C section support help

[LydiaJW]

Hello Ladies!

I just took on a doula client who is scheduled for a cesarean. Does anyone have any tips how to best support someone who is having a c section? I've only helped with vaginal births. TY!

[IrelandsMama]

I had a c-section and so I can tell you from that point of view. I wish I had known more about my rights. Like that I could have insisted that the baby stay in the room with me and that I held it. Also that you can view your surgery with a mirror and/or take the curtain down. The baby could stay with me, sleep with me, refuse vit k, eye goo, and other things. I hated all the things they kept me hooked to I couldn't sleep.... I had the pulse ox, the blood pressure, and an IV the first 24 hrs after. I didn't sleep even one minute of that time. They also kept coming in and I wish they hadn't. I hated the thing my baby had to wear, in case some one stole him it would go off, impossible since I held on to him 24/7. I wish I had started pro biotic early on too. I also was so glad to have breastfeeding help. I needed some one to bring me H20 constantly once I went home. I'm glad I had a good breastfeeding pillow and extra pillows around since they helped me breastfeed. Hmmmmm thats all I can think of right now exept that it was nice to have a pair of hands to help me do everything for a couple weeks.

HTH

sav

[maxmama]

Two sections myself and circulating on goddess knows how many have given me this:

It's still a birth. Our moms breastfeed as soon as they leave the OR. Breastfeeding is easiest for a lot of moms sidelying, but I hated that because it pulled on my incision.

Someone needs to take a camera in the OR. My favorite pictures are ones my friend took when she wasn't supposed to.

Most anesthesiologists will allow two people in the OR if they're asked. They run the OR, not the surgeon, so what the OB says means exactly diddly.

Early eating means earlier recovery. Ask for Zofran or Anzemet in the OR (preferably before the repair, if they exteriorize the uterus -- that's when people barf).

There's nothing different about the *baby*. We keep all babies in the room with mom at all times.

Walk walk walk. I was out of bed at 6 hours post op. Most nurses will not push you to get out of bed, because quite honestly it can be a PITA to get a post-op section up, but walking means less pain in the long run. Get that Foley out and you'll have to walk as you pee off the three or four liters they dump into you perioperatively.

Tell her: TAKE YOUR PAIN MEDS. Yes, I know not to type in all caps. This is worth it. Less than 1% of narcotic transfers into breastmilk and it is more important to be comfortable. Women in pain don't let down well.

Write a birth story. I wrote my own, but I love to look at it now and remember my daughter's birth. I didn't write one for my son and I wish I had.

It's a birth. It's a baby. You know how to take care of this mom.

[Meche]

I've attended both planned and unexpected Cesarean births. My recommendations for when you have time to prepare:

Have the client find out ahead of time who the anesthesiologist will be, and have her contact them for permission for you to be in the OR.

Go over the process of c-section birth with your client in a prenatal meeting. Tell them what to expect from arriving early to discharge.

Explain that they will probably have to wait on OR or OB availability--most people expect to get in the OR precisely upon their appointment time, and are majorly let down when they have to wait for an OR to open up or for their OB to deliver another baby! This is so common, I tell my clients to be prepared for getting bumped by at least an hour or two.

Take some orange, lemon, tangerine or citrus blend essential oil in the room with you. If the mom accepts it, you can dab a tiny drop on her chest or the skin between her upper lip and nose. Opening the bottle in the OR helps cut the odor of the cauterizing scalpel, which can be strong and unnerving to the client and her s/o. Citrus oils also help curb nausea.

All the previous posters' suggestions are great too. Good luck with your client!

[rnchrista]

There are some great tips above!

The mother can also ask to walk into the OR instead of being wheeled in by wheelchair.
They can bring along music to be played in the OR.
Sometimes they will let them have 1 or both arms unstrapped

Give her all the information she needs about her options so she can feel like she has control over the decision making.

