Csection Support Thread April 2005 (cont discussion from March) - Page 3

[Llyra]

Maybe I'm a rare individual, because I felt the cut. It didn't HURT, but I definitely felt it. That's why I wound up with a general-- I panicked, kind of freaked out. I didn't want the csection to begin with, I was terrified for the baby and for the whole experience, and so I freaked, and they shot something into my IV and I was out in less than a minute.

I have no idea why I felt it.

Anyway, I seriously regret letting my panic get away with me, because that general anesthetic had a lot of effect on Julia. She was mostly asleep herself when she was born, and she was groggy for almost a week afterward. I blame that grogginess for our breastfeeding trouble.

Plus I completely missed the entire birth, and that bothers me. DH says she was purple like a blueberry bagel, and I would have loved to have had a memory of that moment.

[wenat]

Originally Posted by RacheePoo

I can honestly say that I have zero regret or guilt about having a c-section. Ds was malpositioned (had been transverse for months) and never engaged. ... I had an incredible surgeon, a speedy recovery, and I never experience pain or numbness. The scar is microscopic. I went through all the normal feelings of "what if" for a couple of months after his birth, but then they just faded away. I will have a c-section again if I ever get pregnant again.

Thank you, RacheePoo, for posting this. It's exactly how I feel.

DS was head-down and perfectly positioned for my entire pregnancy. But when my water broke, he popped out and when my doctor checked my cervix, he couldn't feel the head. A quick ultrasound showed that his shoulder was presenting, which is a problem because if the cord came out, DS would have died. So I was told that I'd be having a c-section in the next 30 minutes (probably faster if they'd felt a cord coming out), but at that point, they figured they had time to clear the operating room from the previous delivery.

I'm SO glad that one of my friends kept telling me that a c-section wasn't the end of the world, that the best thing is "healthy baby, healthy momma." The nurse told me that I had one of the calmest reactions she'd ever had for someone being told that she'd be having a c-s shortly.

There is a funny part to my delivery story. My DH was waiting outside, and heard my doctor (one of the senior obs/gyns at the hospital; most of the nurses wanted to know how I got to be his personal patient) asking where the resident was (I guess for assisting in the c-s). They were saying that there was no resident, and DH is standing there thinking that we've gotten ourselves into a messy situation, and what kind of gong show is this?

Anyways, he gets into the operating room, and an older doctor walks in, and DH said that you could see all the nurses and everyone else in the room visibly straighten themselves up. Turns out that there was no resident to assist, so I got one of the senior surgeons. So between my senior obs-gyn and the hospital's senior surgeon (who had great fun teasing each other while delivering), I had an impeccable c-s, with no complications and no major scar.

I remember being told that DS had the cord wrapped around his neck 3 times. I guess that's another good reason to have had that c-s -- I'd have been horrified if the cord had strangled him on the way out! (One of my pregnancy nightmares.)

There were two bad parts to the cs: the shakes in the recovery room, and the sadistic nurse who made me get out of bed that night. I know that she wasn't really sadistic, and I'm grateful now because I realize that it really helped with the recovery time, but at the time it was pretty hard to do.

We had a rough first week of bf'ing, just because DS was so sleepy all of the time (probably from the drugs that I got), but once the milk came in, he bf'd like a champ, and is still nursing through this pregnancy.

I'll probably have a scheduled c-s with this current pregnancy. It turns out that I have a small pelvis and make babies with huge heads, so unless the baby is early, I'll probably have the same problem this time around.

I just have some questions for mommas who've been there:
* are the post-operation "shakes" better with a spinal or an epidural? Or are they about the same?
* will they let you nurse the baby while you're in the recovery room? I'd really like to be able to get the baby to the breast asap this time, despite the shakes
* is the recovery period easier the second (or third, or more) time around? I was out doing half our evening walk by 4 weeks, and doing laundry and a 3-mile walk by about 6 weeks.

