A guide to having a C section: the truth step by step

Our journey to having a caesarean Section and becoming a family of 4

step by step guide to having a c section - the truth. Our journey to becoming a family of 4
step by step guide to c sections – the truth
Let’s get serious…sort of:
Advice and support in a lighthearted way

Here is our step by step guide to having a C section, and then having another!

Step 1 in the guide to having a C section: be at peace with whatever decision you make

When I was pregnant with Ava I remember discussing my birthing plan with a colleague (she’d asked, I didn’t go round telling my bosses at work how I didn’t want my fanny to tear, or the fact that pooing on the doctor was a scary thought). I said I wanted every drug possible and the least amount of pain, please. She looked perplexed and said ‘but you never know, you might be brave’. Up until then I didn’t even consider wanting drugs to be a cowardly thing. After a split second of doubt in myself, I pulled myself together and realised she was talking a load of rubbish. Instead, I thought to myself – I am carrying a precious life inside me. I am brave. I am going to be a parent. I am brave. I have a massive responsibility for a helpless human being. I am brave. I have the responsibility of bringing this baby up to be a well-rounded human being. I am brave. (I wish at the time I had the balls to say it to her but I did the nervous laugh and slowly backed away stating I had work to do). I went away and thought some more about what she had said. I would be going through some labour pains before any drugs are given, and, as Ava was my first baby, the labour could have lasted drug free (well, I had Paracetamol, but please, what does that do – ‘oh. hi pain, I’ve come to stop you. No, ok, you go right ahead and carry on being painful’ – pushover!) for days. Regardless of drugs, I was still pushing a far too big thing out of my fanny, that had to have drug free repercussions afterwards, right?! I was made very aware of this possibility with friends ‘kindly’ telling me their tear stories and how I should get the anti-burn cream for my first wee! Ouch! Most of all, I thought, the end goal of this pregnancy is surely the baby! Who cares how she gets here? If I want an ‘easier’ process of meeting my baby, then why can’t I have that if it’s allowed? That doesn’t make me a coward! And, on that note, I say ‘easier’, but I’m not sure what is easy about major stomach surgery – but I think the anti caesarean section, natural birth is the only birth activists forget that.

Step 2 in the guide to having a C section: Throw the birth plan out of the window

The sentiment of ‘who cares how she gets here?’ became a massive reality the following week.

Ava's 20 week scan before having a c section
Ava’s 20 week scan before Caesarean section

Previously, at my 25-week midwife appointment, the student midwife said she thought I was breech but the midwife overruled. The same thing happened at my 38-week appointment. This time, however, I had ketones in my wee and if this happens after the 38-week mark, they send you to hospital for checks the same day, so the midwife ordered a scan just to be safe. And, guess what, I was breech! Telling the midwife this was a little embarrassing, but probably more for her than me. Worst of all, the lump they said was Ava’s head had been in the same place since around 21 weeks! Oops!

Around 4% of babies are breech, which means they are likely to come out bottom or feet first, rather than the desired head first position. This makes vaginal birth more difficult but not impossible, but more dangerous for mum and baby. If the baby’s bottom is presenting downwards, and the feet are up near the head, then a vaginal birth is very possible, as the bottom would create a similar pressure in the birth canal than the head. Ava’s feet, however, were sideways on.

Step 3 in the guide to having a C section: consider all of the options before making a decision

While at the hospital hooked up on monitoring machines due to the ketones (all was fine).

Getting checked over with baby heart beat monitor before having a c section
Getting checked over with baby heart beat monitor before caesarean section

I had numerous obstetricians came to chat with me about my options –

  • Do nothing
  • ECV
  • Caesarean section

Do nothing: This wasn’t something they were keen on due to the possible complications and the fact I was already passed 38 weeks.

ECV: This was the one they were definitely pushing for (no pun intended), was the external cephalic version (ECV).

They really didn’t sell it well: It’s can be painful; we don’t like giving pain relief as we like for you to be able to tell us if it’s working; it might not work; the baby may turn straight back; only the top, top, top consultant can do it as it can cause preterm labour or an irregular heartbeat; it may distress the baby and the baby’s distress may result in an emergency caesarean section etc etc.

