How to prepare for inevitable C section

[fmajor84]

Long story short, my pelvic opening is very small, due to my pelvis having once been broken. There's no hope that I will be able to deliver vaginally, and my doctor is recommending that I schedule a C section now. While I acknowledge the medical necessity, I feel like I'm going to miss out on something unique. What can I do to make sure I have a good birth experience?

Also, are there any upsides to C sections that I can think about to cheer myself up?

[kltroy]

I understand and sympathize with your feelings - my first was a scheduled c-section for breech presentation and I too felt as though I had missed out on an experience. There are a number of threads on having a better c-birth and I know you'll get lots of replies to this one. Some of the things I did for my birth included:
-schedule it for first thing in the morning so that you can enjoy your baby for the rest of your day (also everyone is fresh and unhurried)
- talk to your baby before he/she is born and tell him that it will be his birthday and to get ready to meet you
- if you don't know the sex, you can ask the doctor not to announce it - ours had my husband stand up to take the first look and tell me. it was really cute.
- you can still delay cord clamping if you wish - we donated cord blood with ours and I feel like we were able to at least help someone with that.
- ask about who will be allowed into the OR and recover, whether you can bring music in with you, etc. talk to the surgeon ahead of time. Also the NIH has videos of c-sections online with quite good commentary. It is located here:
http://www.nlm.nih.gov/medlineplus/surgeryvideos.html
-finally, take all of the energy and concentration that you would have spent getting through labor and channel it into your best efforts to heal your body quickly.
I suggest watching it and having your husband watch it too. It helps when you know what to expect.

The good things:
1. You know when you get to meet your baby. We went out to dinner and a show the night before mine to celebrate our last night of pregnancy.
2. Beats the heck out of laboring for 20 hours and THEN having a c-section.
3. Baby looks good for all the pictures - nice round head. (silly, I know, but it's a bonus)
4. If you have other kids, easy to arrange for care of the other kids. If not, at least you can arrange for a parent to be in town to help out.

Best of luck with a peaceful birth.

[Sk8ermaiden]

My personal take on it would be to see if instead of scheduling it, you could come in at the first sign of labor. Even though I DID labor for 20 hours before mine, one of the best things was that my (42-weeker) picked her birthday! I can't imagine how under-developed she would have been at 39 weeks. Our ICAN leader here has had 4 c-sections, but all but one picked the day. She said scheduling that one is her only regret. Plus, babies exposed to labor hormones do better than those that are not. If you can't swing it, you can't, but I know it's what I would do in your position.

Buy a belly bandit. The soft bamboo one. I would say if you KNOW you're having a c/s, then splurge on it. Moving around afterward (and for me, riding in the car) is kind of not fun, and the belly bandit really does help SO much.

Ask for stitches, not staples. Uck.

IF you think you can handle the surgery OK, ask them not to put extra drugs in your IV. I forget what it's called, but there's something that a lot of women are given without being asked that makes them kind of forget most of the day of the c/s. The women I have talked to have felt robbed of seeing their baby born. They give it to you to help you relax. I did fine without it and am glad I wasn't given it.

I don't know if everyone feels this way, but I personally didn't feel comfortable putting pants on for over a month. I wore knit dresses.

Bring a boppy to the hospital, or make sure you have looots of pillows well ahead of time in your room for nursing. It is hard to position that baby ina comfortable way, and the pillows make it much easier.

I am sorry, I kind of suck at this. My c/s was pretty terrible (the doctor's fault - not necessarily the surgery itself) and I usually try to block it out. But I felt compelled to respond because there are some things I wish I'd known (especially the Belly Bandit) and I really hope you have a good experience. There are lots of women I know who put lots of thought and planning into their c/s and felt they had very good experiences - especially if they had a sympathetic and naturally-minded OB.

Good luck, and I will come back if I think of anything else!

[chely7425]

I have to have c/s as well and I agree with trying to let baby pick their birthday... I have a similar problem to you though and have never actually gone into labor on my own. Definitely worth a shot tho! Also, think of things you can do to make the experience more special. I like them to lower the drape so I can see the baby and they always let DH put on sterile gloves and do the first cut of the cord... things like that.

