Caesarean section (C-section): an OR 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
Caesarean section in one minute
What it is: an operation to deliver a baby through a cut in the abdomen and womb (uterus).
Who it is for: planned for some pregnancies (for example breech or a previous complicated birth), or as an emergency if labour or the baby's wellbeing becomes a concern.
Main risks: bleeding, infection, blood clots, injury to bladder or bowel (rare), breathing problems for the baby (usually short-lived).
Usually: under spinal or epidural anaesthetic (awake), 40–60 minutes, home in 1–3 days.
On this page: What is a caesarean section? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ
What is a caesarean section?
A caesarean section (C-section) delivers the baby through a cut, usually a low horizontal cut just above the pubic hairline, then a cut in the lower part of the womb.
Caesareans are grouped by urgency category (1 to 4), from immediate threat to life to planned, which sets how quickly the team works, as per national guidance and centre protocol.
- most are done under spinal or epidural anaesthetic, so the woman is awake and a birth partner can usually be present
- a general anaesthetic is used in some emergencies
- the midwife and neonatal team care for the baby at birth
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- a planned caesarean, for example for breech position, placenta praevia, or a previous complicated birth
- labour that does not progress
- concerns about the baby's heart rate or wellbeing
- maternal request, after discussion
The decision is made by your surgical team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
It may be planned or urgent. Before it, you usually have:
- antenatal checks and an ultrasound scan
- blood tests, including blood count and group and save
- antacid medicines and fasting advice, as per centre protocol
- a discussion of the reasons, risks and alternatives, and consent
Step by step
1. Getting ready
Team brief and WHO checklist (maternity version) first, with the urgency category stated. The anaesthetic team and ODP site the spinal or top up the epidural and check the block, or give a general anaesthetic if needed; antibiotics and clot prevention are given as per centre protocol. The circulating practitioner checks positioning with a left tilt, the diathermy plate, the urinary catheter and warming. The scrub practitioner sets up the caesarean trolley and does the first count. The midwife and, when needed, the neonatal team prepare the resuscitaire.
2. Access
A low horizontal cut is made just above the pubic hairline (Pfannenstiel), occasionally a vertical cut. The layers are opened, the bladder is moved down, and a low horizontal cut made in the womb.
3. Delivering the baby
- A. Abdomen opened. The skin and layers of the abdomen are opened.
- B. Womb opened. A low cut is made in the womb.
- C. Baby delivered. The baby is delivered and handed to the midwife or neonatal team; the cord is clamped, often after a delay, as per centre protocol.
- D. Placenta and repair. The placenta is delivered, a uterotonic given as per centre protocol, and the womb closed in layers.
Skin-to-skin contact in theatre is encouraged when mother and baby are well.
4. Finishing
The abdomen is closed in layers and the skin with sutures or clips. Blood loss is measured, swabs and instruments counted, and the mother goes to recovery with a full handover; the baby stays with her when well.
Recovery and aftercare
- First hours: in recovery with the baby; checks of bleeding, blood pressure and the wound.
- Getting up: usually within hours; the catheter is removed when you can walk.
- Going home: often 1–3 days.
- Activity: avoid heavy lifting (heavier than the baby) for about 6 weeks.
- Driving: when you can do an emergency stop comfortably; check your insurance.
- Clot prevention: injections or stockings, as per centre protocol.
- Future pregnancies: your team will talk about birth options.
Call 999 if you have heavy bleeding, severe pain, breathlessness, chest pain or collapse. Contact your team or GP if you have a fever, smelly discharge, pain or swelling in a leg, or a wound that becomes red, hot or leaky.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- heavier bleeding, sometimes needing transfusion
- wound or womb infection
- blood clots in the legs or lungs
- injury to the bladder or bowel (rare)
- breathing problems for the baby (usually short-lived)
- a small cut to the baby (rare)
- placenta problems in future pregnancies
Theatre kit list (printable)
Example kit list
Every theatre has its own protocol, and sizes and doses vary.
- caesarean instrument set and Doyen retractor or equivalent, per surgeon
- obstetric forceps or vacuum available, per surgeon
- cord clamps, blood gas syringes and placenta bowl
- uterotonic drugs, as per centre protocol
- resuscitaire and baby equipment
- cell salvage, per centre
- suction, swabs and blood loss measurement
- closure sutures and dressings
Procedural steps
- Team brief, WHO sign in with urgency category; anaesthesia and block check
- Left tilt; catheter; prep and drape; count
- Skin and layers opened; bladder moved down
- Womb opened; baby delivered; cord clamped; baby to midwife or neonatal team
- Placenta delivered; uterotonic; womb closed in layers; blood loss measured
- Abdomen closed; counts; sign out and handover
First time in theatre?
đź’ˇ First-time tip
- Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.
- Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.
- Know the category. The urgency category sets the pace; listen for it at the start.
- Baby ready. Check the resuscitaire is on and stocked before the start.
- Measure blood loss. Weigh swabs and measure suction as per centre protocol.
FAQ
Will I be awake?
Usually, with a spinal or epidural. Your birth partner can often stay.
Can I have skin-to-skin in theatre?
Often yes, when you and the baby are well.
Can I have a vaginal birth next time?
Many people can; your team will discuss it.
Related guides
Sources
All checked on 14 October 2026. Each page's own date is shown where it gives one.
- NHS. Caesarean section. nhs.uk/conditions/caesarean-section
- NICE. Caesarean birth (NG192). nice.org.uk/guidance/ng192
- StatPearls (NCBI Bookshelf), search: cesarean section. ncbi.nlm.nih.gov/books
- World Health Organization. Surgical Safety Checklist. who.int
Disclaimer
Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.
Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.
All diagrams on this page are original illustrations created for rodnieoro.com.
