After over two decades of working as a midwife and childbirth educator I have had the honour of working with many birthing families. These families have taught me so much!
Hindsight is such a wonderful thing especially if you can use the hindsight of others to improve your experience in the present! Below I have penned a few thoughts about Caesarean Birth that have been gleaned from the experience of others. I hope that this helps you to avoid an unnecessary Caesarean in the first place. If however, it is my sincere wish that these thoughts will help you to make the most of the experience should it become your reality.
Some thoughts on avoiding Caesarean Section in the first place
Choose your caregiver carefully:
Ask them what their rates of Caesarean Sections are. Be aware that the higher their rates the higher your risk of having an unnecessary Caesarean Section. In most practices you will end up with one of several doctors or midwives depending upon who ever is on call when you go into labour. So it is a really good idea for you to know the “Practice” Caesarean Section rates not just those of the individual practitioner.
Ideally you would want to know this information as early as possible in your pregnancy. It is possible to change your care- giver if you find out that they are not as supportive of you as you would like. So the earlier you get to know how they like to get things done the better as this becomes much more of a stressful thing to do as the pregnancy progresses.
I have known of many couples that have “interviewed “several birth professionals before choosing the one that was right for them. In general it has been my observation that the couples who were most satisfied with their birth outcomes are the ones who have put as much energy into choosing their care giver and prenatal education as they would in planning a special birthday or a wedding for example.
The information age is well and truly upon us, most mothers- to -be has more information at their fingertips than ever before. Gone are the days when our family Doctor knew us from birth and we just do as we are told. Increasingly, I am finding that expecting parents today are much more “discerning consumers” which I think is a wonderful thing. A passive dependency on what the Doctor or a midwife will “allow” a woman to do is the antithesis of what birth requires of a woman, which is strength courage and endurance.
Consider hiring a doula:
According to a recent Cochrane Review a woman who uses a Doula is 26% less likely to have a Caesarean Section. Doulas are professional birth attendants that support the birthing family physically emotionally and can often help the birthing couple to negotiate the care that they want.
Take an Independent Childbirth Class such as Calmbirth®:
In my experience most couples don’t need to know a lot about how to give birth but they do need to undo a lot of what society has taught them about birth. Independent classes usually go into much more depth than the hospital classes.
A good facilitator will be able to enhance the partnership between the birthing couple and get them working as a team. Keep in mind that an Independent Educator works for You So you can expect to come away from these classes feeling confident and safe in the knowledge that you have to birth your baby and be in a much better position to work with your care- givers in a more collaborative way.
Avoid inductions of labour when possible:
If however, you need to be induced for some medical reason research ways to keep it as normal as possible. Your Doula or Childbirth Educator are great resources to keep in mind for this.
Stay at home in early labour for as long as you can:
The intensity of the contractions is generally a much better guide than how long they are or how far apart they are. Most mothers will have at least three “check in” phone calls with their midwife or hospital before they decide to go to hospital or the birth centre. Keep in mind the more hours that you have in hospital the higher your risk of intervention including Caesarean Section.
Avoid Epidurals if possible.
Epidurals especially epidurals early in labours increase the risk of Caesarean Section. There are times of course when an epidural can be an enormous help especially for very long labours and the mother is becoming very tired. However, epidurals make it almost impossible for babies to help in the little ways they do to negotiate the birth canal because it limits the mothers range of motion and requires a lot of other interventions such as Catheters’ and Intravenous therapy and Continuous Foetal Monitoring and the like.
Be careful what you read and what you watch on TV.
It is worth noting here that pregnant and birthing women are in a very suggestible state because of their pregnancy hormones that enable them to slip easily into a trance like states when in labour. Surround your self with positive people and influences and limit your exposure to TV shows and people who want to tell you their horror stories.
Some suggestions for good books to read at this time are:
“Ina Mays Guide to Childbirth” By Ina May Gaskin
“ Gentle Birth Gentle Mothering” By Dr Sarah Buckley
The Birth Partner” by Penny Simpkin
“Birthing From Within” By Pam England and Rob Horowitz
“The Down to earth birth Book” by Jenny Blyth
“From the Heart” By Louise Luscri
Get your Partner involved:
It is hard to do this alone and you will need support. A good childbirth education class will help you do this. Especially if you and your partner don’t have the time to wade through reams of information that may not be that helpful anyway.
Consider an out of Hospital Birth:
The research is pretty clear on this one. With the right support you have a better change of a normal birth if you give birth at home or in a Birth Centre
Believe in your self.
If you need a little help with this calmbirth® classes are a great place to start. You can expect to come away feeling confident in your ability to birth your baby regardless of how things unfold.
So, what if you have to birth your baby by Caesarean Section?
Regardless of the reason for this birth option, there are many simple things that you can do to take ownership of your experience. I always think that it is reassuring to know that a Caesarean Birth can be a very special and personally satisfying experience.
If you find out in advance that you are having a Cesarean Birth, you will have the advantage of more time to adjust to the idea and think about ways that you can improve your experience.
If the need for a Cesarean Birth arises during labour, much of the emotional and physical adjustment will happen after the birth. This can be a very challenging time for any new family.