[OnTheFence]

Originally Posted by mellybean

i love my daughter like i've never loved anyone before ... but i can tell the bonding doesn't go both ways with us. we lost breastfeeding in her fourth week, because of my medical problems and medications, and i think that's a major part of it. there's this huge "disconnect" between us ... i was in labor, we were dancing together, then boom, she was gone and out of me. no natural transition of things, you know? and now, she's hungry, she gets a bottle, again something artificial is between us. no matter how lovingly i bottle-nurse her, nothing can get close to breastfeeding bonding.

have your c-births caused any delayed bonding, or bonding problems, for you and your babes?

Sorry it has taken me some time to get back to the thread. First I want to say (((hugs))).
I wanted to address your post because I think that in the more "natural. ap" community where natural vaginal births are touted as the best, and breastfeeding is the ultimate bonding experience -- we get lost in those ideals of that is how our own parenting experiences should be, and if we dont have it that way we are failures.
This is when I say "Ignorance is Bliss". Most women who have csection have no bonding issues at all. They are just as happy and feel just as blessed as their sisters who had vaginal births. Both traumatic vaginal and cbirths can bring about bonding issues, and both can carry problems with breastfeeding.
I know with my first child I sunk a lot of faith into the vaginal birth, immediate bonding, sucking on the breast idealogy -- I think it was my own mind and feelings that played a part in my difficult bonding with my daughter. Even though I successfully breastfed her, and I was attached -- I surely did not share a bond with her like other mothers had with their children. I PTSD from a traumatic csection and I had PPD. This also played a part -- and I nursed my daughter for 19 months.
Can a csection cause bonding problems? Sure, but I think some make it sound as if this is a common occurrence when it isnt. Cannot breastfeeding cause problems? Sure, but probably its more of a "me" thing (meaning the mother) rather than a child thing. Think of the thousands of children that are adopted that are never breastfed or preemies -- and I can assure you if you ask their mothers, the majority will disagree with the premise that they couldnt bond because of not nursing.
You made the comment "nothing can get close to breastfeeding bonding" -- I disagree. Breastfeeding is not the end all and be all! I know women who have breastfed and felt detatched, and I see mothers who bottle feed their babies, like you have described and its the best damn thing in the world to them! This is a premise in your head that breastfeeding bonding is superior -- and actually I will say its not. I quit breastfeeding a child because it made bonding worse! He was much happier to have his bottle and coo and smile at you through a plastic nipple but on the breast he made no eye contact and would fight it! I am of the belief that breastmilk is best for babies, no doubt of the benefits, but is it the best bonding experience -- not for all. It wasnt for me with two of my children.
Melly, I think its important to see how beautiful and happy your baby is, that each relationship with your children is going to be different. Whether its your first or your last, and when its your first, you are just learning and stumbling through the motions -- which can often make it harder. You have had obstacles to overcome, a surgery to heal from, and you had nursing issues, and I hope that with time, and as your daughter grows you will find healing with all of this. Just don't put so much value in things that may or may not be the case or listen to those people who say "this is the only way". There are many ways for us to become mothers, birth babies and bond with them -- and from what I get from you -- you are being a wonderful mom to your daughter!

[OnTheFence]

<<<DH thinks that if I hadn't refused pitocin, I might have fully dilated sooner, but I don't see how that would have helped the entanglement. When I look at the whole thing objectively, I see that there really was nothing I could have done, and that we're incredibly lucky that the technology existed to help Julia. But I can't help feeling bitter, especially because of the resulting breastfeeding problems (see above post) and because I am very clearly NOT a good candidate for VBAC, so I will have to go through another section if I want another baby, which I do.

I try and just concentrate on the fact that Julia is healthy and happy and thriving, and forget everything else.>>>

Welcome!

