Preparation for a C-section varies depending on whether it is scheduled or is being done as an emergency, and depending on whether regional or general anesthesia is used.
Usually, women undergoing a scheduled C-section are not allowed to have anything to eat or drink 6 to 8 hours before surgery.
To reduce stomach acids, you will be given antacids to take before surgery. (Stomach acids can, in very rare cases, can leak into a woman's lungs during a C-section.) You will also be given a dose of antibiotic just after delivery of the baby to reduce the risk of infection.
Just before surgery, an intravenous line (IV) will be placed into a vein. It will be used to deliver medications, fluids and, if needed, a blood transfusion during surgery. Wires connected to heart-monitoring equipment will be attached to your chest, and a blood pressure cuff will be placed on your upper arm. You will be given a mask through which you can breathe extra oxygen, and an oxygen monitoring device will be placed on your finger.
A flexible tube, called a Foley catheter, will be inserted into your bladder to drain urine and keep your bladder as empty as possible during the surgery. This is often done after anesthesia is started so you probably won't feel it. Your abdomen and pubic area will be washed with an antiseptic or antibacterial soap. It may be necessary to clip the hair in the area where the incision will be.
Doctors usually prefer to use regional anesthesia for C-sections. Regional anesthesia means that you remain awake, while your abdomen and legs are numb.
Regional anesthesia for a C- section can be done a few different ways.
Spinal anesthesia. Spinal anesthesia is given by injecting anesthesia into and around the nerves of your spinal column, near the middle to lower back. This gives a rapid and complete numbing sensation, relaxing all the muscles of your legs and abdomen. Surgery can be started soon after the anesthesia is given because the effect begins quickly.
Epidural anesthesia. Epidural anesthesia requires a little more time and is given by inserting a small catheter into the space around the spinal column, called the epidural space. The epidural catheter is used to keep constant levels of anesthetic medication in the space around the nerves. The extent of numbing in the legs and abdomen and the length of time you are numbed can be controlled and adjusted as needed to prevent pain.
A combined spinal/epidural, called a CSE. A CSE provides both the immediate pain relief of the spinal anesthesia and longer acting pain relief with fine tuning, if needed.
No matter which regional anesthesia is used, you are awake and alert during the baby's birth, and can breathe naturally on your own. Some women worry that they will have pain with regional anesthesia. However, regional anesthesia numbs from the mid-chest down to the toes, and its effects last for a short time after the cesarean is completed.
General anesthesia is usually reserved for emergency C-sections in which there is not already adequate anesthesia. (In many cases, when a woman is in labor and has an epidural, this can provide the needed anesthesia for the emergency C-section.) If general anesthesia is used, you receive anesthetic medication through an IV. After you are asleep, a plastic tube called an endotracheal tube will be placed in your throat and into your trachea. The trachea, or windpipe, connects the throat to the airways of the lungs. When the endotracheal tube is in place, the anesthesiologist can manage breathing for you while you are unconscious.
Your partner or a friend can be with you during a C-section if you have regional anesthesia, but usually not if you have general anesthesia.