How can I have a better c-section?

[CorasMama]

I'm going to need a c-section. This really is a case of a necessary cesarean, no doubt. There is significant risk to baby if we don't. So the necessity of my c/s isn't what I'm asking about.

What I want to know is, how can I best handle the c/s? I'm really anxious about a number of things.

-I'm terrified of needles, the larger the scarier! So the epidural scares the poop out of me. And I really hate even the idea of surgery.

-The idea of being cut open while conscious, and feeling the tugging that people talk about when the baby is being born, really creeps me out. Just the thought raises my pulse rate! I had to be put under general anaesthesia for a lumpectomy, which they rarely do, but I couldn't handle being awake for the surgery.

-And I'm worried about recovery. I'm overweight, and I worry about getting an irritated or infected incision due to the "flap" issue, iykwim. Also, my immune system isn't what it could be.

Would a home study of something like hypnobirthing help me with the stress of this?

How can I prepare, physically and emotionally?

And what can I do, during and after the surgery, to make it easier?

Thanks in advance!

**eta: oh, and I won't be able to hold or nurse the baby immediately afterward, as s/he will be necessarily whisked off to the NICU, probably in a different hospital, but I'm hoping to pump as soon as I'm up to it. And DH will probably go with the baby, but I'll hopefully have my sister or bff with me.

[kltroy]

Oh how tough that your baby won't be at the same hospital as you! I had a scheduled c-section w/ my first (breech) and can sympathize with this aspect of the birth. I found that watching some videos of a c-section was helpful because it helped me know what to expect. You can find one here: http://www.nlm.nih.gov/medlineplus/surgeryvideos.html

I would write up a c-birth plan. Who do you want with you? Is there music you'd like to listen to? Do you already know the sex of the baby - do you want the doctor to wait for your husband to see it instead of announcing it? Have a conversation with the doctor who will be doing the surgery ahead of time and ask what is standard and what they are flexible on, and what to expect.

Hypnobirthing would definitely help, since it would help you put yourself into a more relaxed state. With labor, it's mostly a physical challenge. With a c-section it will be a more emotional challenge (nervous, anxiety, etc) and there are definitely parts of the surgery that feel odd (like when they push - HARD - to get your baby born) and surreal (the moment the baby comes out).

The other thing I found helpful was:
1. schedule it for first thing in the AM so that everyone is fresh and not in a hurry
2. have your husband use clippers to clip off the top inch or so of pubic hair - he will be nicer than the nurses will
3. ask that they catheterize you AFTER you've been anaesthetized. they will probably do this anyway, but make sure.
4. have a nice talk with your baby the night before - tell him/her that it will be his birthday and to wake up.
5. try and stand up the same day as your surgery, even if briefly. get up and go for a very short walk the next day. take all of the energy and focus that you would have used to get trhough labor and instead use it to heal your body quickly.

good luck with a peaceful birth. I hope your baby is healthy!

[tessie]

I would ask for the screen to be removed as the baby is born so I could witness the birth.

Hope everything goes well.

[gardenmommy]

Is there any chance that you will have a few minutes with the baby after the birth before they take him/her away? If so, that might give you something positive to focus on while you are in surgery. I also think that hypnobabies or something similar might give you some tools for relaxing a bit better.

[4Blessings]

Originally Posted by CorasMama

-And I'm worried about recovery. I'm overweight, and I worry about getting an irritated or infected incision due to the "flap" issue, iykwim. Also, my immune system isn't what it could be.

I am currently recovering from my forth c-section so I might be able to help with this part

Make sure to keep the incision area dry. After a shower, dry the area with a towel (patting works well) and then use a hair dryer on air or low heat to finish the job. Then I fold a 4x4 gauze pad and tuck it into the "flap". Change during the day as needed.

I've been taking my vitamins every day/eating well and have been very healthy this year and feel like I am healing very well (baby is 2.5 weeks). FWIW I take a prenatal, C, D, B complex, flax oil and calcium.

Good luck to you!

[soso-lynn]

You mentionned that the baby might be sent to a different hospital. Is there anyway the c-section can happen in the hospital where the baby will be going. I assume it is because the baby will need to be in a Children's hospital but many do deliveries in those cases as well. For me, I think that would be the main thing I would want to make happen, if at all possible of course. I would even consider traveling to a different city if needed (this obviously depends very much on a lot of other factors).

[kltroy]

Originally Posted by tessie

I would ask for the screen to be removed as the baby is born so I could witness the birth.

Hope everything goes well.

