Preparing for a Caesarean Birth: TEN THINGS YOU CAN DO
At the moment, approximately one third of births in BC are by Caesarean.
Some Caesarean births are planned in advance. This would usually be for a specific, pre-diagnosed reason such as Placenta Previa. And some ‘belly births’ are chosen during the labour because the labour isn’t progressing or the birthing person is exhausted. The technical term for an unplanned Caesarean is an “Emergency Caesarean”, although it is not necessarily (or even usually) an emergency.
If you have a scheduled Caesarean, or if you end up needing an unplanned one, there are several things you can do to improve the experience. Here are ten things you can do. Although these things work for most people, you know you best, so remember to personalise and customise all approaches to reflect your own preferences and needs.
1.Advance Planning
Whether scheduled or unplanned, a Caesarean birth is always a possibility. So it can be useful to think about what your priorities might be in advance. If you end up giving birth that way, what would be important to you? What would help make the experience wonderful, to celebrate it, personalise it, and make it your own? These are things you can include in your birth plan, or at least discuss in advance with your partner, doula, or support team.
2. Support
During a belly-birth, you are usually able to invite at least one support person into the operating room with you. This might be your partner or your doula or a support person of your own choosing. Having someone there for you, to support your experience and help you emotionally, can transform this from a potentially stressful surgery to a magical birth experience.
3. Touch
Your support person can usually hold your hand, or your shoulder, or maintain some form of physical contact throughout the birth. This can be very grounding, and also very supportive. It can help you feel a sense of teamwork and togetherness, so that you don’t feel alone. Our nervous systems are very responsive to touch during labour, and it can help us produce oxytocin, and feel-good hormones, which can also help us bond with our baby.
4. Eye Contact
Some people like to lock eyes with their partner or doula or support person during a belly-birth. Sometimes that eye contact can help centre or reassure you, or can help you feel solid and calm. Support people should offer eye contact, but don’t worry if the birthing person doesn’t use it. Some people close their eyes during a belly-birth, and some prefer to look at the obstetrical team. Make sure your eyes are available if she is seeking eye contact, but trust her instincts to look wherever she feels most comfortable.
5. Words of Encouragement
Your support person can help transform your belly-birth into a wonderful experience with positive words. Words of love, words of comfort, and words of encouragement, go a long way to helping you relax and supporting your positive frame of mind. Words of affirmation. Words of reassurance. Words of support.
6. Sportscasting
But also words of explanation. Usually, the birthing person is the only person in the room who can’t see what’s going on. It can be unnerving if everyone else suddenly goes silent, or gasps, or shares some collective reaction, and you have no idea what just happened. Your support person can actively and immediately reassure you that the baby is okay, or explain that everyone just gasped because the baby has a lot of hair, or shockingly blue eyes. They can tell you that the baby is out, that the baby is breathing, that the baby is okay. Support people can narrate the events so that you stay in the know, and you don’t have to guess what’s actually happening.
7. Photos
Most of the time, the support person will be welcome to take photos of the birth. If this is permitted, I encourage you to do so. Later, the birthing person will almost always treasure the photos, and want to go through them over and over again. After all, this is your baby’s birth: their first breath, their first facial expression. Most parents love having photos of their baby’s birth, especially since the birthing person wasn’t able to see it in real time. If the support person gets queasy at the thought of watching a surgery, someone else can often take photos (doula? nurse? midwife?) depending on who’s in the room. And sometimes, depending on the circumstances, the obstetrician will advise against photos, in which case your memory will have to serve. But if it’s allowed, I suggest taking some and preserving the moment. You won’t regret it.
8. Immediate Skin to Skin
Often, you can have your baby immediately skin to skin with you following the birth. Even as you are getting stitched up, your baby can be on your chest. This can be very powerful, very bonding, and very emotional, as parents and baby alike are primed to fall in love with each other right after the birth. Sometimes, the birthing person can’t hold the baby yet due to shaking from the anaesthetics, or for some other reason, in which case the partner can hold the baby skin to skin. If the baby needs immediate medical attention, the skin-to-skin can wait until after, but if it’s possible right away, you can request it. Skin contact with you is stabilising for the baby–all their systems are co-regulated by proximity to your body–and it stimulates instinctive bonding behaviours in both parents. So if it’s possible, immediate skin-to-skin contact is a wonderful thing to request.
9. Delayed Cord Cutting
Sometimes, even in a belly birth, you can ask for delayed cord cutting. Sometimes the delay has to be shorter (such as one minute instead of two or three), but every second helps. The more of the placental blood that gets to travel into the baby, the better for the baby’s health. So asking to delay the cord cutting for as long as the obstetrician will allow is something that people often request. Sometimes, due to medical circumstances, this is not possible. But it never hurts to ask.
10. Postpartum Healing
Possibly one of the most important considerations when having a ‘belly birth’ is recovery. The healing is harder, takes longer, and is more uncomfortable. No matter what kind of birth you are anticipating, it is wise to prepare for this contingency just in case. You can make the first week or two at home much, much easier if you prepare for it. Have plans for someone else, whether it’s friends, family, or hired services, to do all your housework, grocery shopping, meals, pet care, garbage, laundry, and anything else you can think of. Services for meal delivery or dog walking make great baby shower gifts! Or make and freeze all your meals now, and have them ready to thaw. Or use paper plates for the first week. Anything you can do to limit chores will be a huge help. Likewise, consider a postpartum doula for the first while, as the birthing person will have a hard time moving or standing. Again, postpartum doula services make a great shower gift. Consider adding this to your wish list.
Sometimes we know in advance that we will be giving birth by Caesarean, and sometimes the ‘belly birth’ is an unplanned and unexpected outcome. But it can still be a wonderful, magical, and perfect birth experience, especially if you lean into it and do everything in your power to make it amazing. If there’s anything that’s especially important to you, do not hesitate to ask your medical care team if it’s possible. Sometimes we have to let go of a particular wish because safety or health considerations take priority, but it never hurts to ask. The worst that can happen is your care provider will say no.
Another time, we will post about what you can do to limit the likelihood of an unplanned Caesarean. But sometimes there’s nothing you can do to prevent it. It’s simply the safest or the only way your baby can be born. In which case, embrace it, celebrate it, and make it your own. A belly birth, after all, is a real birth.
Stephanie Ondrack lives in East Van with her partner, 4 kids, 4 chickens, and 5 cats. She has been with The Childbearing Society since 2003.