I clearly wasn’t keen on this so they sent the next doctor to try to convince me (it really was like that friends episode where they are trying to quit the gym, as first they sent the top man, then the top woman, then the kindly woman and then the good looking doctor). This doctor helped us weigh up the pros and cons of a caesarean section compared to an EVC. I’m not sure how much I was listening, as he really was Dr. McDreamy.

Caesarean section: This has a much longer recovery rate than a vaginal birth (with or without an ECV beforehand) and the pain is, well, painful, for 6 weeks or more. It is major abdominal surgery with the possibilities of many things going wrong.

We were sent home to chat about our options. I was very much Camp: ‘it’s my body, my choice’, Geoff was very much Camp: a caesarean section is a major operation and I don’t want to lose you or the baby. We decided we needed our mums’ opinions too (who doesn’t feel comforted by their mum’s opinion) and both mums said the ECV can put the baby at risk and to go for the caesarean section – this made our decision easier. We were booked in at 39 weeks. At our booking appointment, I was hooked up to the monitor again to see if she had moved (she hadn’t) and I had to fill in lots of paperwork. It was mostly to say I understood this was a major operation and things could happen. I could lose blood and need a transfusion or they could cut things they shouldn’t, like the baby, or my bladder, and would have to repair it etc. Again, they tried to convince us to have to ECV and again, we said no. At this point a first year doctor asked if he could practise taking blood pressure manually on me, I said yes, he couldn’t find my pulse and told me so, looking panicked, I told him not to worry, as I was definitely alive. The midwife told him to try again tomorrow.

Step 4 in the guide to having a C section: Get prepared – it’s baby time

I had to take a tablet to help reduce the acid in my stomach around 10pm the night before and another at 7am the next day. I also had to stop eating 8 hours before the operation, and stop drinking 4 hours before. We had a great midnight feast of pancakes before the cut off deadline! This also served as a last ‘this is us, alone, without a child’ time together. 

We had to be at the hospital at 6.45 am the next day having phoned in to check they had beds first (in case they had lots of emergencies overnight).

When we got there I had to put the hospital gowns on (luckily 2 so my bum wasn’t on show!) and the tightest socks in the world to stop blood clots forming (like on a plane). All very fetching gear. We were first on the list, as no emergencies had arrived, so off we went. We being Geoff and I, as you’re only allowed 1 other person in with you. If it’s an emergency under anaesthetic job then no one can go in.

We had one more scan to check the baby hadn’t moved to how she should be (she still hadn’t). Then we went into theatre. I found the whole experience calming and really quite peaceful other than the scary thought I wasn’t coming out of there without a baby to look after. The operation side of things didn’t scare me. I knew I wouldn’t be able to see anything, my adrenalin was so high, and I was very much looking forward to meeting Ava (and deliriously happy I didn’t have to go through labour!)

Geoff had to get some operation scrubs on in the next room. He was advised to wear a bigger top so he could have skin to skin afterwards.

Geoff in hospital scrubs before having a c section
Geoff in hospital scrubs getting ready for the caesarean section

They then introduced us to a 15 person strong team, there were midwives, student midwives, doctors, student doctors, anaesthetists…so many people…I hoped they wouldn’t test me afterwards. Even Geoff had his own midwife, as he’s a fainter.

First, they gave me anaesthetic to numb my back via a cannula in the back of my hand, and then painted my back in freezing cold, yellow iodine to clean the area. They then made me sit forward and arch my back, not an easy thing to do with a giant baby bump. They inserted the epidural (yay, I got my drugs after all!). This started to take affect almost immediately so they assisted in laying me down. This was the strangest thing ever as they then inserted the catheter (wee catcher) with my knees out to the side and then the epidural took full affect and they straightened my legs. However, my brain still remembered them bent, I could feel that they were still bent, like an imprint, but I could see that they were straight! So odd! Finally, to check the epidural has worked correctly, they sprayed me with freezing cold water from toe to head down the side of my body. I had to say when I could feel it. They started at my feet and I couldn’t feel it until my arm pits. So clever! We were all set.

