Pregnancy and birth are unpredictable. It is useful to think about your birth preferences but you can change your decision at any time. You may want to keep an open mind, or go-with-the-flow. If a caesarean is planned but labour begins on its own, you should contact your maternity unit.

Consent for your caesarean birth: • This may take place in person or over the phone. • You will be asked to sign a consent. • This is a good opportunity to ask questions you may have. Pre-operation assessment: This may be an appointment or happen at the time of booking your operation, depending on the hospital policy. We will usually: • Measure your blood pressure. • Take some blood tests. • Check your general health and pregnancy. • You may be given antacid tablet to take the night before your caesarean. When to stop eating and drinking before your operation: • You will be given a time to stop eating and drinking before your operation because having food in your stomach carries a small risk of it going into your lungs and causing an infection if a general anaesthetic is needed. • You may be given a sugary drink to have before your operation. On the day: • You will usually be seen by the obstetric and anaesthetic doctors to check your consent and anaesthetic. • You may be given some antacid medication to take. • You will be asked to change into a surgical gown, given some tight socks (TEDs) and perhaps a cap. • Your birth partner may be asked to change into a theatre outfit. Click 'Read more' for further information about preparing for your caesarean birth. This information will be most useful to women having a planned caesarean birth. The process for unplanned and emergency caesareans includes most of these steps but will happen within 72 hours for an unplanned caesarean or 30 minutes for an emergency caesarean.

Typically, a caesarean birth takes about 60 minutes, but it varies according to the complexity of the operation. There are steps taken, the timing of each varies according to if the caesarean is planned, unplanned or an emergency. The steps are usually the following: 1. Confirmation of consent 2. Taking bloods 3. Preparation for surgery 4. Before the operation starts 5. The surgical procedure 6. Managing bleeding 7. Post-surgery

There are two options for anaesthesia during a caesarean birth. Regional and General Anaesthesia. Regional anaesthesia: Regional anaesthesia involves an injection into your back so you are numb from the belly down and are awake for your birth. Types of regional anaesthesia and procedure: Spinal anaesthesia: The most common method for caesarean births. An anaesthetic is injected into your back. Epidural anaesthesia: A thin tube is placed near the nerves in your back to deliver a local anaesthetic. It is often used during labour but can be used for a caesarean. Benefits of regional anaesthesia: • Safer for you and your baby. • You can share your birth experience with your partner. • Less sickness and vomiting. • Your baby is usually more alert at birth. Potential side effects: • Low blood pressure, dizziness, sickness/vomiting and shivering. • Severe headaches are uncommon, about 1 in 200 women. • Permanent nerve damage is very rare, approximately 1 in 50,000. General anaesthesia: General anaesthesia means that you will be asleep for your birth. It is used for: • Certain medical problems (e.g. bleeding conditions) preventing regional anaesthesia. • If you are not comfortable with regional anaesthesia (spinal/epidural). • Emergency caesarean births where the team feel a general anaesthetic will be quicker than regional anaesthesia. Potential complications of general anaesthesia: • Common problems are sickness, sore throat, shivering, and itching. These are short lived. • Uncommonly women have problems with breathing or damage to lips/teeth. • Rarely, there are severe allergic reactions. • Brain damage or death is very rare.