ELCS- can someone walk me through the whole experience?

[Greenknees]

With my first baby I needed an EMCS under general anaesthetic so I was asleep the whole time. Now I am due baby no 2 and have decided that a ELCS would be the best and safest option for me and the baby.

So the whole experience is very unknown to me! Can someone talk me through what it was like- how they anaesthetise you, what it feels like, what it feel like after, how they patch you up, what you can see, how quickly you got to hold your baby, what it’s like for your partner, any decisions you had to make etc? I would really appreciate being prepared this time!

So from what I can remember...

Walk to theatre and they sit you on the bed.

Give you the spinal block. Feels like a weird pressure in your spine but doesn’t hurt

Then you lie down and check your numb before starting anything. There’s a lot of prep that you can’t see as they put a big screen up literally just under your boobs so you can’t really see anything at all.

Couldn’t feel the incision and could just feel them sort of moving around to get the baby, like they were doing the washing up

The getting the baby out was super quick and he was on my chest pretty much immediately for skin to skin

The sewing up took the longest but to be honest by that stage I wasn’t paying attention.

The whole thing took about 45 mins from leaving the ward to being back on it

I did have some weird pain during the op, which the anaesthetist said was something to do with how much amniotic fluid there was and it seeping to places it shouldn’t. They gave me drugs to sort it.

DH did not enjoy the experience. He was far more nervous than I was for the ELCS and then the weird pain I had made him panic. He had to leave for a few mins as he was feeling faint.

But to be honest, I loved it! Was much better than the horrendous birth for DS1 and I don’t think the pain thing happens for everyone as I’d never heard of it before.

wow i could have written this post myself! had an emergency csection under general in 2017 and due to have elective csection in april. so following with interest 🙂

Wow, thank you for the detailed reply! It sounds like a dream compared to my last birth. How long were you on the ward for before your spinal block? Did you have to not eat for a while before it? Is the spinal block a needle?

For me, it went like this:

• afternoon section, so no food after 0600 and no water/drinks after 1000 (I did rinse my mouth out with water, which helped.)

• arrive at hospital at 1000. Lots of activity - into gown and stockings, second dose of antacids given, chats with surgeon, anaesthetist, etc. I was in a complete state due to previous birth trauma and the midwife arranged for me to see the theatre area again (having seen it at the pre-op). Some time spent hanging around in waiting room.

• went down to theatre just after 1400. Partner gowned up. Then into theatre, cannulated. Sit on the bed for spinal. This feels like a couple of scratches then some pressure, and they help you stay still (and calm if you’re panicking like me). Then your feet feel warm and start to go numb. You may be able to have your own music on.

• Then they get you lying down. At this point they put a screen up so you can’t see anything. Catheter in. Test for numbness. Lots of clinical checks. Lots of activity generally. Monitoring pads on your chest, clips on your fingers. They will line things up so skin to skin is possible if you ask. Partner sits next to your head. I suspect they could see more than they want to - they probably need to keep looking at you or straight ahead if squeamish!

• op starts. You will feel pressure but shouldn’t feel any pain. Baby is out really quickly. They can lower the screen for this so you see baby coming over your bump but you don’t see the incision. Most of the op is stitching you up. If baby is well, after initial checks they’ll bring him/her to you and you can try to have skin to skin, though there’s not much room. Or partner can hold baby next to you. Baby may be weighed in theatre.

• once stitching is complete, you’re moved onto a bed and into recovery. They’ll help you breastfeed if that’s your feeding choice/preference. You’ll be offered a drink and perhaps toast.

• Once they’re happy with both of you, you’ll be transferred to the ward.

Things I thought about in advance this time (having had previous EMCS under spinal) were:

• I wanted skin to skin in theatre if possible.
• I did not want baby to leave theatre unless medically required.
• I wanted own music in theatre if possible.
• I wanted staff to be aware I was terrified and had had a bad experience previously.
• I wanted to see baby being weighed, because I didn’t get to see that last time.
• I wanted to see the placenta!