[turtlewomyn]

My doula dumped me when it turned out I was having a scheduled c-section (coerced for fetal macrosomia, i wish she would have gone to the dr's appt. with me when the decision was made, and I wish she would have been there with me to hold my hand when my dh went off with dd). I don't know if it was a lack of communication, perhaps she would have been willing to be there, but I didn't ask and she just gave me a partial refund without offering to be there.

Anyway, if I ever have to go through another c-section, I would like the doula there to be with me after DH leaves with the baby. I would like the opportunity to nurse in the OR while they are stitching me up. I would like to be the first non-medical person to hold my baby. Take lots of pictures for them, I have pictures of my daughters "birth" (I can't personally call my experience a birth, I know some women do, but I can't). They are gory but I am glad that I have them. I am not certain about having the curtain lowered or using a mirror to see the actual emergence, I think seeing myself cut open like that may have been too much, the pictures are upsetting enough to know that is my cut open abdomen in the background.

Good luck and thank you for doing this for this mom.

[chana613]

As much as possible, help the mother feel like the baby's mother. With my first, I had an emergency C-section, and it was just awful. My arms were shaking uncontrollably while I was on the table (they told me it's common due to the anesthesia). It was cold in the OR, and my teeth were chattering. I felt like I had no control over my body, lying there completely helpless. They took the baby to my husband to hold after they cleaned her up, and that was so hard. I wanted to be the first one to hold her.

If I had had a doula, I would have wanted her to tell me what was happening every step of the way (the curtain was up), and speak calmly and reassuringly to me throughout. I would have liked to be praised a little for how well I was doing. I would have wanted someone to insist the baby stay in the OR. I would have liked the nurse to bring the baby over to me, and hold her next to me while the doc was stitching me up. I would have liked to be able to croon to her and gaze into her eyes.

There's no reason the baby can't stay with the mother while the anesthesia is wearing off in the recovery room. Obviously she can't hold the baby, and very often will need to doze off, but the father or whoever can be there holding the baby so that as soon as she wakes up, she can touch her baby and, depending on how she's feeling, nurse her.

I am so glad that your client is going to have you there to make the best of a less-than-ideal situation! If she feels helpless and vulnerable, as I did, you will be able to push and make sure that she gets the best bonding opportunities possible under the circumstances.

[kltroy]

I had 1 scheduled c/s ( breech) that was greatly disappointing to me. I was able to come up with a c/s birth plan, which helped. It's posted in some other threads maybe on the VBAC board. Also, definitely have someone bring a camera - one of my fave pics is the first one we had as a family - my anaesthesiologist took it for us and despite the fact that I disliked the surgery, I love seeing my son for the first time.

Agreed - the mom can ask for several things - you may or may not get them all.

1 or more hands free (maybe can get)
mirror to watch surgery (maybe can get, maybe don't want)
if she doesn't know the sex, have the doc hold up the baby to show her husband instead of announcing "it's a boy!" - this was a nice touch
husband can hold the baby after surgery and for remaining time
I got to take my son as soon as they were done with me - had him in recovery and was able to breastfeed
my midwife was in surgery with me for support - she let me know what they were doing since I couldn't see

Mostly, I would help her mentally prepare for the birth. have her talk to her baby and make sure he's ready to come out. Also (this is key) tell her to shave the top 2" of pubic hair off BEFORE she gets to the hospital. I promise her husband/partner will do a much nicer job of it than the nurses will

[maxmama]

Originally Posted by kltroy

Also (this is key) tell her to shave the top 2" of pubic hair off BEFORE she gets to the hospital. I promise her husband/partner will do a much nicer job of it than the nurses will

Actually, please don't shave. It creates tiny skin breaks and increases the risk of infection. We clip now, and that should be standard in all ORs.

[kltroy]

Originally Posted by maxmama

Actually, please don't shave. It creates tiny skin breaks and increases the risk of infection. We clip now, and that should be standard in all ORs.

Ahh good to know - that's definitely less itchy anyway. I would clip, then. Either way it will be a lot nicer/more fun if you do it yourself the night before