It has been my observation that these parents more than any other can benefit from having some “calm Skills”. A calm mother is a lot easier to work with and generally have much better outcomes than mothers who have a high fear component associated with the births of their babies.
It is worth taking the time to consider the impact that this can have in the postnatal period. A mother and her partner are less likely to grieve for a long time if they have been able to participate wholeheartedly in the pregnancy education, labour (if any) and in the decision to have a Caesarean Birth.
A live mother and baby may be the result of a Caesarean Birth. However, prolonged anger, depression, guilt and relationship breakdown can often result if a mother/couple are taken by surprised and decide to take a passive role in the experience.
Birthing a baby by Cesarean Section is for most mothers unexpected and disappointing, even when they know it was for them the safest possible way of bring their baby into the world. Many mothers will need time after the birth to adjust and even grieve over the experience especially if there was a strong desire to birth normally.
Some ideas for optimizing the experience of Caesarean Birth:
Before the Birth.
- Be sure that you understand and agree with the reasons for the Cesarean. Such as a medical problem with the mother or her baby for example.
- Learn about the procedure and what you can expect.
- If possible meet with the anaesthetist and learn what your anaesthetic choices are.
- Learn about the layout of the operating room.
- Find out about the hospital policies regarding Caesarean birth.
- Ask where your baby will be for his or her initial care.
- When you are booking in for your Caesarean if you have a choice of times try and get the earliest one that you can. There are two reasons for doing this. Firstly, there is less likelihood of there being a delay from earlier surgery taking longer than expected. Secondly, you will not be as hungry as you will be later in the day. (Most probably have to fast for at least six hors before the surgery.)
Some thoughts on supporting a mother who is giving birth by Caesarean Section.
Operating theatres are cold impersonal places, full of strange sounds, smells and bright lights. The birthing mother is very likely feeling a mixture of overwhelm and excitement.
The mother may be relieved that the “whole ordeal is coming to an end!” Or there may be some concern for the health of the mother and/or her baby. The feelings that surround such a birth can be a mixture of so many different ones it can be difficult for a mother of a father to adjust.
Mothers’ and babies’ and their partners are especially vulnerable at this time and the memories and impressions that are laid down during this experience will stay with them for a lifetime. So it is worth the effort to take the time to do what you can to make this as joyful an experience as possible.
It is very reassuring to know that there is much that can be done to improve the experience of a Caesarean birth and to a certain extent you can tailor the experience to make it special and personally satisfying.
Remembering that your perceptions of the events will be the most important factor in the end. The perceptions can either be a wonderful asset to the bonding and recovery processes or not. You get to choose so it is worth choosing positive ones. As a positive birth experience is more likely to lead to a positive relationships.
As the partner or support person of a mother who is giving birth by Ceasarean Section your perceptions of what happened will become very important to the mother as she works towards “putting all the pieces together”. You are her witness. You can help the mother come to terms with her birthing experience if you stay with her, ask questions, hold her hand and keep her posted as to what is going on.
On a practical note you may consider:
- Put some pleasant- scented lotion on a tissue or on your wrists so that the mother can sniff them this is very soothing and can help to counteract the “hospital smells”.
- Ask if at least one arm can be left unrestrained
- Bring your own music that you can play during the surgery. One couple that I was looking after once brought along songs from their wedding and the birth really did seem like a celebration of their life. The birth of their baby was beautiful and there was not a dry eye in the house!
- Plan to use your relaxation techniques during the birth and afterwards such as slow breathing like sighing.
- During the surgery even though the mother has an epidural or a spinal anaesthetic in place she will most likely be aware of some pressure or tugging. You can help the mother through this by holding her hand and applying gentle pressure on her out breath working towards helping her to slow her breathing rate down.
- Ask if they can lower the screen when the baby is lifted from the mother’s body so that you can see the birth.
- Ask about picture taking during the surgery or afterwards. Sometimes there are policies restricting picture taking. A digital camera has the advantage of allowing you to see pictures almost instantly so if your baby is out of sight it may be possible to get a nurse or someone else to take a picture and show it to you.
- In most cases babies are put on to a baby warmer and examined by a paediatrician (baby Doctor) Provided the baby is okay the partner may be able to bring the wrapped baby back to the mother for their first contact. Remember to keep these wrappings for later on as these birth smells are important of the baby as he or she learns to find the breast on their own.
- After the birth of the baby do as much as you can with the baby so that the mother can see you. If possible hold the where the mother can see smell and touch. Our sence of smell passes through the limbic system of the brain and is very important in the experience of bonding between the mother and her child.
- If there is a delay in the mother and baby being able to get some skin -to -skin time another option is for the father or birth partner to be skin to skin. Usually the midwives are very happy to help you with this.
Above all remember a Cesarian Birth is a birth. It has all of the emotions that often come with birth. What is more important than the way a baby is birthed is the perception of that birth by the mother her partner and their baby. It is all about memories and you are creating memories! In the end that’s all you get, and its all that you leave behind.
At Calm Connexions® we are committed to helping as many families as possible enjoy their birthing experience. We now offer private “Calm Caesarean Classes” on request.
Please contact us through our web site. www.calmconnexions.com.au