The above was all very bread-and-butter for my hospital but they pride themselves in offering “woman-centred care” and I had a brilliant midwife.

Went in first thing, very early, DH allowed with me despite covid. Went to recover ward, had bloods done, general checks, anaesthetist and surgeon came around to explain all.

I was brought down by myself, cannula put in, spinal block done (well explained above). Then they lay me down, checked I was numb, screens put up, inserted the catheter,I couldn't feel a thing. DH brought in around time of first incision. Again, couldn't feel anything. He sat at my head while they got DD out. It does feel a bit weird, heard it described as being like they're doing the washing up in your stomach, but not painful or anything.

At some point your blood pressure will likely drop and you'll feel a bit light-headed and nauseous, they'll have warned you in advance. You tell the anaesthetist and they give you something to help which works quickly.

DD2 ELCS had some minor complications, but DD1 EMCS was straightforward - baby's out quickly. They held her up so I could see her (but not high enough for me to see if she was a boy or girl!). Baby and placenta taken out together and brought over to the resuscitation bed bit to be checked. DH was brought over too and cut the cord. She was weighed and wrapped up then brought over to me. I could've had her on my chest but I didn't feel safe so DH held her at my head for the rest of the op. They took photos of the three of us together.

At the end, DH and DD were taken to recovery while they got me cleaned and moved from the operating table to the bed. I then followed them to recovery where I immediately breasted, and then they got me washed and into my nightie. DD tucked in under nightie, more feeding etc and then we were brought to the ward an hour or so after leaving theatre.

My ELCS was a great experience, I know this sounds weird but I had a really horrendous vaginal delivery with my first. I went in for 7am lots of checks got ready walked down to theatre about 8.30 my husband came down with me and they took him to change into scrubs while I got spinal. They will worn you you can feel a bit funny when you first lie down after the spinal it’s your blood pressure adjusting tell them and they will give you something that makes you feel warm and lovely! You will get a catheter in and there’s a few staff in there doing checks and prepping everything.I knew the surgeon who did my section as I work on the hospital where I delivered, I had my playlist on and there was lots of chat and banter. It isn’t painful but you can feel some pulling and tugging. Baby was out just after 9.15. They lowered the screen for me as I wanted to see them lift her up and out but you don’t have to do that. I also got one of the staff to take pictures of her being delivered. Next they took baby to the side and DH wanted to cut cord then they brought her straight to me for skin to skin while I was getting stitched up. The stitching up takes the longest of the whole thing. Next baby went to DH while they wheeled me through to the recovery area and checked my observations. I was sat up in bed having tea and toast breastfeeding baby in recovery it was so calm and lovely. My other half was allowed to stay with me for 2 hours in recovery (this was last summer so covid restrictions too). Just before going to the ward 2 midwives came and helped me have a wash and put my nightie on and helped my husband change our daughters nappy and baby grow while I had more tea and toast! I went to the ward just after lunch time and I was up walking and catheter out at tea time. I know you have had a section before but the surgeon really stressed the importance of early getting up walking around and regularly going for a walk and frequent painkillers to speed recovery. also standing tall when you stand up it’s really easy to hunch which can actually make things worse. I followed his advice and I was walking around ikea on day 4 and off painkillers after about 6 days I don’t know if I was just lucky or his advice worked!

We had to get to the hospital at 7am and no eating from the night before. I could have water until about 6.30am from what I remember.

I didn’t go down for mine until about 11.30am as a few emergencies came in before me

Yes it’s a needle but you don’t see it

Thank you so much for telling me your experiences everyone. They made me quite emotional! How was the recovery from the spinal block? when were you able to feel things again? How long until you were discharged from hospital after the section?

Recovery was fine, they took the catheter out after 12 hours but I’d already started to feel my legs well before that

I was only in for 24 hours

You get a special shower gell to use for the week before, and can't eat on the morning of the op. Everyone on the morning list had to be at the hospital for 6.30 (in case you are first) but I didn't actually go to theater until 11.30. I waited in the room I'd be going back to after the op, so I could unpack a bit and leave my stuff there, which was nice.

