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 it doesn’t enter your lungs. You’ll receive an IV in your arm or hand to deliver medications and fluids during the procedure. A tube called a catheter will be put in your bladder to empty it during surgery, lowering the risk of injury.
After the prep, you’ll be given either an epidural block, spinal block or general anesthesia. With an epidural, the drug is injected into a space in your spine to numb the lower half of your body and typically kicks in after 10 to 20 minutes. A small tube is also usually inserted into that same space, which doctors can use to give you more drugs, if needed, without having to resort to another shot. A spinal block is similar to an epidural in that it numbs your body’s lower half and is administered as a shot, but it’s injected directly into the spinal fluid and starts working faster, but only lasts for an hour or two. If you’re given general anesthesia, you’ll be completely knocked out for the delivery.
Once you’ve been given the drugs, your doctor 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 they don’t normally need to be cut.) 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 therefore bleed less and heal better, transverse incisions are usually the first option. However, some circumstances, such as a very preterm baby who isn’t in the head-down position yet, may require a vertical incision.
Baby is then delivered through these incisions, and the umbilical cord is cut and the placenta removed. Your uterus will be closed with dissolvable stitches, and more stitches or staples will close up your skin. If you’re awake for the surgery, you can usually hold baby right away.
Expert source: American College of Obstetrics and Gynecologists. Your pregnancy and birth. 4th ed. Washington, DC: ACOG; 2005.