I have SO many clients that are afraid, even terrified, of a Cesarean. They are aiming for a natural birth, planning for relax and endure labor contractions and have the right mindset to be successful. But, sometimes things happen and plans change! If you missed my Facebook Live (that was cut short by a “it’s go time!” labor call), I wanted to give you a chance to get caught up on all things C-Section.
My goal behind this topic is to educate, not to scare. If anything you read below causes you anxiety, please reach out to your support network, partner or doula to process!
Ultimately, I want to give you tools to feel more in control in these situations and decrease fear that may be associated with Cesareans.
First, let me break down some common misconceptions and help you understand this procedure more clearly.
**What are the different types of C Sections??
C-Sections can be categorized in one of two ways —
Unplanned or Planned
Within the category of Unplanned C-Sections lies two sub categories- Urgent and Emergent. The main difference between these two sub categories is the time in which it takes the medical staff to go from “decision to incision” after making the call that you need a C-Section.
Urgent– this type of C-Section happens quickly, with a decision to incision time that varies based off of the reasoning for the procedure, which could be if you have a very long labor or “stalled” cervical dilation, a result of a vaginal exam (abnormal pelvis shape, or part of the baby’s head that is coming through the cervix), or if the baby is having mild to moderate decelerations in their heart rate.
With this type of C-Section there is usually time to place a spinal block so the mom can be awake for the procedure.
Emergent– this type of C-Section typically has a less than 30 minute time frame from “decision to incision,” and happens very quickly. Reasoning behind this type of C-Section could be a dangerous or potentially fatal change in vital signs of you or the baby, an umbilical cord that is coming past the babies head into the vaginal canal, or an issue with the placenta detaching prematurely from the uterus.
Most likely you will be put under general anesthesia, though sometimes an already placed epidural will be utilized for the procedure.
There are multitudes of reasons to have a planned C-Section. It is a decision that you and your doctor make based off of how your pregnancy is going, the way your baby is growing and how they are doing in utero and the safety of delivery. There may be a red flag or two that come up to your doctor based off of your health history, the position or behaviors of the baby and so forth. If you have been able to have an in depth, two way conversation with your care provider about this delivery option and feel that it is the best and safest thing for you and your baby, that is a win! On the other hand, if you have questions about the necessity of your C-Section, want another opinion or don’t feel heard, reach out to your support system and continue to research and talk with your doctor. Ultimately, the best thing to do in a planned C-Section is to get all of the facts and prepare to meet your baby!
**What happens in a C section??
In order for you to understand some of the ways in which you can modify a C-Section to best fit your comfort level, let me explain what a normal procedure is like!
*This is a planned or urgent Cesarean. An emergent cesarean may look different based off of the status of mom and baby*
Normal Cesarean Section
- have to be “NPO” (nothing by mouth) for 6-8 hours before hand, if possible
- done in a cold operating room where the staff will be in OR gear- scrubs, head caps, face masks and shoe covers
- receive a spinal block (like an epidural), in the OR
- lay down flat with arms out in a “T” shape
- IV/ blood pressure cuff and ECG leads to monitor your heart rate will be placed
- numb from the chest down, but you may feel like your arms are heavy from the different medications they give you
- medication to decrease nausea will be given
- you will have a drape placed about chest line and a hair cap on as well
- your partner can sit at your head and will also be in OR gear, sometimes your doula is allowed as well
- you will have a low abdominal incision that runs horizontally and is usually 4-6 inches long
- may feel a pressure and a pulling sensation as your baby is born
- after baby is born, depending on the type of c-section you have, they will be dried off and taken to the warmer for immediate assessment and to suction out their lungs to help them breathe
- baby will be weighed, measured, foot printed and wrapped up and given to dad to hold and show mom
- the doctor will remove your placenta, clean you up and suture you, which takes 30-45 minutes
- after they are finished you will be rolled into a labor or recovery room where you can hold and nurse your baby at that point
- stay in the hospital for 48 hours to heal
- nurses will keep you comfortable with pain medication, but you will be encouraged to begin moving as that helps the healing process
- you will bleed vaginally, as well as have soreness in your incision site for 4-6 weeks (on average)
**What are my options??
A term that has been brought into the birth world is “Gentle Cesarean.” With this type of procedure (which varies by provider), you have some room to discuss how you would like the atmosphere of the OR to be, what the immediate postpartum period will look like and some measures to help ensure comfort if a Cesarean becomes necessary.
In a Gentle Cesarean you can have conversation about–
- ice chips or water for your mouth in the OR
- music in the OR
- dimmed lights
- access to your arms during the procedure, including having your IV and blood pressure cuff on your non dominant arm for more mobility
- ECG leads placed on your back for better skin to skin with baby
- extra person in the room (doula/ photographer, etc.)
- slower, more explained procedure with doctor asking permission before beginning and delivering baby
- a clear drape to see baby as they are born
- dad or mom announcing gender
- delayed cord clamping
- skin to skin with baby as soon as possible
- breastfeeding in OR
It will depend on your provider, but it is definitely worth having a conversation about your options if you are heading down the C-Section route! C-Sections don’t have to be a scary, out of control type experience. The more knowledge you have, the better it can be.
**If you have had a frightening or traumatic birth experience, please contact a counselor or talk with someone about what you experienced. Though it is very important to have a healthy mom and baby, being mentally healthy is as important, if not more important, than being physically healthy.**
Lastly, I wanted to leave you with some encouragement from moms who have been there!
“I would tell other moms two things. First of all, do not fear the cesarean – it can actually be a pleasant, completely satisfying and enjoyable experience! Secondly, do not feel guilt about having a cesarean. My husband and I had fully planned and prepared for a natural, vaginal birth during the months proceeding our delivery. I will admit that it was hard to come home from the hospital and see our Birth Boot Camp booklets around the house as a reminder of what could have been. But in the end, the cesarean was the absolute right and necessary choice for us to deliver our baby safely into the world. I choose to focus on feelings of gratitude for a healthy baby.” – Amanda S.
“I would say don’t overthink the procedure. I overthink everything and I am so grateful I didn’t have time to overthink the c-section. It wasn’t scary. Trust your doctor, your anesthesiologist, and your nurses. It will be okay and you get to meet your sweet baby within 10 minutes! It’s such an amazing feeling!” – Lyndsay H.