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What happens during a cesarean?
Preparation for the surgery includes starting an IV, shaving the pubic hair that shows when your legs are together and inserting a bladder catheter. Your belly will be washed with antiseptic and sterile drapes placed around the incision site. A blood pressure cuff and sensors on your chest and finger will monitor your blood pressure, heart rate and blood oxygenation. A curtain will be hung across your upper chest so that you cannot see the operation. Many hospitals permit your partner to be present. If so, he or she will be seated next to you and behind the curtain as well.
Most cesareans are performed under epidural anesthesia because it is safer than general anesthesia (53). If an epidural is already in place, the anesthesiologist will strengthen it so that you are numb from your toes to your breastbone. If general anesthesia is used, you will be put under by injection of a medication into your IV. Once you are unconscious, the anesthesiologist will put a tube down your throat to maintain an airway and deliver a gas anesthetic.
The operation generally takes an hour or so, with the greater part of the time spent after the delivery suturing the various tissue layers. With rare exceptions, the roughly four-inch incision is made horizontally just above the pubic bone. A horizontal uterine incision is preferred because it produces a much stronger scar. However, in certain situations, such as when the placenta is covering the cervix, the incision is made vertically. During the surgery, you will feel pulling and tugging but no pain. The manipulations can make you queasy. At the delivery, the obstetrician hands off the baby to be examined. Some hospitals permit healthy babies to remain with your partner and you during the rest of the operation. In others, staff will take the baby to the nursery, regardless of the baby’s condition. As the hospital staff examines the newborn, the obstetrician delivers the placenta through the incision, suctions out fluid and begins closing the uterus and inner tissue layers with stitches. The skin incision may be closed with conventional stitches, staples, or even with tape strips. Finally, the surgical wound is covered with a dressing.