctor may discuss other options depending on your individual situation.
Placenta Problems
A low-lying placenta or placenta previa can sometimes block the baby's path through the vagina. In such cases, a cesarean may be the safest way to deliver the baby.
Certain Pregnancy Complications
Conditions such as pre-eclampsia or other pregnancy-related problems may make vaginal delivery less safe.
Previous Cesarean Delivery
Having had a previous C-section does not automatically mean that every future baby must be delivered by C-section. Depending on your health and previous surgery, your doctor may discuss vaginal birth after cesarean or another planned cesarean.
Problems During Labor
Sometimes a cesarean becomes necessary after labor has already started. This can happen if labor is not progressing, the baby's heart rate shows signs of concern, or another complication develops.
The exact reason for a cesarean should always be discussed with your obstetric team.
Planned vs Emergency Cesarean
It is useful to understand the difference between a planned and emergency cesarean.
A planned cesarean is arranged before labor begins. You are usually given a date and instructions about when to arrive at the hospital. You have time to complete pre-operative tests and discuss the procedure with your medical team.
An emergency cesarean is performed when a problem develops that requires the baby to be delivered quickly or when continuing with vaginal delivery becomes unsafe.
Emergency does not always mean that the situation is immediately life-threatening. It means the medical team believes a cesarean is needed sooner than originally planned.
For a planned procedure, preparation can make the experience easier because you already know what to expect.
What Happens at the Pre-Operative Appointment?
Before a planned cesarean, you will normally have a pre-operative or pre-assessment appointment. The exact timing and tests can vary between hospitals and according to your health.
During this appointment, your healthcare team may ask about your medical history, allergies, previous surgeries, medicines, and any problems you have experienced during pregnancy.
Blood tests are commonly performed. These may help check for problems such as anemia and establish information about your blood group. Some hospitals may also perform other tests or screening based on their local policies.
This appointment is also a good time to ask questions.
You can ask:
- Why is a cesarean recommended for me?
- When is my surgery planned?
- What type of anesthesia will I have?
- Can my birth partner be present?
- How long will the procedure take?
- When can I see and hold my baby?
- How will my pain be managed afterward?
- How long will I stay in the hospital?
- What should I bring with me?
- What should I do if labor starts before my scheduled date?
Writing down your questions before the appointment can help you remember them.
Discuss Your Medicines With Your Doctor
Tell your healthcare team about every medicine, vitamin, supplement, or herbal product you take.
Do not stop prescribed medicines on your own. Some medicines may need to be changed or taken at a different time before surgery, while others may be continued.
If you have conditions such as diabetes or high blood pressure, make sure your medical team knows about them. Your care plan may need to be adjusted around the time of surgery.
Also tell your doctor if you have allergies, especially allergies to medicines or anesthetic drugs.
Preparing for the Day Before Surgery
Your hospital will give you specific instructions for the day and night before your cesarean.
These instructions can include when to stop eating and drinking. The exact timing is important and may differ depending on your hospital, surgery time, medical condition, and anesthesia plan. Follow the instructions given by your healthcare team rather than using general advice from the internet.
You may also be advised to shower before coming to the hospital. Some hospitals provide specific instructions about skin preparation.
Avoid shaving or waxing the surgical area unless your healthcare team specifically tells you to do so. Some hospitals recommend avoiding shaving before planned cesarean delivery because small cuts or irritation can increase infection concerns.
What Should You Pack for the Hospital?
Preparing your hospital bag early can make the day less stressful.
You may want to pack:
- Comfortable, loose clothing
- High-waisted underwear
- Maternity pads
- Toiletries
- Slippers
- Phone and charger
- Important medical documents
- Any medicines you have been instructed to bring
- Comfortable clothes for your baby
- Baby nappies
- A suitable outfit for going home
It is also helpful to arrange transportation to and from the hospital in advance. After a cesarean, you should not plan to drive yourself home.
Your hospital may have its own rules about what you should bring, so check these instructions before your admission.
What Happens When You Arrive at the Hospital?
On the day of your planned cesarean, you will arrive at the hospital at the time given by your maternity team.
A member of staff may confirm your identity and medical details. Your temperature, pulse, breathing, and blood pressure may be checked. Your baby's heart rate may also be monitored.
You will usually change into a hospital gown.
The medical team will review your medical information and confirm the planned procedure. You may be asked the same questions more than once. This is a normal part of surgical safety and helps the team confirm important details before the procedure.
You May Have an IV Line
A small tube may be placed into a vein in your hand or arm. This is known as an intravenous or IV line.
It allows the medical team to give you fluids and medicines when needed.
Depending on your individual care plan, you may receive medicines before surgery. These can include antibiotics and medicines that help reduce certain surgical risks. Your doctor or hospital will explain which medicines you need and when to take them.
What Type of Anesthesia Is Used?
Most planned cesareans are performed using regional anesthesia, usually a spinal or epidural anesthetic. This numbs the lower part of your body while allowing you to remain awake for the birth.
This means you should not feel sharp pain during the operation, although you may notice pressure, movement, pulling, or tugging.
The anesthetist will talk with you before the procedure and explain what will happen.
In some situations, general anesthesia may be needed. With general anesthesia, you are asleep during the operation. The choice depends on your health, the circumstances of the delivery, and medical factors.
If you have concerns about anesthesia, discuss them with the anesthetist before surgery.
What Happens Before the Baby Is Delivered?
Once you are taken into the operating room, the medical team will help you get into the correct position.
A screen is usually placed so that you cannot see the surgical area.
