First, a nurse will prep you for the procedure. Your abdomen will be washed and possibly shaved, and you may be given medication to reduce stomach acid so that it doesn’t enter your lungs. You’ll receive an IV in your arm or hand, through which medications and fluids will reach you during the procedure. A tube called a catheter will be put in your bladder to empty it during surgery, lowering risk of injury. After the prep, you’ll be put under anesthesia.
Once you’re under, your doc will make either a vertical or horizontal (transverse) incision above your pubic hairline, going through your skin and abdomen. (The muscles can be moved, so don’t normally need to be cut.) Then, another incision— again either vertical or transverse — is made in your uterine wall. Because they are done on the lower, thinner part of the uterus and thus bleed less and heal better, transverse incisions are usually the first option. Some circumstances, ,such as a very preterm baby not yet in the head-down position, may necessitate a vertical incision, though.
Your baby is then simply delivered through these incisions, and then the umbilical cord is cut and the placenta is removed. Your uterus will be closed with dissolvable stitches, and more stitches or staples will close up your skin.
American College of Obstetrics and Gynecologists. Your pregnancy and birth. 4th ed. Washington, DC: ACOG; 2005.