This may be good for some people, but if the orig. poster is already weirded out by surgery, seeing yourself cut open may be a bit too freaky. I know that I thought the idea of this was nice before the big day came, but when it came down to the moment of truth I had enough going on mentally that I preferred being back in my little "zone" with my husband and midwife, waiting to see my baby. (plus the hospital wouldn't drop the screen anyway). There was a big part of my mind that didn't want to think about what they were doing to my insides.

[LiLStar]

There's an ICAN white paper on planning a family centered cesarean. http://www.ican-online.org/pregnancy...tered-cesarean And also maybe get in touch with your local ICAN chapter for support?

[MeepyCat]

I read the ICAN article and I don't love it. It's aimed at mothers having c-sections at or near term, with babies who don't require NICU treatment. It also assumes that the mother wants a lot of information about her surgery. It is totally okay to not want those details. Sometimes we get through hard things by avoiding thinking about them too terribly hard or too specifically. I don't recommend tuning out as a coping strategy for every day life, but it is a great plan for unavoidable unpleasantness like long plane flights and surgery under local anesthesia.

Would it be at all possible to have the c-section in the same hospital as the NICU? It would be very hard to be at a different hospital, and unable to visit your baby for those first few days. I'll add that pumping cribside (in view of the baby) was much more productive for me than pumping off in some other room by myself.

My daughter was born at 32 weeks, and went to the NICU within a few moments of her birth, but they were able to wipe her off, wrap her in blankets and hold her where I could see her and kiss her before she went. If she had been in immediate respiratory distress, they wouldn't have done this, but you might mention to the medical staff that if it's possible, you'd like to see the baby.

If your DH will go with the baby, DEFINITELY have someone supportive to stay with you.

[CorasMama]

Thank you all so much for your advice. There's a lot of good stuff here, and I really think I will get the hypnobirthing and/or go to a hypnotherapist or hypnobirthing teacher for a few private sessions first. Obviously, the regular, 6-person standard class won't work, because I don't really want to sit through all the stuff that only applies during natural vaginal birth.

I keep trying to think of the positives here. Since I don't have a choice, I might as well make the best of it, right? So far, I've come up with no vaginal tearing, less chance of hemmorhoids, and no "ring of fire", the last thing being the most painful part of birth with my dd. Oh, and less time with gigantic pads for the lochia. That's a really good thing, since I'll be going straight from the hospital where I birth to living in a tiny room reserved for parents of NICU/PICU babies, one floor up. So the less personal hygeine stuff I have to do, the better!

Unfortunately, if we decide to have the baby go to Children's, I won't be able to deliver there. They ONLY treat kids, and don't have birthing facilities. They have a relationship with the University Hospital, which is just down the street, and I'll probably birth there. (If the baby looks, prenatally, like it won't survive more than a couple of days, however, we'll probably birth at the next-highest-NICU hospital, so we can spend those days with me in the same hospital as the baby.)

And no, I won't even get a few minutes with the baby. They'll need to work on her/him immediately. I may get to glimpse the baby, if the layout of the room and the number of people in the room between me and baby allows for it. Hopefully, DH will take lots of pictures, as he'll be going with the baby.

[CorasMama]

Originally Posted by MeepyCat

I read the ICAN article and I don't love it. It's aimed at mothers having c-sections at or near term, with babies who don't require NICU treatment. It also assumes that the mother wants a lot of information about her surgery. It is totally okay to not want those details. Sometimes we get through hard things by avoiding thinking about them too terribly hard or too specifically. I don't recommend tuning out as a coping strategy for every day life, but it is a great plan for unavoidable unpleasantness like long plane flights and surgery under local anesthesia.

Would it be at all possible to have the c-section in the same hospital as the NICU? It would be very hard to be at a different hospital, and unable to visit your baby for those first few days. I'll add that pumping cribside (in view of the baby) was much more productive for me than pumping off in some other room by myself.

My daughter was born at 32 weeks, and went to the NICU within a few moments of her birth, but they were able to wipe her off, wrap her in blankets and hold her where I could see her and kiss her before she went. If she had been in immediate respiratory distress, they wouldn't have done this, but you might mention to the medical staff that if it's possible, you'd like to see the baby.

If your DH will go with the baby, DEFINITELY have someone supportive to stay with you.

Yeah, I don't want a lot of details about the surgery! I didn't even want to be told when the needle for my chorionic villius sampling was going in!

And yeah, I'll have someone supportive with me. Since we'll be able to schedule the c/s, my best friend will be able to be there.

[Storm Bride]

Feeding the baby asap was my big one, and doesn't apply, so let's see...