Before I went down they took my blood pressure and did the concent paperwork, then I changed and walked down to the theater department. You push the plastic cot down with you for baby to come back in, along with the first outfit to change baby into in recovery. Before I went in to the actually theater they put a needle in the back of your hand, and you I put on the stockings.

Once in, you sit on the side of the bed, hugging a pillow while they put the spinal in, it takes a while and feels kind of strange, but not painful. Once it's in you lie down and wait for it to take effect. It's only a minute, and they just ask you to move your toes, then poke them to see if you can feel it .

Next they put up the curtain so you don't see the op. You birth partner stays next to you, so it won't be in their line of sight, but they can see if they try. I'd recommend they don't though, DH nearly fainted. You feel some tugging, then they tell you when babies about to come out, and ask if you want to see. If you do they dip the curtain a bit so you see baby straightaway, but not enough for you to see the wound.

They wrapped baby up and put a hat on, then passed her straight over for a cuddle while they were sawing me up. Once their done they put baby in the cot, then pushed us both over to recovery. DH helped weigh her, then got her dressed while they were checking me over, then she came back to me for her first feed at about 15 minutes old.

Once recovery are happy with your observations (took ages for me as I have low blood pressure and normal for me is below what they would let most people leave with) they pushed my bed back to the room on the ward. Feeling came back a few hours later, I took the paracetamol and ibuprofen just as feeling started to come back, so it had time to take effect before the spinal were off, pain wise it was fine. I had a shower that evening, pretty much as soon as my legs could support my weight, and went home at lunchtime the next day. It was so much better then the EMCS I had with my eldest.

Thank you @ForeverBubblegum. I hadn't even thought of things like lying the baby's first outfit out ready. I've also got very low blood pressure so a bit worried about that if it dips. I do hope that 'sawing me up' is a typo though

I didn’t need to take a first outfit or even a nappy into theatre! The hospital provided baby with a hat (colour-coded based on baby’s condition, luckily ours was green). Then we put a nappy on in recovery. Partner put everything in a locker when he gowned up and was then able to change back into clothes and bring stuff through.

I did have a first outfit set aside but ended up not putting baby in it until the next day as he was wrapped in a blanket and just spent the whole night feeding on me and it was boiling!

The feeling came back quickly after the spinal, certainly before we left recovery - I remember being able to wiggle my toes. They were concerned about my blood pressure though - like you, mine is low - as it had dropped very low during the op so although they were keen for me to mobilise, they also wanted me to take it steady. I had baby around 1530, was in recovery before 1630, and on the ward around 1800, I think. They took the catheter out the next morning and got me to try standing then. I was discharged early afternoon!

In hindsight, I perhaps should have stayed a second night as I was in a huge amount of pain the second night and paracetamol/ibuprofen didn’t touch the sides - I would definitely have asked for something stronger if I’d been in hospital. But at the time I just wanted to get home, even though care on the ward was about as good as NHS post-natal care gets.

I did feel completely out of it due to the blood pressure drop, which wasn’t the case first time round. They did give me something to correct it but it took ages to take effect. It went down to something silly like 87/43 at one point. After my EMCS, I remember feeling physically ok and starving. After the ELCS, I felt as though I’d been hit by a train (but there had been an emotional build-up as well, and there’s something odd about knowing you’re going to have surgery).

In terms of what to take, what I found most useful was lots of large sandwich bags. I had one for bits and bobs - all the stuff like hair bobbles, deodorant, etc - which I got DP to put on my hospital table. You can parcel up outfits for baby like this too.

I also remember being totally uninterested in food but just wanted sweet drinks - I had a full sugar Ribena after on the ward which was amazing! But you may want to bring snacks too.

Everyone has described it all.
Spinal you have to sort of curl over your bump to curve your spine (making space between vertebrae?) which is a bit uncomfortable with a bump. Doesn't hurt.

