What if I need a caesarean?

The World Health Organisation advises that the caesarean rate should be between 10-15%.  The rate in Australia varies from state to state with the lowest occurrence of csection being in Tasmania (28%) and the highest being in Queensland (over 30%). - http://m.brisbanetimes.com.au/lifestyle/one-in-three-queensland-babies-born-by-csection-20100623-yyyd.html

There is no doubting many caesarean births are happening unnecessarily.  Ultrasounds are overestimating babies size meaning women are encouraged to deliver ‘big’ babies surgically only to discover their baby was a lot smaller then anticipated.  False CTG readings are showing baby in ‘distress’ when in fact the baby is well.  There’s the belief that repeat caesareans are the only option, when in fact VBACs can have less risks then repeat surgery.

And then there are the unreasonable time limits placed on women.  Hospital births are timed and whether you are told or not you have a time limit of approximately 1-2 hours per centimeter of dilation.  Or 24 hours if your waters have broken.  Labour takes a long time, and for many women who have a natural delivery their bodies give them ‘breaks’ from the contractions to rest.

Breech babies CAN be delivered vaginally.  Babies DO turn before birth, sometimes in the last minutes.

I myself know a woman who when pregnant with her first baby was told she would need a caesarean but was allowed to attempt a vaginal birth, her baby hadn’t engaged.  Well he didn’t engage until she was fully dilated and pushing, she had a natural delivery.

Mutliples can be delivered vaginally.  Yes, even triplets.  They can even be born at home.  Twins may even be born hours or days apart!

There are, however, times when a surgical birth is necessary.  And could even be life saving.  I had complete placenta previa with my second child and a surgical birth saved our lives.  But I was still devastated that he was to be born that way.  And it was okay and natural for me to feel that way.

What if you need a caesarean?
Firstly, a surgical birth does not make you a bad mother.  It does not mean you have failed.  It is what it is.  You don’t have to be okay with it, you don’t have to be happy with it.  And you don’t have to buy that healthy mother healthy baby crap either.

What happens before a caesarean?
It is still an operation, despite it also being a birth.  So you will need to sign a consent form.  Unless it is an emergency you will have time to read it, make sure you do and ask lots of questions.

Talk with the anaesthetist and ask plenty of questions.  You will go through a full health questionnaire.  He may be able to forfill any special requests you have.  Make sure you ask for skin to skin immediately.

You will remove jewelry, make-up Abe underwear.  A wedding band may be taped over.  You will most likely be shaved, shaving of the pubic hair can help prevent infections

An IV drip will be placed in your arm to administer fluids and medications.  You may be given a drink of sodium citrate to neutralize stomach acids to help prevent aspiration.  A urine catheter is routinely inserted to keep the bladder empty and out of the way during the operation.

You will be wheeled into the operating theatre and moved onto a high narrow bed and a triangular sponge is places under your right side to prevent aorto-caval compression.  Then you will be prepped, your anaethestist will administer an epidural/spinal/general.

Once you are numb the incision will be made, and the baby delivered quickly and shown to you.  They will then be checked over and usually passed to your partner or support person.  The surgeon will then deliver the placenta by gently pulling on the cord.  Your uterus will then be inspected and will close your incision in layers.  This can take up to 30 minutes or more.

Once the stitching is complete you will be moved back onto a bed and taken to recovery.  If your baby cannot be with you, make sure your partner is aware to do skin to skin during this time.

The first 24 hours will involve resting, sleeping and recuperating.  Make sure you have a partner or friend with you to help with your baby as the midwives are generally very busy.  Drink plenty of fluids to keep yourself hydrated and take pain medication as you need it.

You may experience wind or gas pain during the early days and it can be quite painful, peppermint water or tea can help.

Try and get moving as soon as possible, even if it is just wiggling around in bed.  Drink nursing tea and eat lactation cookies to help your milk come in.

Have plenty of skin to skin contact with your baby.  Your body warmth will help keep her warm.

Write a plan and include all your wishes for during and after the birth.  Request your own music be played, only your own voices during the surgery.

Lotus births and maternal assisted Caesars are possible, just ask.

You may like to take photos, again just ask.  You may also want your partner to announce the sex, make that very clear too.

Bring your own wrap for baby and sleep with it for a few nights beforehand so it has your smell on it.  Newborns have a very heightened sense of smell.

I would probably not have visitors on the first day or make the visits short. For a start you will probably be very tired, and wanting to bond with your baby, and learning to breastfeed.  Even if you are having an elective, keep the date secret so you can still make a big announcement.

And remember it is still a birth and you still have every right to celebrate that and to make it special for you.  Every woman has the right to chose how her baby is born, whether that be elective Caesar or homebirth or something in the middle.  Do not let anyone make you feel bad for your choices no matter what they may be.

Birth by Catherine Price and Sandra Robinson has a great chapter on caesarean birth.