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Share your ideas on how to make a Cesarean Birth a positive experience

post #1 of 56
Thread Starter 

First, I am thrilled to see this forum.  It has been a long time coming and it such a blessing for this community.

 

Second, I thought I would help get the ball rolling and invite moms who have had good experiences to share what helped make it positive.  Personally, I have had both, and know how bad it can be, but I also had a wonderfully healing, transforming experience.  It is my hope that by sharing some of the details of our births we can help those getting ready to birth their babies with practical advice on how to make it the best experience it can be.

 

Down to business:

 

1.  I think the single thing that was the most helpful for me was that, at my request, they allowed my hands to be free instead of strapped down.  It was with the understanding that if I started reaching into the operating field or there was an emergent situation where it was necessary, they would, but to allow me the freedom to move my arms, rest them on my chest and/or hold my dh's hand, made me feel less trapped and greatly reduced my anxiety.

 

2. If the baby's health allows, having the baby put on your chest, even if for a moment (mine was preterm and tiny and needed to be evaluated right away, but they did lay her on my chest for a bit before checking her out.)

 

3.  Meet with the nursing staff at the hospital, tour the hospital, get a feel for how they treat laboring mothers.  The doctors are important, but the nursing staff are the heart and soul of the unit and have a much longer impact on your experience.  See if you can find out how many patients the nurses have to see at a time...are the nurses terribly overworked, or is there enough staff that each patient gets good care.  You shouldn't have to wait forever for them to respond to a call light, and there should be time for them to gently and thoroughly clean you up afterwords, and help you get in and out of bed to use the bathroom for a while.  That first day, especially, you will likely need pretty intense help.

post #2 of 56
- Doctors/nurses can be sensitive about the environment. Music everyone agrees to is nice, and not talking about their Saturday golf game is nice, too. Keep the conversation about the delivery.

- The arms being strapped down was one of the worst parts. Between that and the drape, I became very claustrophobic. If I do have to have another c-section, I would ask to have my arms free. I know what to expect and I'm not going to reach into the sterile field.

- Some hospitals are removing the drape and propping mom up so that she can see the birth. Alternately, they could use a mirror. You can't actually see the incision during the birth, because baby is blocking anything gross.

-"Walking the baby out" may be a way to reduce complications in the babies. The doctor slowly removes the baby over a few minutes, allowing fluid to be massaged out. Baby also gets more cord blood this way.

- Allowing skin to skin contact and nursing for well babies is possible, as well. Dad or a nurse can help hold the baby on mom until mom is transferred to recovery. Baby can stay with mom during this time to nurse and bond.
Edited by cameragirl - 11/18/11 at 10:50am
post #3 of 56

These are all great suggestions that I'm going to keep in mind if I have an RCS.

 

What I learned from my first c-section:

 

It can't hurt to ask for what you want. I asked not to have my arms strapped down, and I wanted my midwife in the OR along with DH. I also asked that only DH announce the sex (we waited until birth to find out) and that he be allowed to cut the cord. I also asked that the baby never leave my site and that I be allowed to breastfeed as soon as possible. They were all very happy to comply!

 

The next time around, if I have an RCS, I'm thinking about:

 

  • Music in the OR
  • Viewing the birth
  • Having a professional photographer present to photograph me and DH, and the baby after it's born
  • Having the baby placed on my chest as soon as possible for skin-to-skin contact and breastfeeding
  • Having all well-baby checks done on my chest
  • Having the catheter and IV removed ASAP so that I can move around more freely and be more comfortable
post #4 of 56

I had requested DH be the first to hold DS, since I didn't think I would be able to. My arms were strapped down as others stated, although I didn't recall that detail until reading it here. DH was also allowed to cut the cord.

 

If I had to do it again, I would request baby be put on my chest and given the opportunity to BF right away.

post #5 of 56

I recommend stitches (instead of staples) on the incision. I have heard a lot of complaints about staples, and I'm glad they gave me a choice & I chose stitches. It takes a little longer in the OR, but it healed up nicely and now (3 years later) the scar is barely visible.

post #6 of 56

ICAN had a lovely article on making csections family centered and as natural as possible. 