A catheter, which is a small flexible tube, is normally inserted into the bladder. It helps keep the bladder empty during surgery and is generally removed later when you are able to move around.
The surgical area is cleaned carefully to reduce the risk of infection.
The anesthesia team will also monitor you throughout the procedure. Your blood pressure, heart rate, oxygen level, and other vital signs may be monitored continuously.
Your healthcare team will explain the steps as they happen and should be available to answer questions.
What Will You Feel During the Operation?
One common concern is whether you will feel the surgery.
With spinal or epidural anesthesia, the lower part of your body is numbed, so you should not feel the cutting itself. However, you may feel pressure, pulling, or movement while the doctors work.
Some people describe the feeling as unusual rather than painful.
If you feel pain or become uncomfortable, tell the anesthetist immediately. The team can assess the situation and provide appropriate support.
Remember that every person's experience can be different.
When Is the Baby Delivered?
Once the surgical opening has been made, the doctor delivers the baby.
The actual delivery often takes only a few minutes, although the complete operation takes longer. The NHS notes that the whole cesarean procedure commonly takes around 40 to 50 minutes, although the timing can vary.
If you and your baby are doing well, you may be able to see your baby soon after delivery. Depending on hospital practice and your condition, skin-to-skin contact and early breastfeeding may also be supported.
Your birth partner may be able to stay with you during a planned cesarean if hospital policy and your medical situation allow it.
What Happens After the Baby Is Born?
After your baby is delivered, the medical team continues working to complete the operation safely.
The uterus and abdominal incision are closed using appropriate surgical techniques. Some stitches dissolve naturally, while other types of stitches or staples may require removal later.
You will then be taken to a recovery area.
The healthcare team will continue checking your condition as you recover from the anesthesia.
You may receive pain relief and treatment to reduce the risk of blood clots. You may also be encouraged to drink and eat when it is considered safe and you feel ready.
How Long Will You Stay in the Hospital?
The length of your hospital stay depends on your health, your baby's condition, the hospital's policies, and how quickly you recover.
Many women leave the hospital around one or two days after a cesarean when there are no complications.
Before going home, your healthcare team will explain how to care for your incision, manage pain, move safely, and recognize symptoms that need medical attention.
You will also receive information about caring for your baby and feeding.
Understanding Recovery Before Your Surgery
It is helpful to understand that a cesarean is major surgery, so recovery can take longer than recovery from an uncomplicated vaginal birth.
You may have discomfort around the incision during the first days. You may also feel tired as your body recovers from pregnancy, childbirth, and surgery.
Your healthcare team may encourage gentle movement after surgery because getting mobile can be part of reducing the risk of blood clots and supporting recovery.
At home, you may need help with cooking, cleaning, shopping, lifting, and caring for other children.
Planning this support before delivery can make your recovery easier.
What Are the Possible Risks?
Like any major operation, a cesarean has possible risks. These can include infection, bleeding, blood clots, reactions to anesthesia, and injury to nearby organs. There can also be risks related to future pregnancies.
However, your individual risk depends on many factors, including your health, the reason for the cesarean, whether the procedure is planned or urgent, and whether you have had previous abdominal surgery.
Your doctor should explain the benefits and risks that apply specifically to you.
Do not hesitate to ask for clarification if something is unclear.
Warning Signs to Know After a Cesarean
Before leaving the hospital, ask your healthcare team which symptoms require urgent medical attention.
Possible warning signs can include:
- Heavy or unusual bleeding
- Increasing redness, swelling, or discharge from the incision
- Severe or worsening pain
- Fever
- Difficulty breathing
- Chest pain
- Severe swelling or pain in one leg
- Feeling very unwell
These symptoms can have different causes, and some may require urgent assessment. If you are concerned about your recovery, contact your maternity or medical team promptly.
How Can You Prepare Emotionally?
Preparing for surgery is not only about physical preparation.
It is normal to feel nervous, especially if this is your first cesarean. You may worry about anesthesia, the operation, pain, recovery, or your baby's health.
Learning about the procedure can make it feel less unfamiliar.
Talk openly with your doctor or midwife about your concerns. You can also discuss your birth preferences, such as whether you would like your partner present, whether you want to see your baby immediately if medically possible, and your feeding preferences.
Some plans may need to change if an emergency develops, but discussing your wishes in advance can help your healthcare team understand what matters to you.
Questions to Ask Before Your Cesarean
Before the day of surgery, consider asking:
- Why is a cesarean recommended in my situation?
- Is the procedure planned or could the delivery plan change?
- When should I arrive at the hospital?
- When should I stop eating and drinking?
- Which medicines should I take before surgery?
- Which medicines should I avoid?
- What type of anesthesia is recommended?
- Can my birth partner be present?
- How will my baby's condition be monitored?
- When can I hold my baby?
- When can I start breastfeeding?
- How will pain be controlled?
- How long should I expect to stay in hospital?
- What help will I need at home?
- Which symptoms should make me contact the hospital?
Having these answers before your delivery date can give you greater confidence.
Final Thoughts
A planned cesarean can feel overwhelming when you do not know what will happen. However, understanding the preparation process can make the experience easier to manage. From your pre-operative assessment and blood tests to fasting instructions, anesthesia, hospital admission, and recovery planning, each step is designed to support a safe delivery.
The exact process can differ from one hospital to another, so always follow the instructions provided by your own maternity and surgical team. If you have questions or concerns about your pregnancy or planned delivery, discuss them directly with your healthcare provider.
For women preparing for delivery, Dr. Mahsa Aghaei can provide appropriate medical guidance and help explain what to expect before a cesarean, based on each patient's individual pregnancy and health needs.
