Caesarean Section (C-section)

During your pregnancy or labour, we may advise a Caesarean section (C-section) for the birth of your baby. A C-section is major surgery so we will only offer it when it is the safest option for you, your baby or both of you. Around 25% of mothers in the UK will have a C-section, either elective, which is planned in advance, or an emergency. The majority of emergency C-sections will be done during labour if vaginal birth is no longer considered to be the safest option.

Occasionally, one may be offered before labour starts. Either way, you will be fully informed throughout your birth journey of any concerns, as well as why we would be offering you a C-section.

If you are thinking of having a C-section, without a pre-existing medical reason, please talk to your midwife or obstetrician as early in the pregnancy as possible. Our experienced staff will listen to your wishes, be able to answer any questions you have and provide you with the information and support you need in order to make an informed decision. A useful link to refer to can also be found here: RCOG choosing to have a caesarean section.

What happens during a C-section?

Ideally, you will be awake and accompanied by your birth partner or supporter. You won’t feel pain, but you can expect to feel some tugging and pulling. A screen will be put across your chest so that you cannot see what is being done, but please be assured that your doctor will inform you of everything that is happening.

Your birth partner is welcome to stay with you and will be directed into a changing room to put on suitable clothes before joining you. To help you relax or distract you, you are welcome to bring some music with you to play on our iPod dock.

Your birth partner will be shown to a relatives’ waiting area just outside the theatre if you are under a general anaesthetic (when you are put into a medically induced coma) where they can wait for you. Our team will keep your partner informed of your progress and will make sure that they're waiting for you when you awaken in our recovery area.

After two hours in our recovery area, you will be transferred to a postnatal ward. You will feel some discomfort which is expected after major surgery. For a while, it may be difficult to stand or sit up straight and it can even hurt to laugh, but we will ensure that pain relief options and support are discussed with you before you go home.

Elective Caesarean Birth Patient Information

This is the information given to you a week before your Caesarean Section Operation Date by the Caesarean Section Co-ordinator

Pre-Op Blood Sample

You must attend the Antenatal Clinic at Birmingham Women’s Hospital to have your pre-op blood sample taken. See the instructions below for when to attend:

  • If your Caesarean Birth is scheduled for Tuesday – Friday –attend antenatal clinic the day before, drop in between 8.30am and 5.00pm.
  • If your Caesarean birth is scheduled for Monday at 7.30am - attend antenatal clinic on the Friday before between 4.00pm and 5.00pm.
  • If your Caesarean Birth is scheduled for Monday at 11.30am  – you will have your blood sample taken shortly after your arrival at 11:30am.

Where to come to 

On the day of your Caesarean Section, please go to the Obstetric Waiting Lounge (OWLs) on the ground floor, past the RVS café and onto the main corridor. OWLs is halfway up on the right-hand side, with a blue sign above the door.

Fasting instructions

  • If you have been asked to arrive at 07:30am – please do not eat after 02:30am and have a large glass of water at 6.30am and then sips of water as and when you need it until you arrive at the hospital.
  • If you have been asked to arrive at 11:30am – you can have a light breakfast (such as 2 pieces of toast or a bowl of cereal or some fruit), but please do not eat after 6.30am. You can drink water freely until 10.30am and then just sips until you arrive at the hospital
  • Once you have been seen by the anaesthetic team on arrival you may be allowed to continue to sip water until your Caesarean Section.

What to bring

  • Your blue pregnancy booklet. (if diabetic, bring your orange notes and blood sugar kit)
  • An overnight bag with items for yourself and your baby. Please note, the minimum stay after a Caesarian Birth is 24hrs
  • Pillows are supplied; however, you may want to bring your own for comfort (optional).
  • Bring a pair of slippers/flip-flops to avoid having to bend down to put shoes on.
  • Please do not bring your baby’s car seat – ask your birthing partner to bring this when you have a confirmed discharge time and date.

Visiting rules

  • Your birthing partner can come with you to OWLs and into theatre.
  • Your birthing partner can visit after your Caesarian Birth between 08:00am and 10:00pm. One child can attend with your birthing partner, however, there is a maximum of one birthing partner and one child at any one time.
  • Other visitors - you are allowed 2 at a time between 2:00pm — 5:00pm and 6.00pm — 7:00pm.

Other information

  • Please remove all jewellery and leave it at home.
  • Please remove all nail varnish/gel nails or acrylics before coming into hospital.
  • If
  • To reduce the risk of infection, please have a shower on the morning of your section.
  • It is also recommended that you don’t shave or do any other form of hair removal in the bikini area from 7 days before your C-section.

