A cesarean birth will be scheduled for you if you have a breech baby or other complications or conditions that indicate the need for such. It may also be performed in emergency situations in which the fetus is in distress. A cesarean is major abdominal surgery and carries with it all the risks of infection and complication that any surgical procedure does. On the positive side, with a planned C-section, the date your physician schedules the procedure is your due date, and no contractions are necessary unless you begin to labor before that time.

In Advance of the Surgery

If you have any advance warning about your C-section, you'll probably be offered an epidural or spinal rather than general anesthesia. Before the procedure begins, you'll be prepped. A nurse may shave the area of the incision, and your arm will be hooked up to an intravenous line to receive fluids as well as pain medication. You may also be asked to drink an antacid solution called sodium citrate to neutralize your stomach acid.

If you are having a scheduled cesarean, try to arrange a few moments to consult with the anesthesiologist ahead of time. If you've had any poor experiences with anesthesia in prior C-sections, let her know so you can improve the outcome this time around. She can also answer any questions you might have about her part of the procedure.

Before the procedure begins you will have a catheter inserted into your bladder. The anesthetic block will give you little control over the muscles that control urine flow, so the catheter will do the work for you both during and after the procedure. Catheter insertion can be uncomfortable, so ask that it be inserted after you've received your anesthetic block (which will likely be in the operating room).

In the Operating Room

Once you're prepped, you will be wheeled to the operating room. In the operating room, the anesthesiologist will have you roll on your side and pull your knees toward your chest (or sit on the edge of the table with your legs hanging off) while he inserts a fine needle and catheter for an epidural or spinal block into your back. You'll then be asked to lie flat on your back with your arms straight out to the sides. A curtain just a few feet high will be positioned at your chest to keep the surgical field (the area where all the action is) sterile. This will also block your view of the procedure, so if you're determined to see baby the moment she emerges, you will want to ask for an appropriately placed mirror as early as possible.

Your arms may be loosely fastened down with Velcro straps. This is not to keep you from jumping off the table but to prevent any accidental movements that again could breech the sterility of the surgical field.

The most uncomfortable part of the C-section procedure is arguably the flat-on-your-back part. It's quite possible you will get nauseous as your heavy uterus compresses your vena cava and starts to lower your blood pressure. In addition, the anesthetic itself may cause your blood pressure to fall. Although the anesthesiologist will administer medication to control this drop (called hypotension) you may get sick to your stomach. Think how long you can stand lying flat on your back at nine months pregnant, and you'll see why. The discomfort is compounded by the fact that you will have to vomit lying down with your head turned to the side. This is where a well-placed mate, tray in hand, is indispensable. If this does happen, hang in there and remember this part will likely be short-lived.

A postdural or postpuncture spinal headache is a potential side effect of spinal blocks and epidurals. It's caused by the change in spinal fluid pressure that occurs if fluid leaks out into the epidural space following the procedure. When rest and fluids don't help, an injection of blood into the epidural space (a blood patch) may be required to ease the pain.

The obstetrician will make an incision, and the baby's head, perfectly round because she hasn't done battle with the birth canal, will be lifted out first and her mouth and nose suctioned. As your doctor helps your baby out of the incision, you'll feel a strange pulling sensation. Once the cord is cut you'll be able to finally see your baby, albeit briefly, before she is taken for assessment and a quick cleanup by the nursing staff. In some cases the pediatric team will be in the operating room to assess the baby immediately. Your incision will be stitched closed, and you'll be wheeled off to the recovery room where your little one will meet up with you once again. The entire surgical procedure will only take about thirty to forty-five minutes.

Emergency C-Section

If your C-section is performed under emergency circumstances, events could move quickly and you'll have fewer options. You could also be given a general anesthetic that will make you unconscious. Most dads are asked to step outside once general anesthesia has been administered, but you might want to talk to your doctor about special circumstances during childbirth.