LET'S TALK CESAREANS
In the last several decades the rate of cesarean births have risen. Depending on where you live in the world or which hospital in a particular city you deliver in your rates can be higher or lower than others. If you live in the United States the chances of having a cesarean birth are around 32% according to the CDC. Even though there are more and more discussions and practices taking place to lower our cesarean rates, having a cesarean birth is very real and often mothers can worry a great deal about having one. "I just don't want a cesarean." I've heard a lot of mothers express this to me as their doula through the years. Doulas can help educate and help mothers in labor along with a few tricks up our sleeves but we cannot prevent any mother from a cesarean birth. Hiring a doula and choosing a good practice definitely lowers your chances of being wheeled into the OR but we also attend plenty of c-sections. I'd also just like to express that cesareans can be necessary and that it is amazing that we have the access, technology, and skilled professionals to perform cesareans!
It still can be incredibly hard emotionally, even if it was a necessary cesarean section. It can take even a harder toll on a mother who has been wheeled into the OR for a second or third time after trying for a vaginal delivery.
A PITTSBURGH BIRTH
When this mother reached out to me early in her pregnancy she was very ready to learn and take all the measures necessary to give herself the best shot at a VBA2C. She picked a solid practice in a nice hospital and knew all her options. We worked very hard in her birth but in the end she needed to go back into the OR for a third time. I knew she wanted a vaginal delivery so badly. She was amazing and strong when they made the decision to go back into the OR. Her husband was so supportive and wonderful to her as well. The OB that performed her cesarean was an incredible doctor that I often recommend to any expecting mother in our area.
So what is it like and what are my options?
Planned or not, most of times you have time to talk with the doctor, anesthesiologist, and nurses before heading into the OR. Some mothers find it helpful to write out their thoughts in a birth plan beforehand so they can hand it to their doctor if needed. Here are a few things to consider in your cesarean birth: These are based on my experience accompanying my clients into the OR as a doula or photographer here in Pittsburgh, Pennsylvania.
1. NEVER be afraid to ask for a second support person to be with you in the OR if you have a doula, photographer, or family member at your birth. Even if your nurse or a doctor at one of your prenatal appointments told you that it's their policy not to have a second support person, situations regarding your birth may change and you may have an excellent doctor and anesthesiologist who just want you to have a positive experience in the OR. The worst is they say is no, but you will never regret if you try. It's important to express to your team performing the cesarean how important that second support person is to your birth and specifically the role they will play in the surgery and what exactly they will be doing. It also helps if that second support person has had experience being in an OR and that she or he has been welcomed as a professional by the medical staff in the birth. That second support person can truly help mom and dad feel at ease and explain things as they are occurring. It is most common that your doula or photographer would be walking in with dad/birth partner so it is really nice for that first support person to have someone by their side getting prepped and waiting with them and talking. Having that second support person document and take photos in the OR is huge for the family. It can really help process the experience and give a perspective they cannot see or were not able to be near.
2. Advocate for Skin-to-Skin in the OR. As long as baby and mother are well there is no reason not to be able to touch and feel your baby shortly after birth. You can usually talk to the Stork Nurse before going into the OR. The Stork Nurse is someone who is usually in-charge of baby once they are born. Her and her team typically take baby immediately to the baby warmer after delivery. It is typical for the doctor to hold up baby for families to see quickly after baby is born but it can take a really long time to see or touch your baby after he/she is whisked away to the warmer and checked over. Ask your head baby nurse to do her best to hold off on the extra examinations of baby after delivery. Once they get that baby to the warmer they love to hold onto them and do everything including weighing, measuring, doing footprints, etc. After baby's lungs are good and clear you can ask your nurse to hold off on all those other things.
3. Watch it! That is right, you might be able to see the surgery being performed if you are up to it. I know a lot of you reading think that is crazy but it's important to remember that you are only seeing baby emerge and being born. Remember that you have a nice size belly at this point and the incision is down by your bikini line so your stomach blocks out a lot of the more gory parts. It can really help moms process the birth and make it feel so much more normal. Doing a quick google search will show that there are plenty of women who have been able to see and watch their babies be born in many ways. This can be a good plan for those who are scheduling their cesareans beforehand but the unexpected cesarean mother also may have the chance to witness the birth of their child. Some hospitals have been providing mothers with the option of clear drapes! Ask if your hospital have them. If they do not and you are scheduling a cesarean birth you can ask if there is any way of getting them before your birth. A lot of hospitals have drapes with a window to see. You can ask for that to be open during delivery. Some doctors will even allow the drape dropped just before the birth of baby. Again, it's one of those things where it is never a bad idea to ask!
Remember that if you have a cesarean or have ever experience a cesarean birth that you in no way failed or that your body is broken and not designed to birth babies. There are many reasons why mothers have to go into the OR for their birth. If you struggle coping with your birth please consider reaching out to ICAN in your area. If you had a very positive and beautiful cesarean birth SHARE IT, and also reach out to ICAN so you can be a hope and positive factor to women that are nervous and need positive birth stories.