• Danielle Dean

Finding Empowerment When Cesarean Birth is Necessary

#cesareanbirth #cbirth #empoweringfamilies #knowyouroptions #seattle

There are a lot of feelings when it comes to cesarean birth. Which you will never hear us referring to as a C-section. The word itself carries so much weight. We prefer C-birth or cesarean birth. Meat is sectioned by a butcher; you birth your baby. The way that we say things has a profound impact on how we view them. We hold a lot of ideas and old conditioning around cesarean birth in our culture. How we speak about birth, what we are saying, is huge.

A cesarean birth is when an incision is made to the lower abdomen and uterus to deliver a baby/babies surgically. Cesarean birth is still a birth. Don’t let anyone tell you otherwise. It takes massive bravery to lay down you’re your body to be cut open to deliver your baby safely into this world. That is courageous.

We have seen a rise in cesarean birth due to the recent COVID pandemic; families going in at thirty-nine weeks just to get the baby out safely. So, this is a topic that needs to be discussed, now more than ever.

It appears there is still quite a stigma when we bring up C-birth. Why is it so horrible across the board? It is one potential outcome. And one we want to be just as prepared for, and excited about, if it is necessary- because it is still the birth of your baby.

We get it. You have a birth plan that you want to follow. We can plan, and plan, but all of this planning oftentimes goes out the door. If there is one thing we can assure you of, birth is unpredictable.

Holding space when a surgical delivery is necessary is something we talk to families about right out the gate. We want to talk to you about all of your options, and help to normalize C-birth as much as we do a “natural” delivery.

A cesarean is a wonderful, lifesaving procedure. We should be grateful that cesarean births save lives. We also respect cesareans by choice. You never know why someone has decided to have a surgical delivery in a normal pregnancy. Past traumas and emotional well-being may be factors in deciding to have one. We often find that doula clients who are the most afraid and unwilling to even consider a surgical delivery end up having a cesarean birth. Dive into where it’s uncomfortable. Educate yourself on all of the what-if’s.

Some hospitals will provide a gentle or family centered cesarean. We encourage all parents to find out if their hospital/doctor holds this philosophy. During a gentle cesarean, the family is the primary focus of the experience. Parents will be able to express their concerns and wishes for the birth and have these requests honored by the medical team. A clear or blue drape is used in order for you to see baby emerge but not see the incision procedure. Watching your baby emerge, that moment of physically watching your baby being born, does something to the brain- it clicks into gear that “I just gave birth”.

In preparation for surgery, our intention is getting the birthing parent as comfy and relaxed as possible. The operating room is typically very cold and extremely bright. We encourage headphones to create a cocoon feel, and love to really get into the scalp, forehead, jaw and hands with gentle massage. Essential oils on a cotton ball can be really nourishing as well. You can ask to have one arm free so that you can hold your baby directly after birth. We find that C-birth parents need more emotional support than most, so words of encouragement and affirmation can greatly reduce anxiety and fear while we are getting ready.

The surgery itself lasts 1-2 hours. During surgery, it’s okay to ask your surgeon to verbally guide you through the process. It’s also okay to ask them to stop talking if talking over your body becomes irritating. Once baby emerges, skin to skin will likely be on your face vs. chest. Skin to skin may not be immediate if baby needs additional suctioning, which is pretty common. During a vaginal birth, contractions squeeze fluids out of baby’s airway, but a baby born by cesarean doesn’t have that advantage. We encourage families to insist on early, frequent contact with their baby as soon as possible. The goal is to bring baby to your partner as quickly as is safely possible so that you can begin to bond as a family.

For the first twenty-four hours post birth, you will need help doing everything- holding your baby, rolling over, sitting up, walking, and using the bathroom. A surgical delivery requires a hospital stay of 2-4 days, so when packing your hospital bag, keep this in mind.

The postpartum period is more challenging when you are recovering from major abdominal surgery. This is why establishing your village before baby arrives is incredibly important. There is no shame in leaning on friends, family, or hiring a Postpartum Doula to help ease the transition. For the first two weeks, you’re sore, moving slowly, and need help with baby care and household to-dos. By the six-week mark, your body should feel back to normal.

Lastly, we encourage you to read through the questions below as you mindfully prepare for the potential of a surgical birth. Things rarely go as planned, and it is always best to be informed of all the potential birthing choices you may have. Remember that it is within your rights to know what the cesarean rate is at the hospital where you are delivering.

Here is a list of potential questions that you may want to ask your care provider- please be aware that in the case of an emergency, a preterm delivery, or a baby at risk for a low Apgar score, these requests will not be able to be facilitated. Your safety and your baby’s safety will always come first. As they should.

o Can I avoid being strapped down for surgery?

o May my whole support team (partner, doula, family member, etc.) be present for the delivery?

o May I have one of my support team members take photographs of the birth?

o Is a clear drape available, or can the drape be lowered so I can see my baby being born? Can the bed be raised a bit so I can see?

o Can the EKG electrodes be placed toward my back and side to leave my chest clear for skin-to-skin contact?

o Can the blood pressure cuff, IV, and oximeter be placed on my non-dominant arm?

o Can I get a nondrowsy anti-nausea medication, if possible?

o What type of medications does the anesthesiologist give during the surgery? Do I have an option of a medication or sedative that won’t make me forget the birth?

o If possible, can the medical team avoid chatter that is unrelated to the birth? We understand that this may be a routine procedure for you, but for us this is the birth of our child!

o Can we bring in our own music and aromatherapy?

o Can delayed cord clamping be facilitated?

o Is skin-to-skin contact able to be facilitated if baby is doing well? Can the baby be suctioned on my chest?

o Can you show me the placenta after delivery?

o If the baby is healthy, will we be separated at any point? Can I room in with my baby?

Here are a few cesarean affirmations that you can repeat to yourself during your birth. Affirmations can greatly reduce anxiety and fear before, during, and after a cesarean delivery.

o “I am birthing my baby in a room filled with love”

o “It’s okay to be afraid”

o “Cesarean birth is birth”

o “My body is going to heal”

o “I love my baby”

o “It takes courage to birth my baby this way”

o “I am surrendering to the flow of life”

Please remember, you are the consumer. You have the power to create positive change in your birthing experience. How’s that for empowering?

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