Call Triage Immediately

Call Triage immediately for advice if you have any concerns:

  • Feeling feverish or unwell
  • Worried about your baby’s movements
  • Changes in vaginal loss – bleeding or waters
  • Pain
  • Signs of labour
  • Consent

Anaesthetic Options

You will receive a phone call from one of the anaesthetists to go through your anaesthetic options. This usually takes place over the phone the day before your Caesarean Birth. The call will come from a withheld number.

FAQs for Elective C-Sections

1. How do I know I'm on the waiting list?  

You’ll get a text message from the hospital confirming that you’re on the waiting list.

2. How is an elective Caesarean section scheduled?  

  • A request for an elective caesarean is sent by a doctor/midwife to the caesarean coordinator
  • Your details are added to a waiting list managed by the coordinator
  • You receive a text to confirm that you are on the waiting list
  • All women remain on the holding list until around two weeks before the due date range
  • Coordinator and delivery suite lead consultant meet weekly to confirm the booking for the following two weeks
  • You receive a phone call one week before your allocated slot to confirm the date and time
  • A confirmation text is sent to you with the booked date and time, as well as a link to all of the information
  • You attend the Antenatal Clinic at Birmingham Women's Hospital for a drop-in pre-op blood test. 
    • Tuesday — Friday Caesarean Sections: Drop in the day before between 8:30am — 5:00pm
    • Monday 7:30am Caesarean Sections: Come for a blood test on the Friday before, between 4:00pm — 5:00pm
    • Monday 11:30am Caesarean Sections: Blood is taken when you arrive on the day
  • You are contacted between your caesarean date confirmation and procedure date by an anaesthetist to discuss your anaesthetic options
  • You arrive at OWLS (Obstetric Waiting Lounge) on the Ground Floor of Birmingham Women's Hospital for your start time

3. When will I know my elective Caesarean section date?  

The coordinator will call you a week before your Caesarean Section date to confirm and share details.

4. How are slots for elective Caesarean chosen?  

Dates are based on your medical needs. The team considers risks to you, your baby, and other women. The team also gives priority to clinical safety.

5. Can I request a specific date?  

You can ask for a specific date, but it’s not guaranteed. Clinical priorities come first, and schedules may change. If you want a different date range, you need to talk to your obstetrician. The coordinator is not able to book a date for a caesarean section outside of the date range that has been given by your medical team.

6. Do I get a letter to confirm my date?  

No, you won’t get a letter. You’ll get a call, a text, and an update on your BadgerNet record.

7. Can my confirmed date change?

Yes, it can. Emergencies or other issues may require changes. If this happens, we’ll inform you as soon as possible and put an alternative plan in place for you to give birth safely within your date range. We cannot take responsibility for inconvenience related to rearranged plans, including travel arrangements or childcare, due to a changed date of caesarean section.

8. How long will I wait on the day?

After you arrive at OWLS (the Obstetric Waiting Lounge on the Ground Floor), you’ll meet the medical team. Surgeries happen in order of clinical need, so there may be some waiting time.

9. What if my surgery is delayed on the day?

Delays can happen if there are emergencies. We will keep you updated and make sure you and your baby are safe and cared for.

10. What if I go into labour before my surgery?

Call triage immediately on 03000 201 201. A clinician will assess you and decide the best plan. You may choose to proceed with labour or have an emergency Caesarean section, depending on the situation.

11. Can I have a caesarean section for future pregnancies?

Yes, you can, but it depends on your health, any complications, and your preferences. Your healthcare team will advise on the safest delivery method.

12. What does being a reserve mean?
If you’re a reserve, you’re on standby for a Caesarean Section operation in case there are changes. You may need to fast on certain days. Being a reserve helps us use slots effectively while keeping everyone safe.

For more questions, contact the Caesarean Section Co-ordinator via Switchboard at 01214721377, ext. 5103 between 08:30 and 16:30.

Why might I need to have an emergency C-section?

Fetal distress

Sometimes babies become distressed or tired during labour. This can be more likely if you are having a small baby than if your baby is well-grown.

If we think that your baby is becoming distressed, we will closely watch your baby’s heart rate on a monitor. If they are distressed, we would usually offer you a fetal blood sampling to confirm our concerns. This test is done by vaginal examination where a small scratch is made on your baby’s head. A drop of blood is taken to check your baby’s oxygen level. The test will either reassure us to encourage you to continue in your labour, or it may tell us that you need to be offered an emergency Caesarean.

Labour progress is slower than expected

Sometimes the cervix (opening to the neck of the womb or uterus) does not open or dilate well during labour. If you do not make progress or the progress is slow, you may be offered a Caesarean after other options have been explored.

Our Theatre team work across our two operating theatres, with doctors (obstetrician, an anaesthetist and a neonatologist), nursing staff (one who assists the surgeon and one other), an operating department practitioner (who assists the anaesthetist) and your midwife with you during the surgery.