[kltroy]

Just wanted to add: after you talk with the doc who will be doing the surgery you will have a better idea about what will fly and what will not. For example, I asked about stiches vs. staples and was told that the doctor would do whatever he normally did and I didn't have much choice. I ended up with staples, which they removed before I left the hospital, and it was actually totally fine. I asked whether my mom, a CNM, could come in along with my husband and was told there wasn't enough room up by my head, so I could pick only one person (I picked DH). Once I got into the OR I pretty much believed them - it was pretty tight. I also considered having them lower the drape so that I could see my son being born (but was told no). Actually I was pretty glad NOT to have it lowered when it came down to it. I was happy just having my own chit chat behind the curtain and not thinking too much about the gorey details of what was going on inside my body. I think it would have been a little too "real" seeing myself cut open - not something I really wanted to remember. So I'm glad that I didn't see that.

I agree about waiting to go into labor - esp because there's no medical reason that would cause that to be risky at all for your baby (like high risk of cord prolapse or whatever). I did feel like I was missing out by having not gone into labor with my first and was glad that I was able to have a VBAC for my second for that reason. I think there are really merits to both sides of this one, (scheduling vs. waiting) - your baby will definitely "know" it's his/her birthday if he chooses it, though! Best of luck.

[liseux]

I've had to have 3 & I like the positives that have been said, I would add one more:

A catheter has to stay in for 24 hours afterwards, this seems like a real bummer & it can be, but...I also really enjoyed the fact that after so many months of peeing constantly I didn't have to get out of bed to pee at all for that 24 hrs. That time can be used to get breastfeeding off to a good start, offering the breast early & often & cuddling in bed with the baby. I'm an LC & I've seen some c/s mamas get their milk in very early, like 24-36 hrs after birth b/c they could lay down & nurse the whole first day.

Even though you can lay down & not get up to go the bathroom, I recommend standing & taking a few steps at 6-8 hrs after surgery, then when teh cath is out, taking slow walks around the unit. It helps get everything back in place & moving quickly. Good luck with everything!

p.s. any medication they give you for pain is safe for nursing, I take all of it, even percosets, everyone's different, but if you do want to take the strong stuff, its safe.

[2xy]

I don't mean to get off-track here, but both of my babies were c-sections (second one was planned) and I had staples with both of them. What's wrong with staples?

[Sk8ermaiden]

Originally Posted by liseux

A catheter has to stay in for 24 hours afterwards, this seems like a real bummer & it can be, but...I also really enjoyed the fact that after so many months of peeing constantly I didn't have to get out of bed to pee at all for that 24 hrs. That time can be used to get breastfeeding off to a good start, offering the breast early & often & cuddling in bed with the baby. I'm an LC & I've seen some c/s mamas get their milk in very early, like 24-36 hrs after birth b/c they could lay down & nurse the whole first day.

Mine came out as soon as I could walk, I think!

Originally Posted by 2xy

I don't mean to get off-track here, but both of my babies were c-sections (second one was planned) and I had staples with both of them. What's wrong with staples?

Well, mine pulled and were generally uncomfortable. But we had a big discussion with a bunch of women in my ICAN group, and the consensus was that any other form of closure (stitches, steri-strips, glue) were preferable to staples - at least according to women who had had more than one type. A small sample size for sure, but big enough that I felt it had merit.

[GoestoShow]

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Edited by GoestoShow - 1/11/11 at 10:16am

[KempsMama]

My cath was out within 10 hours, as soon as I was able to get out of bed and pee-the biggest reason it was in that long was because I wasn't out of recovery until 9:30 at night, had been in labor prior to the surgery and spent those night hours nursing and enjoying my babe.

I second stitches. Staples are so uncomfy, I've had them for other surgeries. And I've heard horror stories about the steri strips.

Post Op, I had a lot of difficulty moving about and doing things like changing DS's diaper. I was so thankful that my DH ws able to take two weeks off. After the first five days things got a lot better, and by the time DH went back to work I was able to handle everything on my own. I highly recomend having help, and either having a family member or hiring someone to clean your home for you two or three times post OP.

