The Positive Cesarean
Not all cesareans are unnecessary, nor are they all traumatic or disappointing. Whether a cesarean is needed for a medical reason, a scheduled repeat or solely elective, both mother and baby deserve a gentle, loving and positive birth experience; One that has their best interests in mind.
In this section you will find cesarean birth plans, recovery tips, positive cesarean stories, articles, as well as tips and suggestions from other cesarean mothers.
Many women have said the way they were treated during the cesarean, the lack of control, and the lack of immediate bonding with their baby, played a huge part in their negative feelings associated with their cesareans.
This is why a cesarean birth plan can be so important. Not only should women who are having a scheduled cesarean write a birth plan, but women who are planning vaginal births should also write one up just in case.
You should go over your birth plan with your care provider well in advance. Let them know how you want your cesarean birth to unfold -- which type of anesthesia you prefer, all the way down to cutting the cord and breastfeeding in the OR.
Below are just a few things that may interest you in planning you cesarean birth.
This is your birth. Make it your best birth.
Barring a medical emergency that requires general anesthesia, many cesareans are done with either spinal or epidural anesthesia. Both have their pros and cons.
Spinal anesthesia (A) is a shot administered through a needle directly into the spinal fluid, therefore it it works much faster than an epidural, and has a lesser chance of providing inadequate or uneven numbness. It is a single shot so it does have a time limit and will eventually wear off.
Epidural anesthesia (B) is often used for cesarean sections when it's already in place, such as during a labor where the woman has already received an epidural for pain relief. The epidural is administered by placing a needle in the epidural space, which is located just outside the fluid filled sac, and a very thin catheter is then threaded through the needle into the epidural space. The needle is carefully removed, and the catheter remains and is taped to your back to secure it into place. Numbing medication is then administered periodically, so you are able to maintain pain relief over long periods of time, which can help with controlling pain after surgery.
Epidural anesthesia doesn't work as quickly as spinal anesthesia, and may not numb as evenly or as "densely".
There is also a technique that combines both spinal and epidural anesthesia. This is called combined spinal epidural (CSE). There are a few studies, like this one, that show CSE may be even better than a spinal or epidural alone, since it combines both the rapid onset of the spinal and the continuous pain relief of the epidural.
There is a small risk of a spinal headache with both spinal and epidural anesthesia. The following is a Q&A with
The word "doula" is an ancient Greek word meaning "a woman who serves". Most people are familiar with doulas present at vaginal births, but some women also choose to have a doula during their planned cesarean births.
There are a few reasons why having a doula for your cesarean birth can be very beneficial:
After the birth
Jenny Smith, a midwife and author of Your Body, Your Baby, Your Birth, suggests the following tips to aim for a more mother/baby friendly cesarean.
- Ask if the surgical team will play music and if your partner can take photographs.
- Ask for an epidural dose that won't make your arms “heavy”.
- Ask for the screen to be dropped so that you can see your baby being delivered.
-You can ask to call the sex of your baby yourself.
- Ask the midwife to pass your baby directly to you so that you can enjoy skin-to- skin bonding immediately.
A cesarean section is major abdominal surgery, but with an added bonus -- taking care of a newborn directly after it.
Many new cesarean mothers are expected to take care of the baby, maybe do some cooking or cleaning, and barely get rest, all the while their body is trying to recover from a major surgery.
Here are some tips for recovering from a cesarean section:
A free downloadable handbook
Ending Female pain
Includes a section for cesarean scar care.
Even if your cesarean was planned or anticipated, it is still normal and okay to have conflicting feelings about it. You have every right to mourn the loss of a vaginal birth, or an unmedicated birth, or homebirth, or whatever it was you had hoped for. Family or friends may not understand why you feel the way you do, but it does not make your feelings invalid. Your feelings about your birth are legitimate and you do not need to be ashamed by them. Many women feel the way you do -- in fact, that is what this site is about.
What may help is to write out your birth story, talk to someone, join a cesarean birthing support group, or maybe work through your feelings through creative outlets such as painting, drawing or writing.