I was hanging round in the wars all morning waiting for my turn. That was really dull, and so hard to concentrate on anything because you're nervous. So take something mindless to pass the time?

Getting baby out is really fast. And like others say, not at all painful, but tugging/wobbling. The sewing up part was apparently 30 mins or so, but i barely noticed it because there's so much more activity up by your head then, with a baby happening! I'm definitely a nervous patient and not the sort to 'not notice' stitches, but it's really so busy by your head and people talking to you, and a new baby to look at/hold.

I don't remember which medication did what, but you your anaesthetist will explain everything. You may feel sick, there's medication for that. You may feel shivery, I definitely had the shivers in recovery. But it's all anticipated and explained and sorted within seconds through your cannula.

I was trying to breastfeed in recovery, so that went really fast, then you're back on the ward in no time. Spinal block wears off quickly so you can move around. I had my section early afternoon and was up and about by evening. Pretty sure I could move and feed my legs pretty soon, don't remember being 'stuck' in bed in the ward at all. I think they put a pessary while your in theatre with more pinkiller for the. The spinal wears off?

You have to have a certain amount of wee before they remove your catheter, to check for blood, so drink plenty! Unless you want to keep it in. It was really nice not experiencing a full bladder for a while!

I went home the following day. I was fine with the meds I'd been given. Didn't have any pain at all. Do take it easy, don't run a marathon, but being up and about a bit does help. I recovered really well and was walking to shops after a day or two.

You will still bleed a lot - take maternity pads to hospital and get them for home afterwards. For some stupid reason I didn't even think about bleeding as it wasn't vaginal. Not sure where I thought the post birth blood came from! It's from the 'scar' where the placenta was, so with a section you'll still have vaginal bleeding.

And like any section, big pants to make sure there's no irritation on the wound.

Oh, also, I didn't have external stitches. Internal ones were absorbed by body, external was glued.

I should also say, I had emcs with my first, under local. The elcs was a totally different ball game. Really chilled out, relaxed. The recovery was so much easier too. I'm guessing with GA especially there was a rush to get baby out and not so much concern over your body, so you were a bit battered after first? I was certainly a bit of a physical mess as they did not waste any time. Elcs was completely different. They can take their time. They even tucked my jaggedly old scar in to give me one nice little new one! And I did not fee like I'd been hit by a bus. Recovery was fast.

I was so impressed and so happy (as still suffering from first birth now mentally and physically).

Went in for 7.30 so hasn’t eaten I think from midnight. Checked in, given gown and a room to go to, sat in a room watching a film on the iPad until they came to get me at 10ish.

Walked in to theatres, husband followed soon after with nurse. spinal didn’t hurt (I think they used a numbing). Lay down, sheet put up so I couldn’t see (although I think if I’d asked I could of). Husband held hand and then watched as he was fascinated, washing up tummy bowl feeling as described (no pain), lovely anesthetist checking I was ok and not feeling sick and keeping eye on blood pressure (mine is very low too). Baby was rushed away (passed meconium) so a fraught few minutes where it was very quiet but calm and they explained it to me. Luckily ok so cleaned and passed to me, so I didn’t notice being stitched up. I do remember when everyone left including my DH and baby, being with one person and examining the placenta though!

Recovery - well monitored, lovely nurses gave me a bed bath. Amazing! Felt so much better even though I could only feel part of me. In for several hours before the ward, fed a few times (toast, tea and repeat and a meal), baby checked several times due to meconium but all fine.

Onto the ward at about 4.30pm luckily husband was allowed to stay (very handy for passing / changing). Gorgeous baby slept the first night with only a few wake ups ( I couldn’t sleep as staring at this amazing being - should of known better and slept!) and then latched on at about 3am for 24 hours and brought my milk in super fast but oh it wasn’t fun. I was v happy DH was there to help and to help me get to the loo/ shower etc.