The giant blue sheet went up so neither Geoff or me could see and they shaved me! Yep, you read it right, they shave you. Basically, you’re told not to shave for a week or so before hand so they can limit infected cuts etc., but that means you’ve got a rather unsightly garden where they want your caesarean section cut to be, so they shave. Oddly, this was one thing I was worried about as I had in my head that someone else shaving me, not very gently, would hurt, never mind the gaping hole into my stomach.

One more ultrasound to check the baby wasn’t near the cut site (so they don’t lose an ear!) and then the screen was turned away from us so we didn’t see any of the operation. They talk you through the main bits of what’s happening but for the rest of the time the doctors were discussing their skiing holidays. All very relaxed. They said they were cutting through my skin and muscle layers, and that I would feel tugging like movement as they were moving everything aside to reach the baby, but that it wouldn’t be painful (it wasn’t). I heard the rush of water and a suction vacuum, like at the dentist, collecting all the fluids inside, and then…ooohh….and then, the most beautiful sound, a little cry. Ava was pulled out and held above the cloth for all to see. Geoff broke into a chorus of The Lion King, and we got to look at that squashed, covered in gross stuff, red, angry from being woken up and taken from such a cosy space, face. Beautiful.

Daddy getting skin to skin after  having a c section
Daddy getting skin to skin after caesarean section

The midwife took Ava to be weighed and checked over and she was declared as having been born at 10.13am weighing 7.15 on February 11th 2016. They don’t measure height in the UK until around the 8-week check at the health visitor, when they are naturally straighter.

Ava being weighed after being born via caesarean section
Ava being weighed after being born via caesarean section

Then back for more skin to skin. Meanwhile, I was being sewn up. They use dissolvable stitches on your womb and either dissolvable stiches or staples, that will need to be removed several days later, on your tummy cut. Timing wise, to get the baby out it only took about 15 minutes, then about 45 minutes to sew everything back together.

Family photo during C section - being sewn up
Family photo during caesarean section – being sewn up

This is one of my favourite photos. Mostly because we’re all in it, but because it makes us laugh every time how we contemplated putting it on the wall only to notice the surgeon covered in blood sewing me up in the background!

Step 5 in the guide to having a C section: Into recovery

Once all is finished you get wheeled to a recovery area so they can check the mum and baby out in the immediate aftermath. Here they checked how I wanted to feed. I said I wanted to breastfeed, so they gave me advice and showed me what to do. Usually, at this point you are taken to a ward as you are not allowed alone after a caesarean section, but they had ran out of beds, so I was lucky to get a side room, and I just had to have people checking on us all the time. It also meant the 2-visitor rule (excluding Geoff) was relaxed slightly, as I needed the constant supervision for safety reasons. It was also great as the amount of farting that happens after a C-section is ridiculous! I farted more than Geoff does, and that’s saying something!

mummy and baby cuddles in C section recovery
mummy and baby cuddles in caesarean section recovery

I continued to try and breastfeed but knew that my milk would be delayed due to having a caesarean section, as the birth hormones aren’t released to tell your body to produce milk, so it slowly dawns on it a few days later. Our feeding journey is another story.

I was on regular paracetamol, Ibuprofen and Codeine for the pain and had to have a daily injection of a hormone that encouraged my womb to contract and reduce blood loss. Like after vaginal labour, you still have to wear giant mattress pads and sit on puppy training pads, as all the inside gunk still needs to come out somewhere.

The hospital staff like to get you up and moving as soon as possible. Therefore, although they are happy to bring you your first food, they encourage you to fetch your own after that. And, although hospital food isn’t the best, I could bathe in that ice cream. Yummy!

Step 6 in the guide to having a C section: Getting ready to go home

We stayed overnight and was ready to go home the next day all being well. There were three things they wanted me to do to be allowed to go home – have enough wee in the catheter to show there were no complications, go for a wee after having had the catheter out, and fill a dish to a certain level (to prove they hadn’t cut the bladder or anything), and have a shower. Catheter was fine, so I did the wee unaided, and that was fine too, so I attempted the shower. As I entered the hot room after only about the second time standing up, luckily with Geoff in tow, I promptly fainted. I woke up back in bed with the doctor saying my blood pressure had dropped and I needed to stay in another night. I uncontrollably cried at this point, mostly due to the hormones, but I really wanted to go home. I didn’t have any sleep the night before because of the pain and 3 hourly observations and Ava wouldn’t let me put her down.

