a

NHS Fife's guide to a planned caesarean section

on the day of your elective caesarean

section we asked you to come into the

hospital about 8 o'clock in the morning

you let I through the main maternity

engines and got to the first floor of

the maternity unit and go to the

observation unit which is where you'll

be admitted for your surgery there you

will meet your midwife and you'll also

meet the anesthetic staff and

potentially the future staff there

before you go to into theatres

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the ideal situation is for somebody to

come and and have a normal delivery and

have nice Lourdes care and but the

reality for a lot of women due to a

variety of circumstances is that doesn't

always happen planned cesarean section

is called an elective cesarean section

and it is essentially pre-planned on the

morning of lucidity in section you get

Anthony to check by your humid wife

she'll palpate your tummy listen to baby

aim and performance' of basic

observations you'll then meet the

anesthetic staff and who introduced

themselves and explained this by no

procedure aim which is the anesthetic of

preference and they will then confirm

that they're going to go ahead they'll

be two to three cesarean sections and a

day for the first thing in the morning

name they'll make a decision as to for

civilian sections going first when it's

time for you to cool you'll be asked to

get changed into your game and your

partner will also change into theater

clothes you'll then be taken along to

theatre along the corridor and you'll

walk with your midwife and shoot EEG

theater and until she told the Future

staff and the anaesthetic team that you

already have meat sometimes when you

come into detail it seems like there's a

lot of people about but they're all

there just to help you help your baby

help your partner so we have a surgical

team and we have the midwifery team and

we have an anaesthetic team as well so

that may seem like a lot of people but

we all are there just to focus on

yourselves and to look after you I mean

you're only as safe as possible and

Safety's very I begin with in theatres

and we'll ask questions that you've been

asked before um and we'll also do a

surgical pause with the whole team a

prior to starting to deliver the baby

and that's just to make sure that

everybody is aware of any spatial issues

that you might have and everything all

the equipments available I am that we're

going to need once you get to theatre

you'll be prepared for your spinal

anaesthetic and you'll set on the edge

of the theater table and face in the

window of the theatre and a nice test

will prepare you for the anaesthetic our

job is to kind of see the woman before

explain them what's going to happen

during their operation first thing to

happen would be as a checklist operating

checklist

and once they're happy with that the

initiatives will place a camera or a

plastic tube in the back of the hand and

just kind of give them the fluids and

medications and everything else

following which colleague would plug

them up for monitors which is the ECG

dots blood pressure cuff on a clip on a

finger and then the woman is positioned

for the actual spinal anesthetic we

cleaned it back with some cold

antiseptic solution it's very cool

because there's alcohol and epi any

arrests will come in and put a drip on

the back a sticky tape just to keep

everything else nice and clean once that

is done two injections are applied

back-to-back the first injection might

feel like a sharp scratch in a sting and

then following which you feel a lot of

pressure in your back once the injection

is done we take all the needles out the

drapes come out we just lay it down on

your back with a slight tilt to the left

side so that the pressure of the baby

will not drop the blood pressure after

the spinal has been placed takes about

ten minutes for the actual spinal to

kind of fully work that is from MIT just

all the way down to the toes this

surgery takes anywhere between 45

minutes to an hour once we finish the

operation and we get a woman back onto

the bed and get the baby skin-to-skin

and take them back to back to the

observation once baby is delivered your

midwife is waiting to say that the

surgeons and will receive the baby from

the surgeons baby is checked in theater

in you're kept involved in that

procedure at all times you'll then be

taken back to observation unit and when

you arrive an observation unit you will

be greeted by the same advice you

admitted you and the well perform a

series of observations to make sure that

you're safe and comfortable your spine

will start to beat off gradually

remember an observation unit and they

will advise you when you're ready to

mobilize this is usually with and they

kind of Fortis ex-ira period you will

also have a catheter and set you and it

used to be that we used to keep the

Kassadin quite strictly for 24 hours

post-surgery for spinal anaesthetic

however we have to adjust the time of

that and that catheter can come out as

soon as you're a mobile so you'll spend

your first night following your seeding

section and the maternity ward the next

day and we were taught by that point

you'll if your cats are removed and

you'll be thinking about going to the

toilet by yourself you'll be up mobile

I think gently by yourself from the room

and maybe I of the room to get a cup of

tea etc um and by that point you may

want to consider if all is well and baby

is feeding well and baby is not having

any problems and then there is every

expectation that you should be able to

go home that day my role is to see the

women on the piece post me award so

after they actually delivered their baby

he asked questions like him can they do

who villain can they go up and down

stairs can how to the part about pushing

prams and early miss really just to make

things easier for them and give them the

confidence that they're gonna manage

once they get back home and also gives

them gently exercises to help them

recover and get their muscles back nice

and tight again the exercises that we

gave are all very gentle exercises and

those exercises are there to get your

pelvic floor muscles and your abdominal

muscles starting to get stronger again

because they've all been weakened and

stray it's just with being pregnant so

will occur your pelvic floor muscles

getting them nice and tight again and

that is more to do with them making sure

that you're getting good control of your

bladder in your bowels and don't have to

any concerns further down the line with

incontinence issues your abdominal

muscles really care gentle exercises

such as just needling from one side to

the other pelvic tilts and also small

set up movement and for your long

muscles that go up and down going home

it's just really about just watching

what you're doing just listen to your

body and just taking things a little bit

more easy if there's people here to help

do that like the more strenuous tasks

getting them to do that and rest when

you can rest as well the community

Midwife will come out to see them in the

day after they're discharged from

hospital and so that they'll be ongoing

support from from staff we want our mums

to go home feeling that they've had a

positive experience and we want them to

go home feeling that they've got

adequate pain relief on board to go home

and gently mobilize and care for their

baby with a little better support from

family in planes and we would like them

to look back and it

and and feel that it was one that we had

the information to deal with him and

that they were real prepared for and

that that information helped to be a

positive experience

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