Things to ask/ think about

• delayed cord clamping? I think they can do it. Discussed with my surgeon and he didn’t do that but did ‘milk’ the cord as standard practice.
• take peppermint tea, peppermint tablets etc etc. Gas gets puffed into you whilst operating and your guts are literally rummaged around and trapped wind can be painful. Also take ducosate? Stool softener.
• in the same vein, husband went and got me fresh fruit salad and freshly squeezed orange juice once on the ward - I was determined to get things working ASAP! (Sorry if TMI) and didn’t want to be constipated with stitches across my tummy.
• have the baby on you not tucked in to the side with your arm up (like a T) when in theatre. Gas got into my shoulder (it happens but I didn’t know) and I’m sure it’s because I held her that way whilst I was being stitched. My shoulder bloody hurt, way WAY more than the c-section incision. It had me broken on the second night.
• stay on top of the pain. Alternate paracetamol and profen for a few days. Take anything they offer in the first 2 day’s.
• water bottle with a straw - easy to get to as you really can’t move other than like a crab at first. So strange. It passes but the first 24hrs I couldn’t even roll over or get around the bed.
• high up pants - LOTS of cheap ones you can bin (you still have a surprising amount of Lochia). And maternity leggings. Anything on the incision is not good. I actually got some C Section pants after a few days, basically high and very light control, just makes you feel a little more secure/ held together.
• have a rolled up small towel to hold to your tummy if you need to cough etc, you can ‘hold yourself in’ so it’s not scary. Ditto when doing a poo (again sorry if TMI).
• injecting yourself, it’s really not that bad (although I’m relieved I don’t have to do it every day)
• you can get a c-section belt for in the car, or a thin pillow. It just spreads the pressure of the seatbelt on the way home (assuming you travel by car).

Hope this all helps. Other than the gas in my shoulder it was just what I’d of hoped for. Calm, yes some healing to do, but actually much quicker to recover from than my first emergency birth.

Sorry just realised you’ve done the post c section stuff before... but it’s all stuff I felt better knowing I had ready

Wow. Even more stories. I’m so glad I asked. The recovery stuff is still useful as I can’t really remember much from before. For anyone who has had a c section before did they just re-open the same scar? And did you have numbness around the area after? If so did it go away? Mine did last time but I remember being worried that it wouldn’t.

Yes, yes and yes to the scar. They opened up my old one for the birth of DC2 and I had the same numbness several inches below my belly button. A year on and that’s pretty much faded to numbness in the immediate scar area.

Yes they reopened the scar, they actually managed to make it neater then it was after eldest (EMSC).

Can I ask how many of you needed birth partners to stay with you overnight in the hospital after a planned ELCS? I'm having my second birth, first c section, in a couple of months and need to arrange childcare if I'll be needing DH overnight with me. I'm really hoping I can send him home but hear horror stories about women not being able to lift their babies to feed after a c section and needing help to do everything for the first few days.

@ForeverBubblegum

Yes they reopened the scar, they actually managed to make it neater then it was after eldest (EMSC).

Yes me too, my scar was neater pretty much immediately second time around. I got an infection in the wound the first time too and not a hint of it second time around.

I wasn't allowed DH overnight either time, even the pre covid one. The staff in my hospital are fantastic, but I managed most stuff on my own even the first night (in retrospect, I should've called them to lift her in and out of the cot on DD2 which is what I was told to do on DD1, but I managed and no harm done). Check with your hospital but I wouldn't expect your DH to be staying over, and at the minute he may not be able to visit at all because of covid. DH was allowed in for an hour a day last summer.

@UnicornAndSparkles I wasn’t allowed DH overnight. He was able to stay until about 8pm I think but I sent him home earlier so he was there for bedtime with our eldest. He came back fairly early the next morning

I didn’t find it too bad getting the baby, I just used the mechanical bed to help me get into a better position etc

Thanks. I think it would be easier to send DH home to look after 3yo, but a friend recently had an emergency CS at the same hospital and was in for 4 days recovering and DH never left. And this was in the middle of a pandemic. They obviously had childcare for their first born, which we don't.