 

I had one almost seventeen years ago, and I wasn't restricted in any way, so i'm always surprised to hear that hospitals still restrain moms.

post #7 of 56

I think being able to breastfeed in recovery is a huge one.  I was lucky to be birthing in NZ, after DS came out he was weighed etc, wrapped and handed to DH.  DH then walked alongside me to recovery carrying him, and when I was settled they started to get him latched on.  It was lovely.

post #8 of 56

- make sure you know your options for recovery and being with your babe: when i had my cbirth, the hospital's OB OR was occupied (and babies are allowed to be with moms in recovery) and they were going to send me to a general OR which did not permit mamas and babies to be together.  (i was able to wait)

 

- arrange to see lactation nurses as soon as possible (especially if it's your first cbirth).  i had no idea what to do, and even women who've nursed with a vaginal delivery might find nursing after a cbirth difficult. 

 

-i love the new articles and research coming out to support immediate skin-to-skin with mom, even while being sewn.  i will be asking to do this if we have another cbirth. 

 

- have a birth plan anyway, even if you are having a scheduled cesarean.  it can make a difference in your nurse selection, treatment of the baby, etc.  \

 

- the nurse we ended up with (see above) was awesome- she took photos of the birth. 

 

- there is research to suggest that you might want to ask for leg compression devices if they are not automatically given to you (they were to me). 

 

-get up as soon as you can and walk around.  some of the pain comes from lying still or in one position for so long. 

 

-if you can, have your partner or doula repeat a reassuring phrase, mantra, or poem during the procedure if you feel that is helpful... 

 

post #9 of 56

I am having a cesarean birth on December 7th.  This is my fourth child, three homebirths and three very large tears.

 

I had the option of having a vaginal but the doctor who did a postpartum fix up on me after birth #3 reported that "the tissues were very frayed and I'm not sure I could ever pull them back together again".

 

But, I wanted another baby.

 

So here I am. 

 

I am delivering at a very supportive hospital, with a wonderful female OB.  She will lower the drape, have my hands free, give us a heads up right before the baby comes so we can sing our baby into the world, and will put the baby right on my chest and do newborn checks there.  The nurses in the tour (before I got pregnant) said "anything you want" to every question I asked!  I couldn't be happier with my healthcare providers.

 

I am doing a lot of talking to the babe - about how his/her birth might feel and what he could do to help. I asked him/her to wait until I say to start coming out so maybe I could go to the hospital in early labor.  I don't know if it will happen but I love talking to my babe!

 

I wrote up a birth plan, declined all test (including diabetes and group b strep) I also lobbied to have my last month appointments 3 weeks apart.  I told them I'd call if anything happened.

 

I went into this with the idea that they would want to be on my side and would want to make this pleasant for us - I'm really happy.  I'm nervous about the day (who wouldn't be with surgery?) but excited to meet my babe!

 

Best,

 

Kim

 

Oh - I'm taking a B complex, Boulardii probiotics (the perfect one for antibiotic use), and a blood builder.  I'm doing some yoga breathing exercises because I'm a bit worried I might "lose my breath/get breathless" on the operating table - like some have experienced.

post #10 of 56
Quote:
Originally Posted by Multimomma View Post

ICAN had a lovely article on making csections family centered and as natural as possible. 

I had one almost seventeen years ago, and I wasn't restricted in any way, so i'm always surprised to hear that hospitals still restrain moms.

I can't remember the name of the article I saw, but I did read about it on ICAN's blog as well. I haven't read any stories about moms reaching into the sterile field. It seems like they do it just to do it. If I must have an RCS (I'm trying for VBAC), I am going to ask to not be restrained.
Quote:
Originally Posted by *Jade* View Post

I think being able to breastfeed in recovery is a huge one.  I was lucky to be birthing in NZ, after DS came out he was weighed etc, wrapped and handed to DH.  DH then walked alongside me to recovery carrying him, and when I was settled they started to get him latched on.  It was lovely.

This is also pretty normal in my area, but in some areas, hospitals are seemingly in the dark ages. Unless mom is waking up from general anesthesia or baby isn't well, mom should be able to nurse and hold baby. I had to wait an hour and a half because my large babe was gurgling a little, and they took her to the NICU. I felt unnatural when she finally came back. I think had I been able to nurse right away, it would have felt more natural to me.
post #11 of 56

I had a planned pre-labour c-section under spinal. My team were amazing.

 

We have a picture my husband took of my daughter half in/half out of my abdomen.

 

My OB delivered her straight onto my chest, and the first words she heard were a prayer, as we asked.

I cuddled her for 5 minutes, then she was briefly checked,  DH held her for 10 minutes, until they finished up with me.