I think it is good to focus on that you have a healthy happy baby! And it appears you really did need a csection. I can tell you that a planned csection is much different than an emergency one, and this is from experience. I am planning my third csection now and I am very excited about it! With my last birth I really thought about the what ifs, and if I could VBAC. This time, I am so glad just to feel great about planning this birth and making it a wonderful experience (since it will be my last) VBAC isnt an option for me and I am just not going to dwell on it. I know that for me I can create a beautiful and wonderful experience.
Breastfeeding is tough after csections, but doable -- it definitely sounds like you had some problems, some that were totally out of control. Things may be different next time. I have a friend who couldn't nurse her first two children but her third one nursed like a champ for 15months. The more I read and talk to other mothers, the more I have come to realize that first time breastfeeding have more struggles than with later children. Milk supplies are lower, takes longer to learn the ropes, longer for milk to come in, etc.
Just know that next time will most likely be different and you can play a huge part in that with planning!

[OnTheFence]

Originally Posted by RacheePoo

I do have a ? though. Has anyone experienced fluttery feelings that feel exactly like a baby kicking them? Anyone that isn't pregnant, that is? This started last night and it is freaking me out. I'm definitely not preg. I can't believe it's been almost a year since ds was born!

Thanks Kim for always starting this thread. It is very valuable for us to know that other AP Mamas do have c-sections, even *gasp* by choice.

You are welcome!!
Yes, when not pregnant I have experience the same thing, its called phantom kicks. And pretty common. I will say that after this pregnancy, the moving and rolling of a baby inside me will be missed.

[OnTheFence]

Originally Posted by Jessmcg

I thought someone had posted a c-sec birth plan, but I can't find it, does anyone have a link to a good one? It looks like I maybe having this baby soon (like maybe this weekend), and I want to go over my birth needs with my doc on Friday morning. He is really good and usually lets me do what I want, but I want things in writing.

Thanks for any help!

They are on previous threads. You can search for them by putting in "cesarean support". I am sorry so late in posting, seeing today is Friday. If you can PM me I will try and help you out before your baby is born. Is there something specific you are looking for?

[OnTheFence]

Originally Posted by Valérie.Qc

Hi!

I'm at my first experience as a Doula and my client will probably have a c-section (baby is breach at 37w - if the baby still breach next tuesday they will transfer her to another OB to do the CS).

She told me she want to have general anesthesia because someone (she said a nurse) told her that some woman feels the cut with an epidural. I know one can feel some pressure (I did when I had my CS 14y ago) but feeling the cut? First time I hear that! I can't find anything in books I have...

I'll see her tomorrow or friday and bring infos about the effects of anesthesia vs epidural but would like to be able to address her fear of feeling pain if she choose epidural.

Thanks

EEK! I hope you come back to this thread Valerie! GA for a cbirth is so much more dangerous! More people have problems feeling with spinals than with epidurals, but most doctors prefer to operate with a spinal. I had a spinal and it did fail (I had a traumatic, emergency situation) but I had an epidural and it worked great. I will be getting an epidural this time too. I hope you will definitely attend her at her birth and I would be happy to give you lots of tips to make it all more comfortable for her! A good OB WILL NOT cut on a woman that can feel the prick test, if there is an epidural in place they will redose, often rocking the patient a little from side to side to get a complete block, for a spinal they cannot do this but they definitely should not proceed -- often what they will do is dope them up with all kinds of narcotics and give them verset, and then some will just knock the patient out. Wtih an epidural she will full pushing and pulling, especially since her baby is breech, but its not painful. (or shouldnt be)
I really hope she will choose an epidural block because with GA risks are higher, she will have a longer post op recovery time without her baby, she will be given amnesia like meds and sedatives in her IV. GA is fine for an emergency or when certain health issues prevent a spinal or epidural, but its really not recommended nor is it safer.

[OnTheFence]

Originally Posted by Valérie.Qc

Thank you for your replies

My client is really, I mean REALLY afraid of ANY pain... She is more comfortable with a c-section than a natural birth because of this (I think her baby turned because of this ) and, if there is a little chance she might feel something, I feel that she will go for the general Well, it's HER birth and HER choice - the only thing I can do is give her all the infos and then support her in her decision and help her welcoming her baby as best as we can.

