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Preparation for the surgery includes starting an IV, shaving the pubic hair that shows when your legs are together and inserting a bladder catheter. Her belly will be washed with antiseptic and sterile drapes placed around the incision site. A blood pressure cuff and sensors will be put on her chest and finger to monitor blood pressure, heart rate and blood oxygenation. A curtain will be hung across her upper chest so that she cannot see the operation.
Most cesareans are performed under epidural anesthesia because it is safer than general anesthesia. If an epidural is already in place, the anesthesiologist will strengthen it so that she is numb from the toes to the breastbone.
You will first be asked to change into surgical scrubs. Upon entering the operating room, you will be given a place to sit near the head of the operative table. You will probably also be told not to touch anything that is a part of the "sterile field" for surgery- this is very important, like an airline pilot asking you not to touch the controls once the plane is in the air! The two of you will be able to talk as the operation progresses, which will be reassuring to you both.
If you wish, you can look over the drapes and observe part or all of the cesarean; her doctor will direct you. It's particularly special to see the baby emerge from the uterus, which is not as yucky as it sounds. Both of you should be able to hear your baby's first cry shortly after it's born; if you didn't find out the baby's sex before birth, your doctor will announce the answer at this time. The baby is then handed to the pediatric staff to be dried off, evaluated, and given medications; these duties are essentially the same as with a vaginal birth.
If general anesthesia is used, she will be put under by injection of a medication into her IV. Once unconscious, the anesthesiologist will put a tube down her throat to maintain an airway and deliver a gas anesthetic
The operation generally takes an hour or so. The time from beginning the operation until birth of the baby is typically about five minutes. The greatest part of the time spent after the delivery is for suturing the various tissue layers.
With rare exceptions, the roughly four-inch incision is made horizontally just above the pubic bone. A horizontal uterine incision is preferred because it produces a much stronger scar. However, in certain situations, such as when the placenta is covering the cervix, the incision is made vertically.
During the surgery, she will feel pulling and tugging but no pain. The manipulations could make her queasy, so reassure her that this is normal.
After the delivery, the obstetrician hands off the baby to be examined. Some hospitals permit healthy babies to remain with your partner and you during the rest of the operation. In others, staff will take the baby to the nursery, regardless of the baby's condition.
As the hospital staff examines the newborn, the obstetrician delivers the placenta through the incision, suctions out fluid and begins closing the uterus and inner tissue layers with stitches. The skin incision may be closed with conventional stitches, staples, or even with tape strips. Finally, the surgical wound is covered with a dressing
After the surgery, she will be taken to a recovery area where she can be closely monitored for the next couple of hours. In some hospitals, the staff will bring her the baby to hold and breastfeed. Policies vary as well as to whether your can be with her in recovery and whether may be in the nursery with the baby.
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