Caesarean section
A caesarean section is a surgical procedure. Compared with a vaginal birth, there is a higher risk of complications for both mother and baby associated with a caesarean section. Therefore, a caesarean section should only be performed when it is clinically necessary and there is a clear medical indication for undertaking the procedure.
In Norway, a planned caesarean section must be based on a medical indication. Medical indications may also include mental health conditions.
Referral and assessment
If you are pregnant and have questions about your upcoming birth, you should speak with the midwife or doctor responsible for your antenatal care. They can answer your questions and, if necessary, refer you to the hospital where you plan to give birth in order to discuss and plan your delivery.
Before the C-section
A doctor will always assess the condition of both mother and baby and determine whether there are medical grounds for performing a caesarean section. The doctor will also consider whether the potential health benefits of a caesarean section outweigh those of a vaginal birth. The woman’s wishes will always be taken into account in this assessment.
Please remember to bring your maternity record and any blood test results. If you are taking medication, it is important that your medication list is up to date.
Have you received treatment at a hospital outside the Nordic countries, or stayed in a refugee camp during the past year? If yes, please contact your GP as soon as possible to arrange screening for MRSA/VRE/ESBL. For more information, please visit www.fhi.no and search for patient information on MRSA/VRE/ESBL.
During the C-section
Planned caesarean section
If it is decided that you will have a caesarean section, your baby will usually be delivered slightly before your due date, which is determined by ultrasound at around 18 weeks of pregnancy. The date of the operation is decided during the latter part of the pregnancy, depending on the reason for the procedure.
Once the date has been scheduled, you will receive information about:
- when to attend the hospital
- any preparations required before the operation
- what to expect after the procedure
It is common to attend the hospital the day before, or a few days prior to the operation, for blood tests and to speak with a midwife.
Before the operation
Hygiene
To reduce the risk of infection, you must shower on the day of the operation. Pay particular attention to the genital area, navel, hands and feet. Do not use body lotion. Remove all jewellery at home. Any piercings should be removed four weeks prior to the operation. Remove nail polish. To minimise the risk of infection, you should not remove hair from the genital or surgical area yourself during the four weeks leading up to the operation.
Fasting
In order for anaesthesia to be administered safely, it is important that you fast. This means you must not eat or smoke after midnight. You may drink water, tea, coffee, cordial, fizzy drinks, and juice without pulp up until 06:30 on the day of the operation.
Rectal enema (Klyx/Microlax)
If you are prone to constipation, we recommend using a rectal enema (e.g. Klyx or Microlax) the evening before the operation.
Klexane/Fragmin
If you are using Klexane or Fragmin up to 40 mg daily during pregnancy, you should not take it on the morning of the operation. If you are using more than 40 mg daily, you should not take Klexane or Fragmin on the evening before or the morning of the operation.
Day of the operation
You should report to the operating admissions unit in building A, 3rd floor (south), at Ullandhaug at the agreed time (this will be arranged at your pre-assessment). You will usually be taken to the operating theatre between 07:35 and 11:00. You may be accompanied into the operating theatre by your partner or another person close to you, provided they are well.
Anaesthesia
For a planned caesarean section, epidural or spinal anaesthesia is most commonly used. This is administered in the operating theatre. You will be awake during the procedure, but you will not see the surgery and will not feel pain. You will hear your baby’s first cry, and you will be able to see and, if possible, hold your baby immediately after birth. Your birth partner may also be present and share this experience with you.
When the baby is born
As soon as your baby is born, he or she will be dried and placed on your chest, provided both you and your baby are well. Skin-to-skin contact is beneficial for both mother and baby. Early physical contact is important for establishing breastfeeding and bonding. During a caesarean section, we aim to facilitate this whenever possible.
Emergency caesarean section
If complications arise during labour, an emergency caesarean section may be required. A consultant obstetrician will always assess whether a caesarean section is necessary and how urgently it needs to be performed.
The main difference between a planned and an emergency caesarean section for you and your partner is the amount of time available for preparation and information. If your or your baby’s condition requires immediate intervention, prompt action is essential, and it may not be possible to provide detailed information at the time. You will be offered a discussion after the operation to explain what happened and why.
Anaesthesia
Once an emergency caesarean section has been decided, you will be taken to the operating theatre as quickly as possible. The anaesthetist and obstetrician will determine the most appropriate type of anaesthesia. You will usually remain awake during the procedure, and your partner can often be present.
If a general anaesthetic is required, only healthcare staff may be present in the operating theatre. Your partner will need to wait on the labour ward. The time from the start of the operation to the birth of your baby is usually short. The entire procedure typically takes around 30–60 minutes. If your baby does not require additional care after birth, your partner may hold the baby until the operation is completed.
After the C-section
After the operation, you will be transferred to the recovery ward. The length of your stay there will depend on the reason for the caesarean section and your condition. In most cases, your baby will be with you. We aim to support the initiation of breastfeeding as soon as possible after the procedure. You will be monitored until your condition is stable and you can be transferred to the postnatal ward.
Following a caesarean section, you will require more support and time to recover. Care on the postnatal ward will be tailored to the needs of you and your baby. The length of your hospital stay may vary, but it is usually a few days.
Be aware
As with any surgical procedure, there is a risk of complications following a caesarean section. The most common complications are bleeding, infection, and urinary problems. After you have been discharged from hospital, you should seek medical advice if you develop signs of infection or feel that you are unable to empty your bladder properly.