Ava in the hospital after being born via C section
Ava in the hospital after being born via caesarean section

The nurse had already told me off for falling asleep with Ava in my arms, but it really was impossible not to drift off. Luckily, the second night, Geoff’s midwife friend was on duty and she took Ava so I could get some sleep.  

Ava fast asleep on mummy after having a C section
Ava fast asleep on mummy

Step 7 in the guide to having a C section: recovery at home

When we finally got to go home, Geoff had to drive really carefully back as any little jolt hurt like fire. Walking was ok but I had to adjust my posture to suit. Walking up and down stairs was difficult but it helped to have someone in front of me holding my hands as an extra leaning post. The first week I had to have Geoff pull me up straight when I was lying in bed and bring Ava to me when she needed feeding in the night. After a week, I worked out which side position I could push up from without it hurting. The one task I found hard for the majority of the 6 weeks was pushing the pushchair up kerbs. Basically, anything that used my stomach muscles hurt and even after the pain had gone, they were so weak that it was a difficult task. I had to use my foot on the cross bar to push down too. (I told this to a fitness fanatic friend and she was horrified that I no longer had tight stomach muscles and worried for her own when the time comes. I never had tight ones in the first place so no mourning here!)

I continued with regular paracetamol and Ibuprofen and learnt very quickly that even if you think the pain is bearable; take the painkillers when your alarm tells you to otherwise the pain will be horrendous. The pain lasted about 6 weeks the first time, slowly lessening each day. I also had to give myself the hormone injections, that I was given in hospital, for 2 weeks. This was quite painful but I learnt it hurt less if I sat down and pinched as much stomach fat as possible (not a difficult task!) and injected into that.

Step 8 in the guide to having a C section: side effects

I was also give iron tablets, as my count was low at the hospital. These are the worst thing ever. Imagine, if you will, the worst constipation ever. Curtesy of these iron tablets and a side effect of major stomach operations. Now imagine having no stomach muscles to help push, and the ones you do have hurt SO SO BADLY! One night, about 1 week after the operation, Geoff went to cricket training and I needed the toilet. Ava also needed feeding (let’s be honest, peace in the bathroom is a privilege you give up as soon as you have a baby) so I had her on my knee too. I was in agony. I might as well have been pushing another baby out of my arse it was that big and hard (sorry for too much information!). I must have rang Geoff 50 times to come home but his phone was in his locker. He eventually came home to a crying, blubbering mess. It was so painful. The next day I went to the doctors to get Lactulose and I stopped taking the tablets. The doctor wasn’t happy with me so sent me for iron level tests, but, luckily, I was fine. The only issue now was that the next time I felt I needed a fart, it suddenly dawned on me that with the Lactulose it may not be just a fart….run, run, run!

For the first 4 weeks or so, you still have to wear giant pads and sit on puppy pads and eventually cut down to panty liners, as blood continuous to come out. And just when you think it’s all gone, a giant clot comes out and you’re on the phone to Dr Google to check it’s normal (it is if not offensive smelling/gushing out but always check with your doctor (a real one, not Dr Google!))

About 3 days later the midwife came to take my staples out; I was nervous about this, as it sounded scary and painful. I was asked to lie down and the midwife did something down there with a funny looking staple remover and 10 pain free seconds later, they were gone. The scar is now forever numb, which is a very strange sensation when you rub your hand down your stomach and you suddenly stop being able to feel your own touch.

The only things that affected Ava having been breech for so long, was one of her feet pointed outwards rather than straight forwards. We were told to massage it pulling it forwards and after a few months, it corrected itself. In addition, as with all breech babies, she had to have a hip check, as they stay in a funny position for so long. But, again, all fine. She was very snuffly and sneezy for a good month because she hadn’t gone through the birth canal where all of the mucus would normally be pushed out, but it didn’t seem to bother her or affect her breathing.

We got through it, as well as all of the other trials and tribulations of being first time parents, but that’s another story!

