Planning a Family-Centered Cesarean
Natural childbirth is almost always possible for healthy moms and babies, and VBAC is a safe choice for most mothers who've had a previous cesarean. I'm a natural birth advocate and my students are frequently VBAC moms preparing for a great vaginal birth. I also realize that sometimes a c-section is necessary, even life saving. I get a lot of questions about “natural cesareans,” so I've pulled together some information for you if you know you'll have a c-section birth for your or your baby's safety.
First, watch this video (tear-jerker warning, it's really touching!!)
Note: I will refer to doctors and anesthesiologists as “he” for simpler reading within the article. Please substitute “she” where appropriate for your medical team 🙂
Choices in Timing Your Cesarean
If at all possible, plan your cesarean for after 39 weeks. Your baby's brain grows amazingly in size between 36 and 40 weeks, so waiting as long as possible before birth allows for phenomenal brain growth.
Your baby's body also lays down a large portion of calcium stores at this point, so it's an important time for bone development.
Choices in Your Medical Preparation
It's standard for moms to be awake and aware during most cesareans today, even “emergency” surgeries. You know you'll be awake – but you can have so much more 🙂
Your anesthesiologist will be by your side before and during your surgery to prepare and monitor you. He is a great partner in having a family-centered cesarean because he positions all of your monitors and equipment.
All monitors can be placed on your back / shoulder area, keeping your chest completely clear. This means your baby can be snuggled onto your chest just moments after he or she is born.
Blood pressure cuffs and IV lines can be put on the arm you won't hold your baby in, so you can hold and snuggle your baby with an unrestricted arm. Often this is the left arm, so monitors are placed on the right arm.
Choices As Your Baby is Being Born
The actual moment of birth during a cesarean section is very different than a vaginal birth, but your doctor can work to make it more “normal” for your baby:
- The incision is made and baby's head is born
- Nurses lower the curtain between you and your baby
- You watch as your baby's body is slowly brought up through the incision
- This slow process helps squeeze fluid from baby's lungs as in a vaginal birth
- Your baby is able to use similar reflexes to aid birth
- You are able to see for yourself baby's sex as he or she is born!
At this point your baby can be placed directly onto your waiting chest while the cord is still pulsing and bringing blood into baby's body.
Other options allow the cord to pulse for a moment while baby is held slightly lower than your thigh, or “milked” to help bring extra blood into your baby. Both of these procedures help bring blood into your baby's body from the placenta. This is safe as long a your cesarean isn't for placental complications.
Choices for Immediate Bonding
All initial newborn observations and checks are done with your baby directly on your body. The cord is clamped with your baby on your chest, and you can enjoy your baby while your doctor is placing stitches and cleaning up from the surgery.
Continued monitoring can be done with your baby snuggled on you. You can stay skin-to-skin all through this point, with blankets placed on top of baby and you to help you both stay cozy and warm.
At this point you can enjoy your first breast feeding session with your baby, or just gaze at each other.
Choices for Recovery
Once surgery is wrapped up it's time to head to recovery. At this point you'll probably be transferred to a fresh bed to be wheeled into the recovery room. During the few moments that transfer takes, baby can be bundled and held by Daddy 🙂 Once you're in your fresh bed you can hold your baby again!
If you and baby didn't breastfeed directly after surgery, you probably will shortly after reaching the recovery room. The smell of your baby (request no hat on baby's head – blankets over both of you keep you both cozy) and breastfeeding help your uterus contract so it can begin healing.
Make it clear that you're breastfeeding, but let your nurses help you figure out a pain medication dosage that keeps you comfortable. You'll be able to enjoy breastfeeding and focus on a better start if you're free from pain. Remember to nurse early and often, and ask your nurse or lactation consultation to help you get baby comfortable and keep your incision site safe.
Working With Your Medical Team for a Family Centered Birth
All of these strategies for a family-centered cesarean birth work well to give you and your baby an experience you'll treasure, even though surgical birth was necessary. But it does take cooperation from your medical team to get this experience.
Most doctors, anesthesiologists, nurses, and other medical team members want to help you have a great birth experience, and are willing to work with you. Ask your doctor to watch the video included in this article. Share the studies with them (references are below). Find out what he thinks about everything, and ask for his help in getting a team assembled to make this experience possible for your family.
You and your baby are worth a great start!
I talk more about family-centered cesareans and give more resources on a recent episode of The Birth, Baby, and Life podcast. Click here to listen in and get more information on a family-centered c-section.
Smith, J., Plaat, F. and Fisk, N. (2008), The natural caesarean: a woman-centred technique. BJOG: An International Journal of Obstetrics & Gynaecology, 115: 1037–1042. doi: 10.1111/j.1471-0528.2008.01777.x
Cesarean with Delayed Cord Clamping [http://cord-clamping.com/2011/09/08/cesarean-delayed-clamping/]
Photo by mmolinari