[AlexisT]

There was a recent study confirming what many women (and even some OBs) believed to be true via anecdote: sutures lead to fewer complications than staples.

http://www.medicalnewstoday.com/articles/178207.php

[2xy]

Well, it's been years but I can't recall any discomfort with my staples. I mean, I was seriously uncomfortable anyway, so maybe any staple issues were just ignored by me. But I've never had any other surgeries with a big incision that needed closing, so I have nothing to compare to. The only stitches I've ever had were in my finger and after my tubal.

[kltroy]

FWIW, I have no idea whether this is typical, but I had staples for 3 days and then they were removed and replaced with steri-strips. So they were out before I left the hospital and did not leave any sort of scar at all. I didn't think they were too big of a deal except for how freaky they looked. And anyway, I wasn't given any choice in the matter so I made my peace with them.

[sanguine_speed]

I had staples after a cholestectomy and have bad scarring unfortunately.

Best of luck to you mama!!

[dollysods]

At our hospital, we have had the occasional father permitted to do skin-to-skin with the baby in the OR after delivery if baby is stable. Simply awesome. Obviously, it isn't something all providers are comfortable with, but it might not hurt to ask.

[Storm Bride]

Originally Posted by 2xy

I don't mean to get off-track here, but both of my babies were c-sections (second one was planned) and I had staples with both of them. What's wrong with staples?

If you'd asked me that after my first two sections, I would have probably said, "nothing". After both my third and fourth sections, I had staples that pulled and twisted, which resulted in an incision that didn't close correctly. Both times, I ended up with an infected incision.

After talking to some other women who had had both, I requested stitches with my fifth (and last!!!) section. I could not believe the difference in pain and mobility in the early post-op days. A lot of what I'd previously believed was just the pain of having the section was actually the pain of having the staples in there pulling. My incision also closed more cleanly last time...the only tiny trouble spot was where I have the indent in my skin from the two infections...and it was only a couple days behind the rest in closing up tight.

Staples suck.

[Storm Bride]

Originally Posted by Sk8ermaiden

Well, mine pulled and were generally uncomfortable. But we had a big discussion with a bunch of women in my ICAN group, and the consensus was that any other form of closure (stitches, steri-strips, glue) were preferable to staples - at least according to women who had had more than one type. A small sample size for sure, but big enough that I felt it had merit.

I've talked (online and in real life) to at least a hundred women who have had both. A few (definitely under 10, probably under 5) didn't really find a difference. The others all preferred stitches. Staples are quicker and easier for the surgeon, is all. But, until one has had both, there's really no way to separate the pain and discomfort from the staples from the overall experience, yk?

[Storm Bride]

OP: I, personally, would also wait for labour. I've only had one completely labour-free section (three were scheduled, but I went into labour on my own just before my third and fifth ones), and I hated it. DD1 also had some minor issues (breathing and jaundice) when she was first born, and I'm pretty sure they were both because she wasn't ready yet. There are a lot of objectins to this from the medical profession, but I really think they mostly boil down to scheduling issues. Showing up in labour and saying, "I need my c-section" shouldn't be an issue, if a hospital is equipped to do c-sections in the first place, yk?

[AllieFaye]

How about a little pampering? If I knew that a section was coming, I'd want the the c-section healing kit from Earth Mama Angel Baby, and maybe a prenatal massage.

[Storm Bride]

Originally Posted by AllieFaye

How about a little pampering? If I knew that a section was coming, I'd want the the c-section healing kit from Earth Mama Angel Baby, and maybe a prenatal massage.

And, a post-partum massage. OP: Try to pencil one in now, for about 6 weeks out. I find that I twist and knot myself up really badly in the first few weeks, because I'm doing all that baby care and feeding and stuff, while constantly compensating for the pain and weakness in my abs.

Oh - talk to your doctor about nursing asap. With dd2, the L&D nurse (I believe she'd been a nurse midwife in the UK) and dh held my baby up over my shoulder to nurse while I was still on the table. It really did help. With ds2, I got to nurse within about the first half hour or so, and that was also pretty good. The separation from my kids with the first two (about 14 hours with ds1, although I slept through most of that, and about 1.5-2 hours with dd1) was really hard on me.