Remember that you are not any less of a mother because you gave birth by cesarean.
The Ideal Cesarean Birth - by Robert Oliver, MD
Delivered safely by cesarean with his mothers hands (assisted cesarean)
Don't let them strap your arms down, and have them lower the screen so you can see your baby come out of your body
I think one of the most healing rituals a woman can perform is a Rebirth Ritual or Ceremony. During the ritual, Mom visualizes her perfect birth and proceeds to act out that birth. This ritual may look different to different moms. It could be as simple as meditating in a quiet place and visualizing the birth or (in the case of a planned homebirth that ends up as an cesarean section) it can be as involved as inviting the HB (homebirth) midwife over and "laboring" and then "birthing" the baby. - Dana
Talk to the doctors about what drugs they may put in the IV. Often women find out that after the birth, they were given large doses of pain killers or tranquilizers and they get very sleepy and disoriented. Let the anesthesiologist know up front that you want to be awake and clear-headed (if that is your wish) the entire time.
Don't let them strap your arms. Don't let them talk over you unless medically necessary. You don't need to hear the outcome of the football pool while your baby is being born (trust me, if you let them, they will talk over you like you are not even there, and as if it's an appendectomy instead of a baby's birth). Make sure you are the first to see your baby by having them hold him/her up for you to see rather than whisking them away.
In short, just make sure you put yourself first on the care list. You ARE recovering from major major surgery, and will need a lot more help than you anticipate
Make sure you demand adequate painkillers. I see so many c/s moms say that they were given too much painkiller. I had the opposite problem: a nurse told me I wouldn't need anything after the spinal wore off, and I ended up in a downward spiral of pain. Remember that you just had MAJOR surgery...you are going to need help with the pain. The second time around I knew better and it made a huge difference!!
I secretly dosed up with arnica just prior to my surgery and took it religiously for 1 day after. I needed tylenol for 2 days afterwards. I really think the arnica helped after all that tugging. Gave it to baby too...he was bruised from having his leg pulled so hard. Bruises went away within a day.
You can still be apart of your baby's birth- even if your arms are tied down and you can't see him/her being born. Sing or talk to your baby, he knows your voice!For recovery, have helped lined up! Someone to pass you the baby and take care of the house. Also, stay on top of your pain-killers, whether it's advil/tylenol or homeopathics.
Physical: getting in/out of bed, coughing, sneezing--squeeze/hold your abdominal muscles by covering it with a pillow or your hand. As much as the incision pain is the severed muscles, just above the scar. Secondly, returning home, have a basket with a handle and put in it mobile phone, tv remove, bottle of water, 5-8 diapers, travel wipes, painreliever, nursing pads, hand sanitizer, snack, anything to be at your side without having to get up. It can travel from room to room with you, wherever you are resting, so there is no getting up to go change baby, get a drink, find your phone, etc. Rest for 10 days in bed, 10 days around the bed, 10 days around the house. Give yourself and your baby at least 30 days before jumping back into the outside world--more if necessary.
Emotional: give yourself permission to grieve and let people know that "a healthy baby AND a healthy momma both matter." Just ask that your feelings be validated, whatever those feelings may be, there is no right or wrong, they are simply your feelings.
I wanted to share 10 easy things to do to get back in shape, take charge of your body again, care for your scar and feel better:
-Elodie from Birthing Goddess
Hire a Doula! Interview several and have on lined up just in case.
Ditto on the pain med advice- Duramorph is a drug they put directly into the epidural and it helps get over that first day hump. Also, bring your own recovery foods. Hospital food is not fit for human consumption, especially for a mom who not only has to recover but has to nourish and care for a baby as well. Clear liquids are on the slate for the first day- I bring my own chicken broth, juices and teas. Do not be afraid to change nurses if things are not working out with the one assigned to you. Somehow I ended up with the only nurse who was allergic to pain meds so didn't have any with her 2 c-sections. My husband requested a change of nurses after she told me that if I emptied my bladder my incision would not hurt so much (this was after my pain meds had completely worn off and I was in desperate pain). She changed her tune completely and I didn't end up needing a different nurse- she was an angel after that. She just wasn't getting the message before then and I really thought I needed a nurse who was looking out for me.
