Tag Archives: c-section

Beautiful Cesareans

I’ve just gotten word from a mom whose baby is breech at 39 weeks and the doc has told her that she absolutely CAN NOT do skin to skin in the OR- and neither can her husband. So this mother has been informed that her baby will be removed from her presence and her husband can choose to stay with her or he can go with the baby. Either way, one family member will be left alone…

As I learn more about pre- and perinatal psychology, it’s maddening to consider the easy, kind, human ways we could change scheduled, non-emergent cesareans that would support the physical and psychological health of the family. Of course, I am NOT advocating for scheduled sections for anything other than absolute necessity- a medical condition in the baby that might make labor more dangerous for him/her (these situations do exist), complete placenta previa, and several other conditions. And the gentle cesarean is not without its critics- and I do understand the concerns.

However, we’re left with the reality that 1/3 of our first time moms are being surgically delivered. When a cesarean is about to happen, what can be done to preserve the psychological health of the baby & mama? Acknowledging the family’s right to determine any non-surgical factors that do not impact the course of surgey seems a no-brainer. Mom feeling some control over her birth, lowers the chances of PTSD and other postpartum mood disorders. And many of the ‘gentle’ things mom might choose increases the likelihood that mom and baby will have successful bonding and breastfeeding after the fact.

So, what ‘might’ a gentle cesarean look like? Here are a few things that could be considered:

Environment

  • Warm the OR so the baby can be comfortable.
  • Lower the lights so make the transition from inside the womb to outside less jarring. Use flamless candles if possible.
  • Play music that is comforting for mom and familiar to baby.
  • Turn down the volume of any monitors if possible to allow family/human sounds to be heard.
  • Refrain from chatter- respect the sacred environment of the

For Mom

  • Have pictures of loved ones in view.
  • Have support people present (partner AND doula).
  • Encourage mom that she’s doing well.
  • Massage mom’s hands with essential oils to release scents she enjoys and finds relaxing.
  • Lower the drape when the baby is born so mom can see her child emerge.
  • Hand the baby to a nurse whose hands are sterile (to prevent contaminating the doctor’s gloves) and have nurse place baby directly on mom’s chest.
  • Do all newborn monitoring on mom’s chest.
  • Encourage and support breastfeeding on the operating table.
  • Respect mother’s wishes in regards to the disposition of her placenta.
  • Have photographer capture special moments.

For Dad

  • Have Dad cut the cord (after it stops pulsing, of course).
  • Have Dad announce gender if it is unknown to the parents.
  • Ask Dad to give input into the birthing space.
  • Assist Dad to give baby a warm bath when mom and baby are ready.

For the Family

  • Have the client’s room prepped. Have flameless candles, comforts from home like pictures, quilts, etc available so when mom and baby return, they can begin bonding in a comfortable, comforting place.
  • Have an established relationship with a Lactation Specialist who will come to see the family during the immediate postpartum. Mothers who have cesareans sometimes have a delay in production of mature milk- support during these early days can be extremely helpful.
  • Order in a special meal for the couple when mom has been cleared to eat solids.
  • Arrange postpartum support- a postpartum doula who visits mom and helps with baby care during the day after dad returns to work is an excellent idea.

While a cesarean is occasionally necessary, there are ways we can make surgical deliveries more gentle and beautiful for the family involved. There are ways we can recognize that this sacred time- when a family is growing- should be recognized for the life event it is. Some practical considerations and efforts to involve the family in their baby’s birth can help the family begin life together- beautifully.

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If only I’d have known…

As a doula- and as a mom- I am constantly learning. When I brought home my son, Alex, I was recovering from an emergency cesarean, trying to nurse and- unbeknownst to me at the time- suffering from a postpartum mood disorder called postpartum anxiety. I am a prime example of someone who desperately needed both a birth doula and a postpartum doula.

Due to medical reasons (chronic high blood pressure brought on by PIH in my previous pregnancy), I was scheduled to be induced at 38 weeks. I trusted my doctor and believed that we together made the best decision for my son. The plan was to induce at 6 am. I wanted my doctor- who had been through my previous losses with me and who was intimately familiar with my complex medical history- to deliver my baby, so I was willing to enter the ‘hospital delivery machine’- break amniotic sac, administer pitocin, get epidural, baby is delivered after 12 hours or so.

