Scheduled C-Section - some questions

[WhiteHorse]

(There are only a very few doctors in my area that will support a VBA2C) but since this is my first scheduled c-section, I am wondering how things should be done.

First, what would be the point of a Step B culture? I am supposed to have this Wed. If I am not delivering vaginally, is there risk to having Strep B? I always tested neg before anyway. The less tests and labs the better, we are paying out of pocket.

Second, do they routinely do an ultrasound to check size, etc. before doing the c-section? The nurse said "no, why?" I had this done every other time and wondered why they wouldn't.

The surgery is scheduled for the 28th. I secretly hope that I go into labor before then and have the baby in a stuck elevator or something :))

[mrsberman]

Sorry I can't be much help here, but I would just ask your Dr why they want to do a GBS test if you're not delivering vaginally. You're right, it doesn't make sense, just like giving eye antibiotics when you have a c/s. I would love to hear the reasoning on this one.

[dayiscoming2006]

I'd be looking into UC if I were in your situation but LOL, I am going that route anyway. I just can't imagine automatically going for another C/S. I imagine those are not the most fun.

Anyway, any reason you can't go into labor so baby chooses it's own time? Some places allow that I know. I've heard that is at least better for baby than having a C/S without any labor. 

And you can decline any tests you want to. 

[WhiteHorse]

I am sure there are lots of great docs and MW out there in the world who would support a vbac, and I could probably fight again for a more natural birth, but for many reasons it isn't worth it especially with a DH who isn't supportive either. In my area there are 2 doctors (both extremely overloaded with patients) who support natural birth, and one of those two I used the last time and after assuring me he was pro-natural birth, when my water broke, he ended up trying to convince me that pitocin would be great to speed up my labor, etc. Very disappointing, the hospitals around here claim natural-friendly but they really aren't. Our insurance only allows us to birth in a hospital.

[Stayseeliz]

I ended up having a c-section due to a number of factors. They didn't do an u/s to check size, etc but I'd had an u/s before an amnio 3 days before I delivered so they knew size, baby's position, etc.

I did the Group B swab and it was positive after being negative with my last three children. My dr said it was more to inform my pediatrician as they need to watch for signs of infection in the baby so I'm glad I did it. If your water broke etc before you had the section it might expose the baby.

[2moms3kids]

I had a repeat c-section 4 days ago, after my OB REFUSED to try a vbac (the others in my area feel the same way). I did the GBS b/c if it is positive they watch the baby more closely, I was also negative. I also asked about an ultrasound, but was told it didnt matter with a c-section so they dont do it. I also never had an cervical check. My c-section was at 39 weeks 3 days, so there was no need for an amnio. Good luck and it seems the 2nd time around is much easier than the first!

sarah

[EricaRN]

If you know you're for sure having a scheduled c-section and you've made your peace with this decision, I have a few suggestions:

-Ask for the screen to be lowered when they pull the baby out so you can see the birth

-If gender is a surprise, ask them not to announce it and let you and DH discover it together when they hold baby up for you to see.

-request delaying cord clamping for as long as they will allow (the peds team can do all their evaluations while the baby is laying on your stomach & in c-sections especially, the baby benefits from delayed cord clamping. I can find you articles on this if you're interested in showing your doc)

-Request that baby is brought to you ASAP

-Request to breastfeed in the OR

These are things that I know other mamas have gotten out of their scheduled c-sections. It's the ONE benefit of scheduling because there's no rush. This can still be a beautiful experience for you if you ask for the things that are important to you. My least favorite thing about my 2 csections has been that I've never gotten to feel my slimy baby. I've never experienced that. So one thing that would be important to me would be that they bring the baby to me while it's all slimy still and lay it on my chest for a few minutes. Seems silly but it's a small "sacrifice" on the doctor's part (just an inconvenience really) and since you're paying them double for less time's work then they can accomodate you in every way possible.

