By Janelle Durham, MSW, ICCE, LCCE. Program Coordinator for Great Starts Birth & Family Education
Whether or not a cesarean was what you had hoped for, it’s possible to have a very satisfying birth by taking a few simple steps to make this experience the best it can be.
Educate yourself
Learn about the procedure through books, classes, and discussions with your care provider.
Find out what the policies and regulations are for cesarean at your birthplace.
Advance preparation for a planned cesarean
The more fit you are before the birth, the more quickly you’ll recover.
Tour the hospital in advance, including a tour of the special care nursery. You can also ask to have any labwork, tests, and paperwork done in advance to ease the day of the surgery.
Meet with anesthesiologist in advance to discuss options and find out what medication will be used.
Mom and partner should take a breastfeeding class together so you both have lots of great ideas to help nursing go well.
If two support people are allowed in the O.R., consider hiring a doula. She can be a familiar presence, who may be calmer about cesarean than you are. It can be reassuring to mom and partner to have her there to help explain what is happening, and she can stay with mom while partner goes with the baby.
Prepare a Cesarean Birth plan
You may want to do this even if you are expecting vaginal birth. Ask your care provider what your options are, and then decide what you would prefer.
What would you want the atmosphere of the room to be like? Music? Would you like care providers to chit-chat to keep you relaxed? Narrate what’s happening? Avoid extraneous conversation? Can you bring two support people into the O.R. with you?
Do you want them to lower drape or use a mirror so that you can view baby being brought up out of your belly? Or can partner take a digital picture and show it to you? Are there restrictions on taking pictures and videotaping?
Who will announce the baby’s gender? Can you have immediate contact with baby after birth? Can newborn exams be done where you can see baby? Can baby be brought to your chest right away for skin to skin contact? Does the baby go to the nursery while surgery is complete, or can he stay in the O.R. with you? Can you request that if you experience trembling or nausea during the procedure that they offer you other options for coping with that before offering sedatives or tranquilizers that may make you too sleepy to enjoy those early moments with your baby?
Wait till at least 39 weeks and/or wait till labor begins on its own
One possible risk of planned cesarean is unexpected prematurity. One study found that rates of preterm delivery were 7% for vaginal deliveries, 9% for unplanned cesareans, and 12% for planned cesareans.
If baby was thought to be full term, but is found to be premature, he is at higher risk for breathing difficulties, NICU admissions, and other challenges. The chance of accidentally delivering baby too soon is less likely if the date of conception is known, an early ultrasound documented an accurate gestational age, lung maturity is documented by amniocentesis before surgery, or you wait until labor begins on its own.
Another advantage of waiting for spontaneous labor is that labor is beneficial for babies, and helps reduce their risk of breathing problems. Babies born after scheduled cesarean, with no labor, are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening situation.
Make sure you understand why the cesarean was needed
Getting a full de-brief from your care provider, and asking questions about the things you did not understand, may help you to come to terms with the birth, and feel that the decisions that were made were the right ones at the time.
Keys to birth satisfaction
No matter how your birth unfolds, it can be a powerful, miraculous moment for you. Some of the most important aspects of a satisfying birth experience are feeling like you understood what was happening, that you had choices in the matter, that you were treated respectfully, and that you felt nurtured and cared for as a new mother.
And the most essential thing? Early, frequent contact with your new baby!