Learning to be a family of 3 after having a C section
Learning to be a family of 3

Then there was Rafe – 5 step guide to having a second C section

Step 1 in the guide to having another C section: Make a birth plan

This time round, we were consultant lead, as we didn’t have a straightforward birth the first time. It is the patients’ choice whether to have another caesarean section for the second baby but the doctors were pushing for a normal delivery (as no complications the first time and it was an elective – and again, no pun intended). However, I wanted a caesarean section, so I was booked in for 39.5 weeks, as they were full any earlier. The booking in doctor explained that if I was to have a third baby, it would have to be a caesarean section as vaginal birth at that point can be dangerous due to bursting etc., and they wouldn’t recommend any further babies as any more that 3 caesarean sections can be dangerous. I had to fill out the paperwork as I had done before but this time there was an added complication that the bladder likes to attach itself to scar tissue so there is a higher percentage of damage (there wasn’t, luckily).

Rafe was breech for about a month but turned himself back around and other than an extra scan for cist pain and being much sicker than I was with Ava; it was a complication free pregnancy. While many babies might be breech at some point in pregnancy, there are many non-medical techniques to help them turn – a website called https://spinningbabies.com has lots of tips, and many babies will turn by themselves. Ava was clearly just lazy and I found out way too late to use any of these techniques.

At my 38-week midwife appointment, the midwife said she would see me next at 40 weeks as she was off on holiday. Little did I know what was about to happen and that I would never see her again.

My friend threw me a baby shower a few days later, and as Geoff and I went to bed that night, we talked about the fact that the following week we would pack the hospital bags and build the swing cot for next to our bed. This is really funny as with Ava, we did everything months in advance, but with your second child, a day before will do!

Step 2 in the guide to having C section: Throw the birth plan out the window

At about 3am, I felt an odd pushing pain in my back and bum, as if I needed a big poo. I happened every 10 minutes or so and although I ignored it for about half an hour, I thought it was about time to consult Dr Google – am I in labour? I woke Geoff up and told him what was happening and we rang the hospital. They said to come in to be checked over. I rang my mum to come to ours to look after Ava and off we went.

Upon arrival, the pain had moved round the front and the midwife confirmed I was in labour. They said as Rafe was 12 days early at this point, they wanted to give me steroid injections to support Rafe’s lungs. In an ideal world, two injections would be given 12 hours apart and then the caesarean section booked in another 12 hours later. They said as I wasn’t dilated yet and my contractions weren’t regular, that they wanted to try and wait to complete the cycle but that 1 injection is better than none, if my contractions start getting worse. That injection bloody hurt! It was massive. In my bum cheek. Blood everywhere!

We weren’t allowed to go home so I got sent to the ward (no lucky side room this time so everyone will just have to deal with my farts) while Geoff drove home to make up the hospital bags we were meant to do the following week. After 5 phone calls asking where I keep everything (we’ve only lived here 5 years!) he came back and I was checked for dilation a few times and contractions were measured, but we managed to make it to the next injection the following day. I was regularly given the go to combination of Paracetamol and codeine to help with the pain (it didn’t!) but I managed to get some sleep that night. The next day, however, I woke up at 6am with contractions every 3 minutes and the doctor telling me to call my husband to come back as I was going to theatre now! If I was in labour, on the labour ward, ready to give birth, Geoff would have been allowed to stay with me, but as I was in a normal ward and getting ready for a caesarean section, he had to stick to visiting times (although they are slightly longer for the dad than other friends and family).

Step 3 in the guide to having another C section: into theatre – here we go again

The theatre experience was pretty much the same. Although after the introductions, somebody told me that Doctor Somebody had to go to the ward so we’ve got Doctor Somebody Else instead (told you not to test me on names) and this new doctor, with face mask up to her eyes and hat down to her eyes says ‘hi!! How are you? How funny! Small world!’ etc. etc. I clearly looked perplexed, as Geoff had to whisper it was the caesarean section booking in consultant. I’m not sure how, in my adrenaline fuelled state and from only her eyes I was meant to know! Then, drugs in, screen up, operation start, Lion King song commence, and then….another beautiful squished baby to hold in my arms. Amazing.

skin to skin with Rafe after having a C section
skin to skin with Rafe after birth via caesarean section