I breast fed  immediately in recovery ( as my midwife said, one of the benefits of a good spinal is that your nipples are numb- so that first feed was painless and perfect).

 

Little things make a difference.

 

If they're going to site a large bore IV- ask for them to inject local first.

Ask them to wait until the spinal or epi is working before catheterising you.

If you don't want to see the surgery, don't look at the overhead lights- they're very reflective, if you don't have a mirror and want to see, use that instead!

If you have a strong preference for how the incision is closed, ask- I had staples (my request- I'm allergic to most suture materials), the scar healed fine.

Multi-task- if you want to get cleaned up and changed into your own nightwear after the c-section, then that could be when the nurses bath the baby.

Make sure the call button is always within reach- you won't be able to get it otherwise.

 

 

post #12 of 56

I've never had my arms strapped down, even with my first (in '93). But, I did have one anesthesiologist (none of the others) ask me if I preferred to rest my arm on the rest, or keep it on my chest. I chose to keep it out, because I tend to shake a lot (cold, panic & shock combo, I think) and didn't think I'd be able to keep it folded on my chest. I was told they just need to make sure the arms are out of the way, so the mom doesn't mess up her IV or the monitors or anything.

 

How to make it better depends on what matters to the mom, of course. I didn't want the drape lowered, for example. OTOH, I don't think anyone has mentioned the spinal. I really, really, really hate the spinal (would much prefer to be unconscious, but they won't just give a pregnant woman general anesthesia with no medical indicator, and I know it's not good for the baby, so I just try to suck it  up). With my last one, I asked if dh could come in with me while they administered the spinal. The person I had the consultation with (not my actual OR doctor) told me it was up to the individual handling anesthesia. The L&D nurse told me she didn't think it was likely, because it would mean having another person between the OR table and the surgical instrument tray. The anesthesiologist did allow it, however - she simply administered the spinal with me sitting facing the other way from my prior two experiences. It made a huge, huge difference for me to have dh there to hold my hand while they did the spinal. It's not always possible, but if you have any issues with either the spinal itself, or going into OR alone (and I have issues with both), it can help.

 

Breastfeeding on the table was the best part. I was told it wouldn't happen by my OB (she said there was insufficient space between my breasts and the drape. But, the L&D nurse just held dd2 upside down (her head pointed at my feet) over my shoulder, and she nursed that way. It helped a lot.

 

And, definitely get stitches, not staples. I can't begin to describe the difference that made for me, in terms of both reduction of pain and increased mobility. (ETA, after reading another post - obviously, this doesn't apply if you have allergy issues, as in one poster's case! I don't have any allergies, and I always forget about that kind of thing.)

post #13 of 56
Quote:
Originally Posted by irishmamacat View Post


Ask them to wait until the spinal or epi is working before catheterising you.

 

OMG - is this not standard practice? If not, why not?

post #14 of 56
Thread Starter 

Although it isn't universal that a child born via c-section will have issues nursing, since a lot of the moms here have c-sections because of medical issues, I thought I would throw this out there:

 

If you have a baby who is not strong enough to nurse effectively, one way that you might be able to avoid using formula is to let them put the baby on IV fluids.  It is hard to see your baby with an IV, but it means that they can keep the baby properly hydrated and have very quick access in case the blood sugar (or some other issue) requires quick interventions, which is more likely in a pre-term infant.  Then, you pump out the foremilk (save it) and nurse once the more fat/nutrient dense hindmilk starts, and nurse as long as the baby can handle it, then, if possible, syringe feed the milk you just pumped (easier on the babe than nursing directly, but teaches the same action in the mouth.)

 

The IV was the key here, both for medical reasons and to give peace of mind while you try to establish nursing with an infant who isn't strong enough to nurse the way a full term, healthy infant would be able to.

post #15 of 56
Thread Starter 
Quote:
Originally Posted by Storm Bride View Post

 

OMG - is this not standard practice? If not, why not?



