Caesarean Sections - The highs and lows
Caesarean sections are a medical procedure that are sometimes vital for saving a mother and her baby’s life. About a third of all births result in a caesarean section. There are a number of reasons why having a vaginal birth is better, but what if you can’t? What support is out there for mother’s, father’s and babies to help aid their recovery from the trauma of needing a c-section?
Why have a caesarean?
25% of reported births in New Zealand are caesarean sections with 10-11% of these being planned, according to reports from the college of midwives. There are many different reasons why women are recommended to have a c-section, these include but are not limited to;
· Placenta praevia (low lying placenta)
· Fetal distress
· Abnormal positioning of the baby (breech)
Women may also be recommended to have one if they have previously had a caesarian. Although it is possible to have a vaginal birth after a caesarean section (VBAC) it is usually recommended to talk to an obstetrician about this decision.
Women also have the right to ask for a caesarean which again would need to be discussed with an obstetrician.
When a labor is not developing as planned and baby appears to be in fetal distress it may be decided that an emergency caesarean is the best and safest option for mother and baby. If this is the case everything can happen quickly. Lots of people can come into the room, forms need to be signed giving your consent. This is often rushed as time is of the essence. Your safety and the safe delivery of your baby is the priority. They will always try and keep the mother conscious during the procedure so that they can be awake to meet their baby straight away, as well as having a partner to support them during the operation. This is important for bonding and attachment.
This can often be a frightening experience for both adults. The feeling of the unknown after you may well have gone through a tiring labor is not easy. The good news is that this operation is done regularly and doctors are very experienced.
I only recently found out that as a mother you have the right to choose how you want your c-section to happen. I think that perhaps by having a plan for the worst case scenario it might make you feel more relaxed and prepared if you should need one.
There are various things that you can think about. They are worth talking to your birthing partner and midwife about before putting a plan together which you can keep in your hospital bag.
· Anesthesia options – epidural, combined spinal epidural or a general anesthetic.
· Who and how many people are you allowed with you during the procedure – mum, partner, doula, midwife.
· Can you have skin-to-skin as soon as the baby is delivered while the operation is being finished?
· Can you have a mirror to watch the birth?
· Are photos allowed to be taken? My midwife took lots of pictures of my baby being born and I was so grateful. At the time I was struggling with the drugs and the safety of my baby so to be able to see this amazing thing that had happened was for me fantastic.
· Pain options after the birth is a really important point to consider. You become so overwhelmed with becoming a mum and your new baby that often you just take the drugs that they give you without really thinking about it. I reacted badly to tramadol. It made me feel nauseous, dizzy, shaky and just generally very unwell. I had no idea that this could be a side effect. Tramadol are also highly addictive so just be aware. The other thing I should point out is that after a c-section you will be put on anti-biotics to prevent infection. Often mothers aren’t aware of this. If you are planning on breastfeeding just check that the antibiotics you are on are compatible with breastfeeding. Generally all medication that you are given will be compatible with breastfeeding but it is important you know what you are taking, especially if you/baby develop problems down the line and a lactation consultant, G.P etc would need to know medical history.
· Check how quickly you can breastfeed. I managed to feed my baby while I was in the recovery room. It is important to try as soon as you can as women who have had c-sections can have a delay in their milk coming in.
· Ask if your birthing partner can cut the cord, this is a great way for them to feel included.
· Music is allowed in some operating rooms, otherwise you may be able to use headphones to help relax you.
· If you don’t know the sex of your baby, you can ask them to not announce the sex on delivery, so that you can see for yourself and make the announcement yourself.
Your birthing partners role.
As with a vaginal birth your birthing partner still has a very important role, keeping you calm and reassured. They can also see what is going on far more easily than you can and they can make sure you are feeling okay. Your birthing partner is your voice and can ensure that what you want happens and your concerns and fears are voiced.
As with a vaginal birth they may also be able to cut the babies cord. This must be requested and discussed beforehand so the doctors and nurses are aware. If you have not found out the sex of the baby it can also be requested that your birthing partner is the first to announce the sex of the baby. You may feel more comfortable with the birthing partner doing the initial skin to skin with your baby if you are concerned about holding them in the operating room. Your midwife is your spokesperson and should be allowed into the operating theatre with you so discuss any requests with them so they can advise you.
I had two vaginal births and then ended up having two emergency caesareans. I found it incredibly hard after having my c-section to deal with my emotions. You still get the baby blues like you do after a vaginal birth but for me and a number of other women, I had an underwhelming feeling of disappointment that I had not been able to deliver my baby how I had wanted to, and in my eyes at that time the ‘correct way’, through a vaginal delivery.
I will never forget the feeling when people would say congratulations on the birth of your son and I would reply by saying, ‘Why I didn’t do anything?’ Of course I had grown my beautiful boy inside me for 36 weeks but I just felt a disappointment. In my eyes I had not been able to protect him because he came early and the doctors had to take him out as he was breech. It is a very strange feeling. You have some many drugs in your system, it is major surgery and you are generally just out-of-whack. However, Mummies you have produced a little person which is definitely no mean feat and your journey is just beginning. A healthy baby and a healthy safe mummy is the best possible outcome, however it may happen.
A side note.
It is not uncommon for cesarean babies not to cry when they are first delivered. This is because their lungs have not been squeezed out of the vaginal passage and so may still be filled with liquid. They may need a little help to remove the fluid and be able to take their first breath. Don’t be alarmed or worried by this and if you are unsure, ask what is going on. The staff want you to be as relaxed as possible. The more relaxed you are the easier it is to produce breast milk as well.
The birth of a baby is a magical and special event. Being prepared both physically and mentally will help aid your recovery. Being empowered to make choices will leave you feeling more in control and happier with the whole process. Remember, however your baby comes into this world you have done an amazing thing by growing a tiny human being. This is only the start of your journey, you now have a lifelong commitment to this person to be the best parent you can be. We need to stop focusing on how the baby arrives and start focusing on how we are going to look after them. Don’t be scared to ask questions there is no such thing as a silly question. Ask for help and don’t put too much pressure on yourself.
Please feel free to ask any questions you may have.