Oh another suggestion, if your doc is balking at any of these or acting like hospital policy wont allow it, tell him that you understand the "need" (their word not yours. lol) for another c-section but there are lots of great surgeons in the area who would jump at the chance to have your business and who have agreed to allow this to be a pleasant experience for you. He wont want to miss out on the extra income for such an EASY and STANDARD c-section and will be more likely to accomodate. I know being a VBA2C myself how docs like to treat you like you're some special case and make you feel like every little thing they do for you is a real treat (gag) but remember that you really do have all the control here if you're getting a c-section anyway. Because honestly there's a million OBs out there willing to do one and do it well. So if this guy isn't prepared to give you the little things that make it special for you, then find someone who will. Like I said, this can still be a beautiful experience! :-)

Good luck to you!!!

[JesKace]

I'll be having my 4th c-sec on the 18th.

I had the GBS test done last week.  The dr's like to do it just in case your water breaks before the c-section then they know if you'd need to be started on antibiotics and if they need to watch the baby.  I tested negative, but I actually asked the Dr today about if you have do you always have it, or if it can come and go.  He said that it can come and go that's why they test you with each pregnancy towards the end.  He said testing in the beginning of the pregnancy would be pointless because it could go away on it's own, and he said if it showed up in a urine test though then it would be throughout your system and you'd most likely always be positive.  It's a super easy test as they just take a swab.  You could ask the price of it and weigh your options if you're worried about the cost though.  It's covered under my insurance and since it's non-invasive I figure why not do it.

I've never had a u/s before delivery or anytime after the big 20wk one.  Even with my first pregnancy when I was in labor for what seemed like forever...LOL  I would think the only time they would do one would be if there was a concern about fluid or lack of movement or something.  I would imagine with a c-section size of the baby and which way they are positioned isn't really an issue.

[EricaRN]

Just wanted to say that I had GBS in my urine with DS at 8 weeks and tested negative this time. If it's in your urine you definitely have a higher colonization count and it's more "serious" but it doesn't mean you'll always be positive. Just wanted to pass that on. Good luck to all of you!

[Taryn237]

Not sure about the GBS question BUT my midwife was just telling me today that they had a woman have a cesarean last week and they let her have the baby skin to skin immediately after birth!  The doctor and nurses were on board with it and they did something with 2 sterile drapes so that the baby could go immediately onto her chest which is where they cut the cord and everything.  My MW said it was so cool that she was nursing the baby within 15 min before she was even stitched up.  If I ever need another csection that is what I want.  It makes it much more similar to a vaginal birth in that baby goes from birth to mom's arms immediately.

[kaPOW!]

i don't know anything about your questions, but i hope you have a smooth delivery and gentle recovery <3

[mclisa]

If your water were to break before hand, they would want to know your GBS status.

They don't routinely do u/s before a c/s because they are +/- 1 pound.  That is some variance, so if it you are already planing a c/s, why go through that expense?

[WhiteHorse]

Thanks so much for all your replies. I really need the encouragement, especially today. I declined the GBS at my wed visit, but going back next week so maybe I will have them do it. When I asked the doc about it he said the pediatrician would want to know the status, for me, that wasnt enough of an explanation/reason to have it, he should have mentioned the water breaking early thing. I know he is counting on that NOT happening since he only does hospital procedures on Thursdays (unless emergency, Ha!). My scheduled c-s is at 39 weeks so I doubt I will start labor earlier than that, although I could be wrong. My last baby was born after water broke at 39 weeks. Anyway, they will be doing abx during the section due to mitral valve prolapse - not sure this offers any protection to the baby ??  I am probably weird or something, but I am not the type of mom who would particularly miss the slimy baby on the chest experience, I will miss the labor part though and the part where you are not being cut open and sewn back together. I dread it and in no way do I feel it gets any easier after you've had one (or two). My first I had no clue and just went with it, the second time I was a bit nervous, but since it was not planned, it went very quickly for me mentally. This time I have had months to pine over it, and will be sick by the morning of the 28th. My DH does not see anything to be nervous about - he thinks all women should want it to be over that quickly (iow, he doesnt want to deal with laboring wife).

[CookAMH]

Quote:

Originally Posted by kaPOW! 

i don't know anything about your questions, but i hope you have a smooth delivery and gentle recovery <3

Ditto.  Let us know how it goes and how we can support you!