Things went wrong from the start- the maternity floor was overcrowded so my induction was pushed from 6 am to 2 pm. My doctor was scheduled to leave the floor at 5 pm, so I knew she ultimately wouldn’t be the one to deliver- I believed that one of the other doctors I’d seen occasionally would step in. However, a doctor I’d never met before- and who knew nothing of my history- walked through the door. This stranger in a white coat wanted to put me under the knife after only 4 hours of labor because ‘I wasn’t progressing as quickly as [she'd] like,’ (no medical reason was given and my L&D nurse assured me nothing was showing that I needed surgery). I laid in that bed, delirious with pitocin-intensified contractions praying that my cervix would dilate quickly so I wouldn’t have to fight with the doctor.

After 12 hours of intense pain and bullying, my son’s heart rate dropped to 30 beats a minute and I told them to take him out immediately. There was no way I was going to risk his life for an ‘ideal’ vaginal birth. Alex was born at 3:54 am, less than 14 hours after I’d been induced.

After my horrible L&D, I was happy not to see the doctor but once for the rest of my hospital stay. I was in a lot of pain, and was really unhappy about my birth experience, but my sweet baby was healthy & here so I pushed down my negative feelings and got on with being his mommy. If I couldn’t have a ‘normal’ vaginal birth (as normal as a hospital induced vaginal birth would have been), by God, I was going to nurse my son!

Nursing went well in the hospital. Even with Alex having a one day stay in the NICU for hypoglycemia, I was pumping and nursing every two hours, he was latching well and I was so proud that something was going right.

When we got home, nursing was harder. I was physically weak from the 12 hour intense labor and surgery- I had no idea how hard labor was on a woman’s body, especially when that labor ended with major abdominal surgery. I couldn’t sit upright without the hospital bed, couldn’t scooch across the couch or my bed to get into the right position to nurse. My husband had to hold my arms up for me while I held our son in the football/clutch hold so I could avoid putting pressure on my incision site.

When we would go to bed at night (notice I didn’t say ‘go to sleep at night’) I would lie for hours, poised on the edge of the bed, waiting for Alex to make the slightest whimper at which I would immediately jump up- or rather, I would painfully pull myself and my healing incision- from the bed and would go to see what had caused the little guy to stir. Eventually, to help me get more sleep, my husband struck a bargain- we would take shifts watching Alex sleep. At 2am each night, Brian would wake me to take over for him and I would sit on the couch with Alex in a bouncie seat between my feet and I would watch him sleep.

Within a week, I’d moved from nursing to exclusively pumping breast milk for Alex. I was so anxious about how I would possibly nurse him by myself- I still needed so much help and Brian was returning to work in a few days. I wanted the security of seeing the ounces flow from the bottle into my sweet baby’s belly.

To this day, I have resentment toward the doctor who treated me so badly. I feel like a victim who will never receive justice- just one more woman who was treated like a disease instead of treated like a person. To this day I have immense guilt for ‘failing’ at nursing my son (who did receive breast milk exclusively for 3 months- not bad when I think objectively, but oh, it was so much less than I wanted.) I wonder what was lost in our relationship- is it possible we could be even more bonded if I had nursed him as long as I’d hoped?

If only I’d known… If only I’d known about doulas, both birth and postpartum! If only I’d have known that I could have someone be there for me at the hospital- someone who would go through the process with me and would help me understand all that happened during my labor and the delivery. If only I had someone to help me ask the right questions, feel like I had some power and voice in my birth choices, a witness to my birth- would her very presence have made the doctor treat me a little more carefully? Would her support have made me feel more in control? Would support then have made me feel better now, almost four years later?

And in my postpartum- Oh, how I wish I’d had experienced help! Someone who could have encouraged me to immediately seek out a lactation consultant! Someone who could have offered the physical support I needed so I didn’t have to fear nursing alone just 10 days after delivery. Someone who could have said ‘Get to a doctor, this isn’t normal’ when I forced Brian to sit up for hours every night so Alex wouldn’t die from SIDS while we slept.

In hindsight, and as a trained postpartum doula, I know how much difference having a doula would have made both at the hospital and at home. Women deserve to have personal, knowledgeable support when they are pregnant & postpartum. Every woman deserves to have someone dedicated to her mental, physical and spiritual health during a time of such wonder and stress. If only I’d have known what kind of support was available to me and what kind of help would have allowed me to have a birth and postpartum experience I have peace with, I would have sought it out long before the ordeal.

If you feel like you would like support during your delivery or postpartum or both, visit www.DONA.org to find a certified doula in your area.

Wishing you a wonderful birth and a peaceful postpartum!

–Angie

www.hearthsidedoulas.com

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