If I was her friend I would recommend an epidural for a planned csection. They will do this outside the OR in her room (or she can ask that this be done) They can give her a prick test and see right there if she needs more.
She may think the actual surgery is the real pain. Ummm, no, its not. And I know from speaking to hundreds of women who have had csections under GA that the recovery time was painful and slow. At least with a spinal she can get Duramorph and with the epidural she can have a PCAPump left in the spinal cathetar to administer meds right into the blocked area, continueing to give her pain relief in the lower half of her body by providing a "block" similar to a walking epidural for up to 24 hours after the initial birth. I had mine in 17hours but they dosed it before they took it out and had relief this way several more hours but was able to walk from the bed to the bathroom. With GA they will giver her shots, or oral meds that may interfere with her "mind" and cause sedation. Also with GA she will be given amnesia medication, making those hours after birth a haze at best. (I lost all memory for more than 12-15 hours)

Here is the bottom line: Your client is going to be in pain but there are ways to manage it, and even more so if she chooses the epidural or spinal. Based on her fears, I would recommend an epidural with zofran for nausea. She needs to be aware there will be pushing and tugging. After she has recovered and the catheter removed she needs to move, get out of the bed, go to the bathroom, and hopefully they can provide her with a rocking chair in her room (which will help with gas) I wil be honest in saying gas can be more painful than the incision site so some gas X and a rocking motion, plus eating soft foods is a way to eliminate some of that. She also needs to take pain meds as needed -- if thats every 4 hours, then its every four hours. There is a lot more plusses to having a spinal or epidural than GA, for pain management and psychological reasons. I hope you can "convince" her that they are a better option.

[OnTheFence]

<<I just have some questions for mommas who've been there:
* are the post-operation "shakes" better with a spinal or an epidural? Or are they about the same?
* will they let you nurse the baby while you're in the recovery room? I'd really like to be able to get the baby to the breast asap this time, despite the shakes
* is the recovery period easier the second (or third, or more) time around? I was out doing half our evening walk by 4 weeks, and doing laundry and a 3-mile walk by about 6 weeks.>>

I did not get the shakes with my epidural. However I did get nauseated from a drop in pressure, i was given ephedrine fro this but no phengran or zofran in my IV. These were the only two drugs I was given for my csection. I cant remember with the spinal.

I did not go to a recovery room, I requested to "recover" in a L&D room. Because my csection was planned, this arrangement was made before hand. This is something they can accomadate you with. My csection was 30min from start to finish and within 15min of being in the L&D room my baby was half-ass nursing. (he was more interested in looking around) My babe was very alert and stayed awake for nearly an hour after his birth.

I can say that my second csection was almost pain free. Alot of folks hate for me to tell this because csection are evil of course and so much worse than vaginal births. My last one was so awesome. I had the epidural block for 17hours after and it was wonderful. I could move around the bed, could sit up, sit even cross legged in the bed and felt fine with no pain. My biggest "pain" was getting out of the bed and moving around. However once the caths and ivs were removed I began moving and took a shower. I also was sewn up verses staples and I really think this made a big difference for me. I did a lot of things to facilitate my recovery, including meditation.

[J-Max]

Birth plan

Thanks Kim, I tried searching for the old threads before, but couldn't find them

Here is my birth plan. I combined several different ones I found online, let me know what you think. Just FYI, this is my 3rd c-sec all at our small local hospital.

Jessica McGregor's Birth Plan
Date: 3/2/05
Birth Attendant:
Birth Facility: Pullman Regional Hospital


Following is a statement of our childbirth desires. We have educated ourselves prior to making these choices and feel that we are prepared to follow through on them. We understand that complications do arise and in such instances trust [physician/midwife] to make necessary decisions. We greatly appreciate your cooperation in realizing our plan.


CESAREAN SECTIONS
I would like my partner to be present at all times during the operation.
I would like to be conscious.
I would like the screen lowered so I can see the baby coming out.
I would like to have one hand free to touch the baby.
We would like to videotape and/or photograph the operation and baby coming out.
I would like to have immediate contact with the baby (if the baby is in good health).
POST-BIRTH
I would like to hold my baby immediately after birth.
I would like to wait until the umbilical cord stops pulsating before it's clamped and cut.
I would like to postpone newborn procedures until I have had a chance to bond with my baby.
I would like all newborn procedures to take place in my presence.
If I can't be with my baby for newborn procedures, my partner would like to stay with the baby at all times.
I plan to breastfeed my baby.
I would like to breastfeed my baby immediately following the birth.
The following pacifiers can be offered to my baby:
I would prefer that no artificial nipples (bottles, pacifiers) be offered to my baby at any point.
I would like 24-hour rooming-in with my baby.