If you have any tips, suggestions, or anything else that you think will help cesarean mothers, please send it to firstname.lastname@example.org.
Grace's Birth Story: How a failed VBAC turned into a brilliant C-section - A beautiful story of a VBAC turned repeat cesarean section with skin to skin contact, a breast crawl, and breastfeeding while still in the OR. With pictures. (WARNING: Graphic)
Marley's Birth - Beautifully told story of a planned unassisted birth turned scheduled cesarean for breech presentation. The mother was able to have her favorite music playing in the OR (in turn the hospital now offers music as an option to c/s mothers) and the father was first to touch his baby.
Bekah's Story - Cesarean section birth for OP position and FTP. The mother says the respectful and supportive way she was treated by staff helped make her experience a positive one.
Emily's Story - One mother describes her two cesarean births, and how her second cesarean, which was emergent, healed her. She says, "I was SO devastated about my daughters birth, but somehow my sons emergency c-section has brought me so much PEACE. I felt robbed by that first C-section, but I felt like the second one was such a gift."
Our birth needed to be after my husband’s assignments were due (30th June) but before he finished his holidays (24th June). Our second daughter was due on the 9th of July and I really didn’t want her going over as I had a suspicion that she would be a big baby. I had done everything I thought humanly possible to prepare for a VBAC. I had exercised regularly, eaten healthily, seen a chiropractor regularly, taken a hypno-birthing class, was being looked after by a midwife and student midwife and the hospital supported my wishes and the most important thing, I was focused on being positive.
At 38 weeks my BH’s were occasional but I was feeling impatient so I was having the occasional cup of raspberry leaf tea which resulted in my Braxton Hicks contractions coming more regularly and a bit of back pain. I also started to use evening primrose oil internally to see if it would soften my cervix. On the Saturday my husband and I had some very hot curry. Not much happened that night so on Sunday I had the rest of the curry (boy that was hot) used the evening primrose oil again and used my meditation. In the afternoon I had a show and by that evening I was having contractions every 10 mins. I was able to sleep through these with no issue and didn’t worry about it. On Monday nothing much happened during the day but that evening I was having contractions every 5 mins and they were a little bit more painful, a bit more show but I was able to go to sleep. Tuesday I woke up feeling great but the contractions had stopped again.
Tuesday afternoon I had a chiropractor’s appointment and felt great. Just as I was leaving I started to get some back pain. This pain started to increase and become regular so by the time I picked my daughter up from school I was pausing during each one. I got home and started to rock through each contraction. As the evening wore on they became more painful and were 3 mins apart. I also had a HUGE show and was hoping this was it.
By 7 pm I was getting uncomfortable so I called my midwife and we arranged to meet at the hospital. Our first daughter, Charlotte, was picked up by my in-laws and my husband and I went into the birthing suite. I was strapped up to the machines and my midwife did an internal. I was only 2 cm along and the contractions weren’t strong enough so with my permission my midwife did a stretch and sweep (boy that was painful!) and we were sent home at about midnight. My husband went to sleep on the couch and I went to bed.
At 5 am I woke and went to the toilet, which wasn’t usual as I needed to go all the time. When I got back into bed I felt a bit weird, like I was still going to the loo and realised my waters had broken. I was so excited and rushed to the bathroom so that I didn’t get fluid all over the carpet. I tried to go back to bed but by that stage I was uncomfortable again due to the back pain. I let my husband sleep til 6 when I woke him up pacing around the house. The shower didn’t help and I called my midwife to meet at the hospital again. We were so glad as we knew we would be meeting our little one sooner rather than later now.