I gotta agree with you here, how on earth is that even an issue?!?  I suspect it isn't the standard of care as much as the occasional stupidity of humans not paying attention to what is going on.  I think they usually pull the catheter out before the spinal has worn off, and I can't even imagine the scream that would issue from me if they tried to cath me BEFORE the spinal.  maybe if I was already in labor, because I didn't even feel the needle at my first, emergency c-section (so it was a bit of a shock when I had it done without laboring...wish I would have known that because I think I accidentally hit the nurse in shock).

post #16 of 56
Quote:
Originally Posted by Jennifer Z View Post



I gotta agree with you here, how on earth is that even an issue?!?  I suspect it isn't the standard of care as much as the occasional stupidity of humans not paying attention to what is going on.  I think they usually pull the catheter out before the spinal has worn off, and I can't even imagine the scream that would issue from me if they tried to cath me BEFORE the spinal.  maybe if I was already in labor, because I didn't even feel the needle at my first, emergency c-section (so it was a bit of a shock when I had it done without laboring...wish I would have known that because I think I accidentally hit the nurse in shock).

My catheter stayed in until the next day and I was so glad it did! My recovery was hard and those first 24 hours were brutal - I did not get out of bed to walk until the day after the surgery (which is NOT standard procedure. They want you up asap.) I know so many women who had a fine recovery - not easy per se, but not hard either. Mine was harder than most and I am not sure why, but I do have some universal advice. Be kind to yourself. Accept help. Don't be afraid to take some pain meds if you need them. Ask lots of questions and, most importantly, remember that you are strong and amazing! Allow yourself time to heal and don't even think about returning to "normal" until at least 8 weeks out - it may come much sooner than that, but just know that it *can* take that long and you don't want to underestimate your recovery time.

Oh, and don't try to zip up pre-pregnancy jeans over your stitches. The zipper caught on the steri-strip and busted open the entire left side of my cut which then took exponentially longer to heal. Bah!
post #17 of 56

Quote:

Originally Posted by tracymom1 View Post

My catheter stayed in until the next day and I was so glad it did! My recovery was hard and those first 24 hours were brutal - I did not get out of bed to walk until the day after the surgery (which is NOT standard procedure. They want you up asap.)

My catheter stayed in until the next day, too, which was wonderful.  I honestly had not even realized it was in until they came to take it out and I thought, "Oh!  That's why I haven't had to pee!" ROTFLMAO.gifKind of funny, that.  It does make resting and that first stage of recuperating much easier, I think.

 

On another note, I knew almost nothing about breastfeeding difficulties that some women experience in relation to having a c-section.  I didn't know that it could even cause challenges.  In my case, BFing after my c-section was about the same as BFing after my first son's birth, which was vaginal.  I am almost glad I didn't know it can present challenges...I tend to worry about things, and I didn't know I had anything to worry about!  I think BFing after a c-section is like many other aspects of having a baby:  it is simple for some, less so for others.

 

ETA:  I have a friend who had a c-section...her husband took the most beautiful, intimate photo of her child's emergence from her body.  I think that for moms who want to see the child come out but can't have the drape lowered for whatever reason, that might be a lovely thing to have.  I wish I had thought of it!
 

 

post #18 of 56
Quote:
Originally Posted by irishmamacat View Post


Ask them to wait until the spinal or epi is working before catheterising you.

 

Just a quick note.  I did not find the insertion of the catheter to be painful.  It pinched coming out, but the insertion was not a problem for me.

 

I was also cathed in college for a ripping kidney infection (or was it bladder?  can't remember...it was in the 80's), and that cathing was also not painful.  I was afraid and embarrassed, but it didn't hurt going in.

post #19 of 56

For me the hardest part of having a c-section was the meds.  I agreed to morphine in the Epidural and it made me out of my mind itchy.  I was also given something else that made me paranoid with mild hallucinations.  So, my biggest tip for anyone having a c-section is to talk with an anestheseologist at your hospital in advance if possible to make a med plan that you think will work for you.  I've also included this in my birth plan in case of repeat c-section. 

post #20 of 56

I agree with parsley about the meds.  I still don't know what to do about them, but this will be the first time I get an anesthesia consult beforehand.  I'm allergic to codeine/morphine and demerol gives everyone in my family hallucinations so I'm unwilling to try it.  I feel ill even after having my mouth numbed at the dentist, so it's about picking the least of the evils for me. 

 

I do know the thing that made it easiest after my second was getting off of meds and my IV fluids asap after surgery.  Every time anyone came in my room when I was feeling well enough to think about it I asked to please have my IV fluids stopped and IV removed.  The IV fluids made me feel terrible with my first, I actually came home weighing *more* than when I went in to give birth to a 9lb baby.  Then I drank as much water as I could get anyone to bring me to wash everything out of my system.

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