Please let me know anything I should change/add/remove!
Thanks so much!

[Valerie.Qc]

Thanks Kim!

I'm going to do my best to convince her and I'll be there for her the day of the birth.

I'm already walking on eggshells with her tho... but I hope for the best.

[Henry's_Mamma]

Valerie ... one other thing ... she shouldn't kid herself that GA avoids all pain. There is still the pain after the birth to contend with. And that can be a lot rougher for many. Moreover, GA will be much, much, much more likely to really interfere with her memory of the birth, breastfeeding, and her bonding. Finally, I seriously doubt that most drs. will allow a patient, barring an emergency situation, to have GA for a c/s b/c of the dramatic and dangerous effects it can have on the baby. GA passes through to the baby in much greater doses than epidural or spinal meds. Most drs. don't want that kind of potential liability. She should discuss pain options with her dr. now. In addition, if it is a planned c/s, she may be able to talk to the anesthesiologist before the birth and make her fears and wishes known. That in and of itself may help calm her. Good luck!

[Valerie.Qc]

We are in Canada, lawsuits are rare... So liability won't be too much of an obstacle to her "wish"

I'm going to see her this afternoon - hope she will really listen to me.

Oh, the breastfeeding argument won't do any good... she just wait for an excuse to not even try...

[shannon0218]

She just doesn't sound like the "Doula" type-IYKWIM
I'm in Canada too but I don't think I've ever heard of them ok'ing a general just cause mom's a wuss. (btw, should you ever want to refer her to this thread to try to change her mind, lemme know and I"ll edit my post :LOL)

[shannon0218]

On the breast feeding/bonding issue, I agree with OTF, I think in being a member of this community sometimes we place far to much pressure on ourselves. I was already 90% sure I would not be able to breast feed, but I had set myself up that I "needed" to at least feed her formula at the breast and bought myself a lact-aid. The LC at our hospital was great and she tried with us but finally she said to me. You are hating this, your baby is really hating this, you both LOVE skin to skin contact and staring into each other's eyes--do that, how much bonding are you doing with you crying and her screaming?? When I let go of my guilt that my baby would not bond if she wasn't feeding at the breast I was able to enjoy the bonding that was happening while bottle feeding my little bundle. My dh also loves that he can enjoy it too, he strips his shirt off and nuzzles her close to him adn stares in her eyes while feeding, as a result, Molly really is bonded to both of us almost the same (he is off on a parental leave-so with her as much as I am)

Please, please, please, let go of your guilt, instead, enjoy your baby.

[Valerie.Qc]

Originally Posted by shannon0218

She just doesn't sound like the "Doula" type-IYKWIM
I'm in Canada too but I don't think I've ever heard of them ok'ing a general just cause mom's a wuss. (btw, should you ever want to refer her to this thread to try to change her mind, lemme know and I"ll edit my post :LOL)

She's not the doula type : I think I was "imposed" by someone else in the medical field because of her situation... It's hard.

I won't refer her to this site - she would freak with all the alternative lifestyles :LOL She's really mainstream... I'm learning a lot about respect and letting go

[OnTheFence]

Well Valerie,
I am really glad you are here visiting out little section of mothering, because maybe if this info doesnt help this mom it may help others you work with.

Kim

[OnTheFence]

OB appointment this week

I wanted to update everyone on my latest OB appointment.

I am liking my doctor more and more. Even though she has a high csection rate, I feel like she is really intune with women in general and I like that she is pretty candid. I make my appointments for the earliest time possible in the day, but arrive 45min early because once I drop my boys off at preschool I have nothing to do. This has really paid off for me because there is NO ONE there in the office and I get a lot of one on one time with the OB.