At the hospital I knew that I would have a time limit to labour as I was attempting a VBAC. We got to hospital at about 8am and was monitored on and off for a few hours. I was leaking fluid all over the place and was quickly soaking everything I had brought. My husband set himself up at the table in our room with his laptop and started keeping all our friends updated on my progress on facebook. My student midwife arrived and helped husband with the pressure points on my back as my contractions seemed to be more painful there than in the front. At midday they were concerned as my contractions were not getting any stronger or more frequent so they administered a very low dose of drip to help speed things up. At this stage I was not using any pain relief other than the meditation I had learnt and the pressure points being pressed by my husband and student midwife. The pain became very strong at this stage and I started growling very loudly during each contraction. I tried the shower, the birthing ball and standing up but these didn’t really help with the pain.
I got comfy sitting on a chair and leaning forward on the bed on pillows to work with the contractions. After what I thought was about half a dozen contractions I raised my head off the pillow on the bed and said to my husband “this isn’t too bad, how long has it been? 10-15 mins?” he replied that it had been about 4 hours and that I had been in a kind of trance all that time. I was so surprised but was then distracted by another contraction. My midwife checked my progress and I was incredibly disappointed to find out I was only 3-4 cm dilated. I was starting to become very distressed from the pain but really didn’t want an epidural. I also wasn’t keen on any of the other options but didn’t know how long I could cope. I tried gas but it made me feel sick and didn’t really help at all.
Since my midwife had been with me for a while, my back up midwife came to replace her. At this stage the hospital ob came in and said they could do a c-section now or let me have some pain relief and go a bit longer. My husband and I replied at exactly the same time – “lets have a c-section”. I successfully started labour naturally and tried it without drugs, but I was tired, I didn’t want to get any more tired like last time and we both were ready to meet our new daughter. So the drip was stopped and the relief was fantastic. We waited about an hour before I was taken to theatre. My midwife checked my progress again just in case and it hadn’t really done anything at all so I was very happy with the decision we had made.
In theatre the staff were all very kind and caring. My midwife, husband and student midwife were all with me and I wasn’t left alone at any stage. They put in the spinal and the relief was so great I nearly cried. I lay down and watched the staff get the theatre ready to take my daughter out. In this theatre they had a video camera trained on the station where our daughter would be placed immediately after birth and the monitor would be right next to me so I could see everything. As my student midwife wasn’t able to do anything during the delivery (she was a brilliant support though) she took our camera and took lots of photos for us (which were amazing), including when the Doctors lifted our daughter from my womb and she took her first breath at 6.59pm Wednesday 1st July2009. It was a magical time for us; she didn’t cry but muttered as if she was surprised that she was in the world. She continued to make noises like that while she was checked on the station and husband cut the stump of her umbilical cord. They asked us what her name was and my husband named her GRACE MACKENZIE. After only a minute or two they placed her naked onto my chest and I had the most wonderful skin to skin contact and my husband kept his hand on her back. From there she did a breast crawl and attached perfectly and had her first breast feed right there while they were stitching me back up.
The paediatrician wanted to send her to the SCN but my midwife stood up to her and said that Grace would be staying with me. She didn’t leave my chest until an hour later when they weighed and measured her, at 8 lb 7 and 50 cm long. Grace returned to my chest and we kept breastfeeding. My recovery was excellent and I felt so much better than my last c-section. I was taken to my room about 9pm and charlotte was able to cuddle her sister for the firs time.
Even thought I had a c-section, by choosing it before it was forced on me for medical reasons, enabled me to have a sense of control that I didn’t for my first daughters delivery and I was able to own the decision rather than it own me, if that makes sense.
Thank you for reading this very long birth story, I hope you enjoyed it as much as I did.
When I got pregnant with my first child I knew exactly how I wanted her birth to look: natural, no drugs. I felt that, as a woman, my body was made for exactly that. I knew that I was strong and willing to do what it took. We were new to town and I asked around my husbands work for a recommendation of a good OB. One came highly recommended.
