April is Cesarean Birth Awareness Month, and the key to having a gentler Cesarean is knowledge surrounding the procedure and your choices. Even if the thought of a C-section really scares you, by eliminating the fear of the unknown you will feel much more confident in case your birth happens this way. Working with new parents and having had a Cesarean birth myself, I know experiences can be vastly different. We are slowly getting to a point now where parents are being able to make choices for themselves and their babies during the process and immediate postpartum. However, a lot of these options remain a mystery to most expectant parents. Whether you are having a planned C-section, or want a vaginal or non-medicated birth, I always recommend that my clients make a Cesarean birth plan and discuss it with their medical team. The reality in Ontario is that almost 30% of births result in a C-section. Even so, this can be shocking, frightening and disorientating if you hadn’t planned your baby’s birth this way. Read below for my top tips on making your Cesarean birth an experience you feel heard in, involved with and that facilitates bonding with your newest family member.
1. Have all of the medical staff in attendance introduce themselves with their masks off
Being wheeled into an OR after your original birthing plan has gone out the window can be extremely frightening. By meeting the people who will be at your birth, even briefly, it can reduce the fear or anxiety of seeing a sea of blue masks and feeling isolated in the experience. There are a lot of nurses, residents and OB’s chattering around you and going about their business as if it’s just another day at the office. I even had one client of mine tell me that while the OB was preparing to birth her baby she overheard them saying “I do so many C-sections I don’t even care anymore”. Most health care providers aren’t as callous or let’s call that person what they are – a jerk. Remember, you have the right to ask any of them to be quiet and keep the conversation limited to what is really happening – your baby’s birthday!
2. Advocate having your Doula in the OR with you
I say this both as a Doula and as a mother, having your Doula in the room with you is essential. I was very grateful that I had a compassionate anesthesiologist at my daughter’s birth that comforted me throughout the process. But having a Doula by my side would have made a world of difference. When the baby was born, Ryan was busy taking pictures and doing skin to skin. I spent most of that time alone, lying on the stretcher, shaking in shock. Many hospitals in Toronto are changing their practice of only allowing one support person in the OR but there are still times when a Doula is left to wait in the birthing suite unable to do two of their key jobs – providing emotional and informational support.
3. Ask for a clear drape during the procedure, or if the drape can be lowered when your baby is born
A clear drape can be requested so that the parents can see more of the birth, but this may make some people feel uneasy. Asking for the drape to be lowered can ensure you witness your baby’s first moments, and your support person can announce the gender if you don’t already know it.
4. Delayed cord clamping is often possible and so is having your support person cut the cord
One of my favourite memories of my daughter’s birth was having Ryan announce that we had a girl. But in all of that excitement we completely forgot that we wanted delayed cord clamping and for him to cut the cord. Unless there are immediate medical concerns for the baby, this is something you can ask for, as well as keeping the placenta to bring home with you or for encapsulation.
5. Ask for immediate skin to skin on your chest, or skin to skin with your support person
You’ve probably heard about the benefits of skin to skin for your baby, yourself and initiating breastfeeding. (If not check out my Facebook post here) If there are concerns with the baby’s well being, hospital staff may want to check them out, but after the baby has been assessed (or immediately if there is no cause of concern for baby’s health), demand skin to skin on the birthing parent’s chest. If you are choosing to breastfeed, breastfeeding can also be initiated at this time. Unfortunately, not all hospitals will allow this, so the next best thing is for your partner or support person to do skin to skin with the baby.
6. Have your partner/support person/Doula/midwife talk you through the process after baby is born
It can be very difficult after your baby is born to hear them but not be able to see them. Some facilities have video cameras and monitors set up so that the birthing parent can be involved in the process and still see their baby while their incision is being repaired. Have someone let you know what is going on, step by step, every little thing. “They are weighing her now, she has so much hair, oh wow she’s sticking out her tongue, she has your ears, etc., etc.” I was very thankful that Ryan did this for me at our daughter’s birth and this made it easier when I wasn’t able to hold her right away.
It has been almost two years since my daughter’s birth and my only regret is that I wasn’t more informed about ways the experience could have been gentler and more family centered. As with any birth, we don’t always get the birth we imagined. Some of these options may not be available due to medical reasons, but by talking them over prenatally with your support person and health care provider you can ensure your birth choices are respected. Cesarean birth can be truly beautiful and every parent and baby deserves a birthing day full of compassionate care.