My BP was the lowest it has ever been, 120/60. My pressure is consistently lower with this nurse. I think she knows how to get a better reading on a fat chick. Luckily the med student next door takes my pressure regularly. I am trying to watch for pre-e this time around, and dont want to alarm my OB if there is no need. Baby I believe is laying transverse, we will know in a few weeks what position she will be in for the rest of the pregnancy. I still think she is predominately breech or transverse and I can only feel her roll clockwise. So far no weight gain. I still weigh 4lbs heavier than I did the day I had Jack but I feel good and I am eating well.

I changed my pediatrician for my csection for this appointment. I went with one that was more intune to how I parent. He is an older man and one I have really developed a good relationship with. So I don't think there will be any problems at the hospital.

Since I have not used this OB for past births I talked to her about her surgery standards and post op care. Nothing I have asked for is out of the ordinary, except for requesting sutures but she has no problem doing them. I am contemplating staying the full three days after this birth. Its really going to be based on my experience this time, how I feel, and care for the other three children. If I have childcare I think I would like to stay the full three days, but if I feel good and childcare is a problem, I will only stay 48hrs.

At my next appointment I am going to talk about cord cutting. If my husband doesnt want to do it, I think I might. He could have done the actual cutting last time but "cared not too". I also want to see if I can get the OB to let a 3d person into my csection. We will see though. I dont want to push the envelope too much!

[Al Dente]

Originally Posted by Henry's_Mamma

Finally, I seriously doubt that most drs. will allow a patient, barring an emergency situation, to have GA for a c/s b/c of the dramatic and dangerous effects it can have on the baby. GA passes through to the baby in much greater doses than epidural or spinal meds. Most drs. don't want that kind of potential liability.

Unlike my doctor, who wanted me to have GA so he could 'squeeze me in' during his lunch hour after the epidural attempts failed...

Valerie-in some cases she won't be able to see her baby for 24 hours if she has GA. She'll recover on another floor. Maybe that will be enough to convince her. I had a spinal and didn't feel a thing. The threat of GA and the potential problems with it make me horrified that someone would actually choose it.

[OnTheFence]

Birth Plan With Previous Csection

I wanted to post my birthplan for my previous csection. I think there will be some modification to it for this upcoming birth.

Cesarean birth plan

As this is a planned Cesarean birth we are looking forward to a positive birth experience. We want to participate in this birth to the fullest. We have listed our preferences below, these decisions have been made after research, consultation, and thought. Therefore your help in attaining these goals is very much appreciated.

We would appreciate preoperative blood work and tests to be done on an out patient basis, and hospital admission on the day of the birth.

My sister, XXXXXX, is to stay with me the entire time, even for procedures and administration of anesthesia.

I would like an epidural for pain relief with continuous pain relief after surgery with a PCAPump.

I would like the catheter put in after anesthesia is administered.

We do not wish to have medical students present during our cesarean.

My arms are not to be strapped down unless general anesthesia becomes necessary during an emergency.

We would like the option of viewing the birth either by lowering the screen or positioning a mirror.

Kim would like a verbal description of the birth as is occurs. Kim welcomes conversation during the process.

We would like to take photos as we did of our first child.

Kim would like to see the baby immediately after birth if at all possible. She would also like to be given the baby or have it held near her in the OR.

No mind altering drugs are to be administered without Kim’s expressed permission. I am aware that some hospitals routinely sedate the mom for the repair portion of the surgery. It is important to Kim not to feel drugged or be unable to remember the events of the birth.

Kim would like to have the incision closed with sutures rather than staples.

We would like our baby to be with us in recovery. Kim wishes to breastfeed immediately. Please do not give our baby bottles of formula or water and no pacifiers.

Kim does not want to be deprived of liquids or food after her cesarean.

Please remove Kim’s IV and catheter as soon as it is no longer medically necessary. She wishes to get up and move after the birth of our baby as soon as possible.


** I had a seperate sheet that was only about our baby and his care following birth.