Rafe joined us at 10.17am weighing 6.15 on August 14th 2018. 10 days before we were meant to meet him!

all squashed up being weighed after having a C section
all squashed up being weighed

Off to the recovery room and then the ward we went.

wondering what all the fuss is about after having a C section
wondering what all the fuss is about

Step 4 in the guide to having another C section: Getting ready to go home

We stayed in hospital two more nights after having Rafe, as my blood pressure was low again, but I pushed to go home the next day, as I knew I just wanted some sleep. I didn’t need iron tablets this time and I already had lactulose in the house, as I wasn’t making that mistake again.

waiting to go home after having a C section
waiting to go home

The best moment this time round was Ava meeting Rafe for the first time, it was so special and I shall never forget it. Even if the picture shows her dodgy fringe cut she’d had the week before.

Meeting big sister after having a C section
Meeting big sister for the first time – sibling love

Step 5 in the guide to having another C section: Home we go – adjusting to life with a baby and toddler

With this second caesarean section, recovery was longer at around 8 weeks. This was mostly due to running around after a toddler so a lot less time to lie down. Also, the advice of not picking up anything that weighs more than your baby is pretty difficult when you have another child. And now I was pushing a pushchair with a buggy board attached too.

toddler and baby day out after having a C section
toddler and baby day out

Even after the pain had stopped, I sometimes felt little twinges if I pushed myself too hard. I don’t drive so not being allowed to drive for 6 weeks (you need to be able to do an emergency stop without all of your insides coming out your mouth) didn’t affect me, but I can see why it’s a rule.  

Life with a toddler and a baby after having a C section
Life with a toddler and a baby

This time I had dissolvable stitches, so once I’d removed the giant bandage (recommended in the shower, as the sticky can be sore when being removed) it was all as it should be. Both scars took the amount of time a large scab takes to heal. The first time there was a bumpy bit where it hadn’t healed flat, but the second surgeon said he’d neatened that up for me (can I have a tummy tuck at the same time please?).

Our families all chipped in to build the cot and fetch everything we needed due to Rafe’s shock early arrival and now we are a family of 4. How did that happen?!

Our family of 4. Jamie, Geoff, Ava and Rafe after having a C section
Our family of 4. Jamie, Geoff, Ava and Rafe

The colleague I spoke about at the beginning has now moved on so I couldn’t point out to her that I have now gone through some labour drug free and experienced the excruciating pain of a C section and that she can bugger off, as I am no way a coward. However, I did get the chance to shout at someone else who thought it wise to ask a hormonal new mum if I didn’t feel cheated out of a real birth having a C section and wasn’t I disappointed that I couldn’t have one. Err, no love, I am not disappointed I didn’t have to go through more of that pain or push a giant out of my fanny, and I did have a real birth and I have two beautiful children to show for it. I went through some labour and hats off to anyone who can endure much more of that; I definitely made the right decision for me. They both hurt, a lot, but I feel labour pains are unpredictable and hard to manage, whereas C section pains are constant and obvious, so manageable. So, I’ll be happy to have another with a third child (just don’t tell my husband I want a third child!)

In addition, whenever people are judgemental about anyone’s choice of birth, I remember that my most prized possession is this scar. This scar is an eternal reminder of 2 wonderful moments in time, this scar bore two beautiful children who are so very loved every day, and no matter how they arrived into this world, they are cherished in every way (except when they refuse to sleep, then they can bugger off!)

Ava and Rafe sibling love after having a C section
Ava and Rafe sibling love

I hope that was a helpful guide to caesarean sections. Feel free to ask any questions in the comments section.

step by step guide to having a c section - the truth
step by step guide to c sections – the truth

Our other blog posts

See how our journey began here.

our journey to how we became a family where it all began
our journey to how we became a family where it all began

After more (funny) advice, see our post on the *real* childbirth education classes: 6 things they don’t tell you, here.

real childbirth and parenting classes
real childbirth and parenting classes

and check out our post on 6 unexpected, weird side effects of having a baby that no one tells you about here

6 unexpected side effects of having a baby that no one tells you
6 unexpected side effects of having a baby that no one tells you

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