When you become pregnant one of the first things you will discuss with your partner and provider is your birth plan. Whether you are choosing to give birth at home, with or without an epidural, or vaginally in the hospital, it is always important to have a plan in place. It is also important to plan for the unexpected and be able to switch gears when things don’t go exactly how you’ve intended them to. In the event that you have a scheduled c-section, you can plan with some pretty accurate foresight and can go into your delivery with solid expectations and confidence.
When someone has a date on their calendar that tells them they are going to be having a c-section at this specific time, at this specific hospital, with this specific surgeon it is very rarely because they simply do not wish to have a vaginal delivery. While this can occur, the most common reason for scheduling a c-section in advance of delivery is because it is the safest option for the mother, baby, or both.
When the baby’s safety is the main concern, and cause for a c-section it is usually because of a couple conditions. The first is that the baby is breech and cannot be delivered vaginally. Additionally, if the baby is of a very large size, it can be dangerous to attempt a vaginal delivery, thus requiring a c-section.
If the mother’s health and safety require a C-section it may be because she has had a C-section before and does not wish to have a VBAC. If the mother has had a previous surgery on her uterus that may cause complications or if the placenta is blocking the cervix, are additional reasons that a c-section may be scheduled in advance.
A c-section is usually scheduled around 39 weeks of pregnancy. That is when the baby is predicted to do the best outside of the womb. In an episode titled “What to Expect When You’re Expecting a Scheduled C-Section” for the Healthful Woman podcast Dr. Nathan Fox, a specialist in maternal female medicine, states “Once you get to about 39 weeks, so a week before the due date, as far as we know, there’s really no advantage to the baby to staying inside any longer meaning outcomes for newborns born at 39 weeks, or 40 weeks, or 41 weeks, they actually do best at 39 weeks around, they don’t do better at 40 weeks.” This 39-week mark plays a huge role in scheduling your c-section.
Once that 39-week mark has been established, the c-section is scheduled about 2 months prior to the big date. This date is chosen based on the availability of your doctors as well as anyone else that may need to be in the room that day. If you have had a prior bowel surgery, for example, your GI surgeon will want to be available that day in case of any complications.
Sometimes people will choose their dates based on other important occasions that occur on the same date. A family member’s birthday might be a reason to choose a specific date or a special anniversary of some kind. Some people choose to avoid certain dates for the same reasons.
Once the date and time are chosen, you will meet with different doctors and specialists who will all play a role in your delivery. You will also take an array of tests that will ensure your safety on the date of your delivery. This can include meeting the anesthesiologist who will be managing your comfort on the day, as well as meeting other surgeons in the event that someone other than your doctor has to perform the c-section.
The blood tests you will have done include a blood count to check your hematocrit platelet count and having a type and screen on file with the hospital’s blood bank in the rare event you need a blood transfusion. These tests can also be done on the day of your operation, but for the sake of convenience can be done in advance so as not to delay your delivery.
Because different hospitals have different rules when it comes to eating and drinking before your operation, pre-surgical instructions specific to your hospital will be provided to you. It is very important to follow these rules, as failing to do so can cause major delays. For example, if you are not supposed to eat or drink x amount hours before your delivery, but you have a cup of coffee anyway or by accident, you will not have your c-section that day.
It is also important to keep in mind that rules and regulations can change from one c-section to the next. Your body changes and so will the measures that are taken to keep you safe. Just because you were able to eat four hours before your last c-section doesn’t mean you will be able to for this one.
With the expectation that you have followed all pre-surgical instructions to a T, you can expect a rather calm day ahead. You will begin by checking in at the front desk two hours before your scheduled surgery time. A nurse will escort you to a recovery room to get changed into a gown where a baby monitor and IV will be placed. Think of timing your arrival at the hospital like you would for traveling at an airport.
Once you get a bed, have your IV placed, and all proper monitors are attached, you will meet the surgeon and anesthesiologist, as well as anyone else on the surgical team that day. Because all the big tests are out of the way, the lead-up to the actual surgery will be rather calm. You will go through your medical history with the surgeon again and they will check your airway in the event that you need to be intubated.
Once all the necessary information is collected, it becomes a rather social experience before you walk into the operating room. You are allowed to have one other person in the room with you, but they will join you after the anesthesiologist has finished the spinal and a catheter has been placed. Once you are all set and ready for surgery, your partner is escorted in to sit by you and then everything begins.
When discussing the recovery of a scheduled c-section, in conversation with Dr. Fox on the Healthful Woman podcast, board-certified OB/GYN Dr. Stephanie Melka states, “Recovery with a scheduled C-section is almost always better than the recovery after the long labor C-section.” This is due to the simple fact that you can make recovery plans with actual dates and times in mind. This means finding childcare, your partner taking time off work, or getting pain medicine ready in advance.
You don’t have to dread your recovery after a scheduled c-section because you are not going into the procedure after pushing for two hours. In addition, a scheduled c-section means that you have been receiving fluid the entire time as well as being in a physically relaxed state before and during the procedure.
To get in touch with Maternal Fetal Medicine Associates or to schedule a consultation with an amazing medical professional like Dr. Stephanie Melka or Dr. Nathan Fox, fill out our online contact form today.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!