IMO, stitches are about 1000X better than staples (had staples four times, and stitches once). I'd suggest asking for stitches to close the incision.

re; the epidural. I'm okay with needles, in general, but I have a HUGE "thing" about needles in my spine. For my last c-section, I asked that dh be allowed in while they were administering the anesthetic. I still didn't like that part, but it did help that I wasn't all alone, with just strangers around me. You may not get that, as it's entirely up to the anesthesiologist in attendance, but it's worth a try.

I have no suggestions with respect to the pulling/tugging. It creeps me out, too, and I've never found anything that helps with that. Hynosis might be the way to go. If that doesn't work, the only other thing I can suggest is to remind yourself over and over that it won't last forever.

hmm...they usually put you on dietary restrictions, so you can't have solids for a while. I basically said "blow that" with my last three sections. It made a surprising difference to my morale to have real food in front of me - dh brings me fruit, which is wonderful, as I'm always thirsty after the surgery.

I can't think of anything else that applies in your circumstances, but I'll rack my brain.

[mrs*kewpie*pie]

heres a link you may find useful. i just skimmed so apologies if its not what you're looking for.

http://www.eheart.com/cesarean/oliver.html

[elisheva]

FWIW, when it became apparent that I was likely going to have a c-section (about 24 hrs before), my FIL (a therapist) did EMDR (?) therapy with me to help me feel more comfortable about the parts of the surgery I was especially fearful of. It might be worth seeing if you can find someone to help - he only did one session and it was helpful enough to get me through relatively comfortably without panicking...

I second the stitches over staples thing, too. I hope I never have to do it again, but I will strongly request stitches if I do.

[4Blessings]

Originally Posted by Storm Bride

hmm...they usually put you on dietary restrictions, so you can't have solids for a while. I basically said "blow that" with my last three sections. It made a surprising difference to my morale to have real food in front of me - dh brings me fruit, which is wonderful, as I'm always thirsty after the surgery.

With each of my sections I found myself very nauseated afterward. This last time I got sick while they were still working on me. I told everyone before hand so that they could give me something to help but what ever they give to help doesn't seem to work for me. I tried smelling peppermint oil too. Didn't work. I wasn't able to eat or drink anything (and keep it down) for a good nine hours after surgery.
I'm not sure if this happens to anyone else but I figured it would be worth a mention.

[elisheva]

Originally Posted by Proud2BeAnAmerican

With each of my sections I found myself very nauseated afterward. This last time I got sick while they were still working on me. I told everyone before hand so that they could give me something to help but what ever they give to help doesn't seem to work for me. I tried smelling peppermint oil too. Didn't work. I wasn't able to eat or drink anything (and keep it down) for a good nine hours after surgery.
I'm not sure if this happens to anyone else but I figured it would be worth a mention.

OMG I had totally forgotten about being desperately thirsty afterward!!! I did get nauseated on the table but I told the anesthesiologist and he put some medicine in the IV that worked for me. About two hours after the surgery they would only give me little sips of water and it was torture so I somehow got someone to give me more and I remember the nurse being really b&*chy about it - "Fine. If you want to blow out your staples by throwing up, you can have more water." Whateva. I'm sure some people are nauseated, but I never was afterward.

Another thing I didn't mention was whatever narcotic was in the spinal made me REALLY itchy while it was wearing off. It also made me high for the first few hours of ds1's life. I'd try to avoid that if I had to do it again...

I

[nudhistbudhist]

Hypnobabies is AMAZING for preparing for birth, and its NOT just for NCB. There is a cd specifically for C-sections. Also, they use a Fear Release technique, which will help with you fear of needles, etc, and they also show you how to create a "Bubble of Peace." If I have to have another C-section, I would definatley use Hypnobabies.

[Storm Bride]

Points in the last couple posts:

Nausea: I don't suffer from it with c-sections. I've had a friends who've had it on the table (I get it a little bit there, but not serious), but nobody who has had it afterwards. I have heard of it before, though - just not irl. I know you can have an anti-nausea drug added to your IV, though. (That's one more reason I'm glad I don't get nauseated. I prefer to keep the medication down as much as a I can.)

Itching: I refused the itch-inducing medication - it's a morphine thing, but I can't remember what it's called - with my last one. The pain wasn't much worse, but I'd have happily suffered ten times the pain to be free of the feeling that I had to scratch off my own skin. That sucked. I'd planned to refuse it with my third one, too - but the guy gave it to me without telling me.

Water: Yeah. Water - I couldn't drink enough of it post-op. Every time, I've been so incredibly thirsty. I just go with it.

[CorasMama]

yeah, I'll be getting something OTHER than morphine, as I'm allergic.

[Storm Bride]

Originally Posted by CorasMama

yeah, I'll be getting something OTHER than morphine, as I'm allergic.

I had a pump with...think it was demerol. It worked quite well, and I liked having control over what I was getting.