My pregnancy progressed well, two weeks before my due date OB stripped my membranes and told me I would go into labor within the next 24 hours. This was very unexpected and I called my mother right away and told her to book her flight. Two weeks passed (and one more stripping of membranes) and still nothing. One week after my due date I was at the doctor again and they sent me for an ultrasound, right afterward I saw my OB and she told me that the baby hadn't dropped, and there was no way she would fit through my pelvis (I'm a small framed person), and she told me that we needed to do a C-section the next day.
I was devastated!! I had NO idea this was coming. I did ask OB if she would consider inducing rather that straight to a C-section, and she told me that if she did I would labor and due to my small pelvis I would end up with a c-section anyhow. I was tied (hello...one week past my due date), tired of being pregnant, hormonal, and I felt like OB knew best, so I decided to go along with her recommendation.
OB told me that next time would be a VBAC. She said she'd induce me a couple weeks early and that it would be "no problem". I didn't know any better.
My daughter was born. She was a BEAUTIFUL, healthy, 8lbs 12oz. But I felt cheated, like I had failed somehow, like I had failed my duty as a woman. When I tried to express these feelings I was mostly met with "you have a healthy baby, that's what matters". Every time I heard other women talk about their births I was deeply saddened, but I felt some happiness in knowing that with the next one a VBAC would be 'no problem'. The recovery was HORRID, The nurses told me I wouldn't need pain relief after the spinal wore off so I was in a downward spiral of pain and even after coming home I didn't feel like myself for months, and my scar was in terrible shape. UGGG
Fast forward 2 1/2 years. My husband and I are living in another state and we find out that we are expecting again!! I know the local hospital doesn't do VBACS (problems with the anesthesiologists) but I know another community about 30 miles away does so I make an appointment with them. I hire a doula to help me through the process, and she is the first one to break some bad news...she tells me that being induced really reduces the chances of a successful VBAC (turns out my OB wasn't totally honest with me). Everything up until 20 wks progresses well, and I am planning the VBAC, that's about when my new docs get my history from the previous OB. Turns out she hadn't stitched up my uterus correctly (only one layer of stitches instead of two) and this really brings down the chances of a successful VBAC. I felt so lied to, and cheated The new hospital decides that it's too much of a risk, they won't let me have a trial labor.
I decided that if I'm having a C-section anyhow I might as well go to the closer hospital. I find a new OB who I immediately LOVE!!! I talk to her about my concerns and she was totally understanding, she plans on using stitches instead of staples to help with the scar. Every thing progresses well until I am 36 1/2 weeks. I wake up one day and baby isn't moving in my belly, I wait a while and still nothing, call my new OB, she sends me to the hospital. They do a non stress test, baby doesn't move. They do an ultrasound, baby doesn't move. Baby's heart rate is a little elevated, and is going up. Doc comes in and tells me that we have to do a C/S that night, and if the heart rate continues to go up we are going to have to do it SOON. The heart rate continues to go up, and we are rushed to a emergency C/S. I see my new baby boy and am so scared for him, but he seems to be alright. Due to his condition when he was born, he was rushed out and I am finally able to hold him a couple hours later when we are all sure that he is okay. He has a high white blood cell count and is on antibiotics but he is going to be okay. He is PERFECT!
We were in the hospital for a few extra days, but every nurse and doctor was caring and warm. The stitches vs. staples made a huge difference and I felt like we were in the best hands possible a. I have nothing but positive, wonderful things to say about that birth.
I was SO devastated about my daughters birth, but somehow my sons emergency c-section has brought me so much PEACE. I felt robbed by that first C-section, but I felt like the second one was such a gift. I don't know how things would have turned out had I not been able to have a C-section. It might have all turned out fine, but I also might not have the beautiful children that I have today. That's how I have chosen to look at my c-sections, and the birth of my son was what taught me to look at it like that. Before I looked at my scar with disappointment, now I am able to look at it with thankfulness!! After all, that is where my children me the world, and to me it is BEAUTIFUL!!
Oh, and I will always have a special place in my heart for my OB who showed me that a C-section can be a positive birth story, even in the midst of an emergency!
Birthcut - thanks for being a resource for women to tell their story! It's much appreciated!!
- Emily Natale