[JesKace]

Originally Posted by EricaRN 

Just wanted to say that I had GBS in my urine with DS at 8 weeks and tested negative this time. If it's in your urine you definitely have a higher colonization count and it's more "serious" but it doesn't mean you'll always be positive. Just wanted to pass that on. Good luck to all of you!

Oh that's good to know.  Definitely another reason to get tested toward the end of pregnancy, so you don't get unneeded antibiotics.

to the OP, you should ask about the abx you're going to be getting durring delivery and see if it would be the same if you were gbs+.  If it is  then it wouldn't matter and you'd be able to forgo the test then... Might save you a little money :)

 

Originally Posted by Taryn237 

Not sure about the GBS question BUT my midwife was just telling me today that they had a woman have a cesarean last week and they let her have the baby skin to skin immediately after birth!  The doctor and nurses were on board with it and they did something with 2 sterile drapes so that the baby could go immediately onto her chest which is where they cut the cord and everything.  My MW said it was so cool that she was nursing the baby within 15 min before she was even stitched up.  If I ever need another csection that is what I want.  It makes it much more similar to a vaginal birth in that baby goes from birth to mom's arms immediately.

That sounds awesome.  It just seems like it would be so hard though.  The 3 times I've been in they strap your arms down and you have the blood pressure cuff on and lots of tubes everywhere.  Plus I spend most of the time they are putting everything back and stitching me up, throwing up and relying heavily on the oxygen so I don't feel like I'm going to pass out... For some reason I think all the pressure and movement in my stomach makes me nauseous no matter how many anti nausea meds they give me.  Things have gone pretty good though for my deliveries, I've gotten to watch while them weigh the baby and wipe them up while they are putting me back together and once the baby is wrapped DH has got to hold all 3 of them right next to me so I can snuggle before I'm done getting stitched back up.  So even though it wasn't direct skin to skin contact right after delivery I still felt like I got that little bonding time in.  Then once I've been transferred off the operating table and back into a bed they put the baby in my arms while bringing me back to the recovery room and I've been able to breast feed as soon as I got in the room with all 3 that I've had.  Not as soon as 15 min after delivery, but it didn't feel like it was too long after.  I think it's been a pretty good experience considering it's been major surgery...lol.

to the OP, I hope everything goes smoothly for your delivery!

[Taryn237]

Originally Posted by JesKace 

Oh that's good to know.  Definitely another reason to get tested toward the end of pregnancy, so you don't get unneeded antibiotics.

to the OP, you should ask about the abx you're going to be getting durring delivery and see if it would be the same if you were gbs+.  If it is  then it wouldn't matter and you'd be able to forgo the test then... Might save you a little money :)

 

That sounds awesome.  It just seems like it would be so hard though.  The 3 times I've been in they strap your arms down and you have the blood pressure cuff on and lots of tubes everywhere.  Plus I spend most of the time they are putting everything back and stitching me up, throwing up and relying heavily on the oxygen so I don't feel like I'm going to pass out... For some reason I think all the pressure and movement in my stomach makes me nauseous no matter how many anti nausea meds they give me.  Things have gone pretty good though for my deliveries, I've gotten to watch while them weigh the baby and wipe them up while they are putting me back together and once the baby is wrapped DH has got to hold all 3 of them right next to me so I can snuggle before I'm done getting stitched back up.  So even though it wasn't direct skin to skin contact right after delivery I still felt like I got that little bonding time in.  Then once I've been transferred off the operating table and back into a bed they put the baby in my arms while bringing me back to the recovery room and I've been able to breast feed as soon as I got in the room with all 3 that I've had.  Not as soon as 15 min after delivery, but it didn't feel like it was too long after.  I think it's been a pretty good experience considering it's been major surgery...lol.

to the OP, I hope everything goes smoothly for your delivery

Yeah, I felt like I was going to throw up on DS.  I didn't even want to see him in the very beginning.  Probably partly because I was totally not expecting to have a cesarean.  If I ever have another one I will ask for something for nausea beforehand.