Caesarean Section (C-section)

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 any time from 8.30am-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 Caesarian Birth 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, please have a large glass of water at 6.30am and then sip water 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 c-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.  Note: 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.  They can go with you to the operating theatre if a spinal anaesthetic is planned.
• Your birthing partner and your other children can visit after your Caesarian Birth between 08:00am and 7:00pm.
• Other visitors - you are allowed 2 at a time between 3:00pm-4:00pm 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 you are planning to wear makeup, we request that it be kept to as minimal as possible, as we need to be able to clearly see and monitor your complexion during the procedure.
• 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

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 Caesarian Birth. The call will show as a withheld number.

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

When you are added to our holding list, you will receive a text message confirming this from the Hospital.

2. What is the process for scheduling an elective C-Section?   

• Your doctor or midwife makes a referral to our C-Section Co-ordinator.  
• The co-ordinator will send you a text to confirm that you are on the holding list.  
• Slots are allocated two weeks before your expected date by the Lead Clinician for the Delivery Suite.  
• You will be contacted by phone a week before your scheduled date to confirm details, including pre-surgery instructions, visiting hours, and what to bring. This ensures the schedule is stable and you have all the necessary information.  
• On your scheduled date, you will come in for your C-Section at the allocated time.  

3. When will I know my elective C-Section date?  

Your C-Section slot will be allocated two weeks before the planned date. You will then receive a call from the C-Section Co-ordinator a week prior to confirm the date and share important details.

4. How are slots for elective C-Sections allocated?  

Slots are allocated based on clinical priority to ensure every woman gives birth safely within their gestational range. Factors considered include:  

• Cot dependency  
• Collaboration with the Foetal Medicine Department  
• Conditions such as FGR, GDM, placenta previa, previous C-Sections, fibroids, twins/triplets, ruptured uterus, hypertension, or mental health concerns 
• Procedures such as sterilisation or VBAC (vaginal birth after caesarean)  
• Other medical considerations like previous tears or high BMI    

5. Can I request a specific date for my C-Section?  

You may request a preferred date, but it cannot always be guaranteed. Clinical priorities take precedence to ensure the safety of all women and their babies.

6. Do you send letters to confirm my C-Section?  

No, we do not send letters. We will call you directly, update your BadgerNet record, and send a confirmation text to ensure you receive timely communication.  

7. Can my date still change after it has been confirmed by the C-Section Co-ordinator?

Yes, your confirmed date may still change in cases of emergencies. While we do our best to keep schedules stable, urgent cases or unforeseen circumstances may require adjustments. If this happens, our team will inform you as soon as possible and work to minimise any inconvenience.

8. How long will I wait after arriving at OWLS?  

We allocate time for you to meet the medical team on the day of your C-Section. Procedures are then carried out in order of clinical need.

9. What happens if my C-section is delayed on the day?

Delays can occur if emergencies or urgent cases arise that require immediate attention. If your C-section is delayed, our team will keep you informed and provide updates on the timing. We aim to minimise any waiting time and ensure that you and your baby receive the safest and best care possible. Please rest assured that you will be well-supported throughout the process.

10. What happens if I go into labour before my scheduled C-Section?

If you go into labour before your scheduled date, please contact triage immediately. A clinician will assess your situation to determine the urgency of your care.

• If labour is progressing rapidly or there are additional clinical concerns, your C-section may be classified as Category 3, meaning it will be performed as soon as safely possible but is not an immediate emergency.
• If the situation is stable and there is no immediate risk, your C-section may remain a Category 4, the least urgent category, allowing for a planned approach.

Our team will prioritise your safety and the well-being of your baby while keeping you informed every step of the way.

11. Can I have an elective C-section for a future pregnancy if I have one now?

Yes, you can have an elective C-section for a future pregnancy if you have one now, though this will depend on individual circumstances. Your healthcare team will assess factors such as your overall health, the condition of your uterus, any complications during this or previous pregnancies, and your personal preferences. They will provide guidance on the safest delivery method for future pregnancies, whether that is another C-section or attempting a vaginal birth (VBAC).

For further queries, please call the C-Section Co-ordinator via Switchboard on 0121 472 1377 ext. 5103

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.

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.