Mothers Circle

So you need a cesarean or you come to that decision during labor. How can you make it the safest and most satisfying experience for you?

If you are pregnant and planning a vaginal birth, it’s still important to remember these tips for cesarean birth. I believe it’s vital to understand the procedure and your options. With a cesarean birth rate of over 30% in the U.S., even if you’re not expecting to, you could end up in the OR. Read, learn, and discuss it with your provider; then let it go and envision the birth you want.

If you are already scheduled or know you will be having a cesarean, use these tips for cesarean birth to create the birth you want.

7 Tips for Cesarean Birth

1. Be Involved in the Decisions

As with a vaginal birth or labor, Moms having a cesarean need to do their homework to be educated and to make truly informed choices. Even though this is surgery, you DO have options to consider and things you can request or discuss with your doctor. This is your birth and the more involved you are in making decisions that affect your experience, the more likely you are to have a satisfying birth, even if it’s not what you’d hoped for or planned.

I had a client who was planning a home birth but it turned course leading to a transfer to the hospital and a cesarean birth, two opposite ends of the birthing spectrum. While disappointed, she knew she made the best possible decisions for her family at each stage; she felt empowered and at peace with her birth because she was not a passive participant and made the choices at each crossroads.

Own your birth. Select a provider you trust, feel comfortable with your doctor and place of birth. Understand the surgery procedure, the anesthesia, the recovery expectations. Read, reasearch and ask questions. Read blogs and forums that discuss c-sections so you feel well informed of the aspects that may not be as widely known or discussed. Ask for a consent form ahead of time so you can actually read it and ask any questions that may arise. Too often you only see this form as someone glosses over the content while hovering waiting for you to sign it.

Even if you’re planning a vaginal birth, having an understanding of a c-section is important since nearly one third of Moms in the U.S. have cesareans and most of those are not expected or scheduled ahead. This in itself does not mean they were emergencies, as some are, but more often it means they weren’t planned and something during labor lead to the decision.

2. Learn and Practice Relaxation

For both vaginal and cesarean birth, having good relaxation skills is essential. Relaxations skills are pretty important for life in general, too, and certainly for sleep-deprived life with a newborn!

There are a variety of tools to try, see what works for you and incorporate it into your birth preparations. Aromatherapy, affirmations, progressive relaxation, meditation, breath work and visualizations are all effective. You could even simply listen to a song you love daily while consciously relaxing; this practice will create a relaxation association in your mind and when you play that song in a cesarean (or during labor), your mind and body will respond by relaxing.

I recommend the book “Prepare for Surgery, Heal Faster: A Guide of Mind-Body Techniques” by Peggy Huddleston. Peggy comments that “Of all medical problem, 85% are caused by stress. When you are anxious, you produce excess levels of stress hormones, such as coritsone and the catecholamines, which diminish the functioning of your immune system.” If you know ahead of time that you’ll be having a c-section, this book is full of solid advice and ideas to prepare yourself and to recover quickly. (Incidentally, the book is not only about cesareans and is good for any surgery.)

3. Gentle Cesarean Options

Gentle Cesarean is a Mom and family-centered practice that aims to allow families to create a cesarean birth experience that is defined by them. You still have options when a cesarean birth is planned ahead or when labor changes course leading to a c-section.

Some things you can ask for, discuss with your provider and include in your birth wishes/plan:

• Can the staff place your baby on your chest after delivery so that you can see, smell, snuggle and speak to your baby while the doctors complete the surgery? Skin to skin in the OR is a key component of Gentle Cesarean.
• Can the baby have its first exam on your chest/in the OR instead of leaving to go to the nursery?
• Can the baby come directly to Mom’s chest instead of the exam table to initiate breastfeeding immediately after surgery?
• Can the anesthesiologist avoid giving you sedatives or medications that could make you forget the birth?
• Can you play your own music in the OR?
• Can you take pictures and/or video the birth?
• Can the doctor “milk” the umbilical cord before clamping to give the baby its own cord blood?  (This parallels delayed cord clamping in a vaginal delivery. Milking it 5 times is recommended based on a research study occurring now.)
• Can Dad/partner announce the sex of the baby?
• Can Dad/partner cut the cord again after the doctor has cut it initially?
• Can your doula to be in the OR and recovery room with you?

4. Ask for Your Doula in the OR and Recovery

This falls under the options in a cesarean birth but it’s important enough to warrant it’s own listing. In some hospitals, it’s routine and expected that the doula will accompany the family into the operating room, in other hospitals, even when planned and asked ahead, they won’t agree to it.

In one local hospital, I have had two very different experiences with two different surgeons and two different anesthesiologists. In one case, even though the surgery was scheduled, no matter what the couple asked, nothing convinced the doctor  to allow me to be admitted; he claimed hospital policy as the reason. In another case, at the parent’s request, after the nurse said, “No,” I was welcomed into the OR by the obstetrician and the anesthesiologist even kept making sure I had the best spot to be able to support the Mom and Dad both.

I have been thanked by doctors for being there, saying I made their job easier by having a Mom who’s more at ease and attended to by someone who understands the setting. I have been hired specifically to attend cesareans and have accompanied couples into the OR when the determination has been made during the course of labor. As they need, I am able to comfort, explain, distract, calm or answer questions for the couple who are often uncertain, nervous or anxious before and during the surgery. As mentioned in Tip #2, with less stress and anxiety in your surgery, your immune system will function better thus allowing for faster healing and recovery.

5. Keep Your Baby With You

I think that one of the keys to feeling satisfied after your cesarean is keeping your baby (and your husband or partner) with you during the whole surgery and repair. One of the single greatest reasons for sadness, distress, regret or even trauma I hear from new Moms post-cesarean comes in this moment of being left alone in the OR. Their baby and husband have been lead out to the nursery and Mom is left on the table with the doctors and staff, who are usually wonderful and kind, but who are also otherwise occupied.

If there is one universal thing I hear that increases Mom’s satisfaction with her cesarean birth it is to not be separated from her baby and loved one. Some hospital policies are still routinely separating Moms and babies after cesarean births. In this situation, it is even more important to have a doula stay with the Mom in the OR as doctors finish the repairs.

6. Get Moving … And Rest!

As soon as the anesthesia wears off, move your toes. Then move your legs. Then as soon as you’re given the go ahead, get up and walk. Take your baby for a walk in the see-through plastic bassinet every morning and every afternoon that you’re in the hospital.

Moving will help prevent blood clots, eliminate the gas from abdominal surgery, help get your bowels going and it will begin your healing. One caveat: Don’t overdo it! When you get home, have extra help (see Tip #6) and alternate rest and movement. You are still recovering from major surgery and getting less sleep than usual all while figuring out and caring full-time for a new human. You need to rest!

An extra little tidbit: For the first day or so after surgery, don’t drink ice cold liquids. Instead, have room temperature or warm drinks to minimize abdominal gas.

7. Plan for Extra Support at Home

One of the top tips for cesarean birth is to arrange extra help for when you and the baby come home. All new Moms need additional support after the birth of a baby from household chores (meal preparation, laundry and dishes), to childcare for older kids, to practical help like feeding, bathing, and soothing the baby.

First time and experienced Moms all deserve to be mothered during the postpartum period by family, friends or trained professionals such as a postpartum doula. The experienced, non-judgmental presence and guidance of a postpartum doula can bring a sense of peace amidst the chaos of having a new baby in the house. It’s remarkable how one little newborn can turn so much upside down!

Give yourself time to heal and enjoy your new baby. Accept offers of help – no matter how hard it is for you – your friends really do want to help!