The first order of business -- after consent forms are signed -- is anesthesia. If you already have an epidural in place, the anesthesiologist will increase the dosage. If not, your obstetrician and the anesthesiologist will most likely choose an intrathecal (spinal). Both involve an injection in your back (for which you'll be numbed), and both numb you from the rib cage down. Next, you'll drink some chalky stuff called Bicitra to neutralize your stomach acids, and you'll be given a catheter and IV. Then it's on to the operating room, where your partner suits up in scrubs and a mask.
In the operating room, a curtain will be pulled across your midsection so that in addition to not feeling the proceedings, you won't see them either. With so many of your senses out of commission, you may find yourself listening hard. You're likely to hear a fair amount of activity in the far half of the room: a scrub nurse, another nurse or two, the anesthesiologist, and perhaps a hospital pediatrician. In a teaching hospital, an extra doctor may be observing.
A nurse will shave just enough of your pubic hair to clear the way for the incision, which is usually about as long as your middle finger. When the surgery begins, you won't feel pain. According to Anne Wigglesworth, MD, an ob-gyn with 19 years of experience practicing in Manhattan, Kansas, many patients feel a bit of a pinch as the peritoneum -- the shiny, hard-to-anesthetize tissue that lines the abdomen -- is reached.