Advice for friend having Csect.

[txgal]

A friend of mine is going to have a Csect. for some placental issues. In addition to this she is also moving and meeting a new doctor just 3 weeks before the date. I wondered if you who had been there and done that might offer her some advice of what to ask for. She had planned on an unmedicated birth, so this is quite a change for her. I have told her to request double sutures, and a low tranverse incision, but I wonder if there are other things she should ask for. This is her first baby and although the surgery is medically necessary it is not what she had envisioned, so I want her to get as close to a natural birth experience as she can. Thanks for your help ladies.

[ChattyCat]

You should search for the csec support thread in the main B&B forum. A lot of people have posted links to those threads for csec birth plans.

Obviously, she'll want to try to keep the baby in the OR while she's being sutured. If not, she'll need to decide whether she wants her support person to remain with her or stay with the baby. Some people really prefer sutures for the external wound, while others (myself included) really had a good experience with staples and don't want anything to do with the stitches. She might inquire as to whether she can play her own music, ask that her arms not be strapped down, try to avoid sedating meds. Even when spinal or epidural anesthetics are used, it is common to give anti-emetics that can cause sedation. If she wants to view the actual birth, she may request that the curtain be dropped or a mirror be placed so that she can see it. I'm sure there's other things that I'm not thinking of. Hopefully, that's a starting point though.

I think it's important to have decisions made regarding choices for cesarean delivery, even if you're planning a vaginal birth, because you never know. I wish I had had better plans in place before I went to the hospital with ds.

It can be frustrating to have a csec, when you've really desired a natural birth. I hope your friend has the best experience possible. :)

[loudmama]

If they allow another person in the OR, & mom wants it, that's really nice. That way, DH can be with baby & Mom is not left alone with just hospital staff.

Don't let ANYONE hold baby, except DH, until Mom does. Many Moms express extreme upset about others holding their child first. And who can blame them?

If Mom wants music in the OR, request that.

Keep baby around Mom as much as possible in OR & definitely in recovery.

Room in with baby as much as Mom wants. There is NO reason, except some health issues w/baby, that the baby can't stay in the room with Mom.

That's what I can think of for now....

L

[AnditheBee]

There's lots of info in the Natural Family Living Cesarean Resource Thread (http://www.mothering.com/discussions/showthread.php?t=401645) in Birth & Beyond. Good luck to your friend!

[stellimamo]

See how many people can be in the OR. I had 2 my mum and a doula and it was much better that way. My mom stayed w/ my dd and the doula with me. I had issues so it was nice to have my doula hold my hand when things statted to go wrong. See if they'll let her hold the baby while she is still in the OR. They let me hold dd when they were suturing me.

See if it is hospital policy to strap the mamas arms down. It is still done at some hospitals. ine didn't but it would have been frightening if they did and i didn't know about it in advance.

Have a birth plan- particularly include info about baby care- no artificial nipples etc. if there is a reason they have to be seperated atleast her wishs for her babe are known. I had to be put out all the way at one point afterwards. The nurses wanted to give her sugar water for for blood sugar issues. My mom told them no she's EBF (Go Mom!!!) :thumb and that she could wait as long as it wasn't medically nessecary. She told them then to review my birth plan.

Good luck to your friend!!

[yellowwood mama]

Nurse that baby ASAP!!

[Karah R]

I had a medically necessary cesarean w/DS, and I had a great c-section birth plan and made my wishes clear-everyone had a copy of it who would be involved in my care and DS's care-and since I made them clear ahead of time and everyone knew how I wanted things, they were honored. My arms were not strapped down, the sterile drape that you often see strung two feet in the air was literally just laid on my chest, and I held a mirror myself to watch my son enter the world. They kept music soft in there, and he was immediately brought over to me to hold and snuggle. The anesthesiologist just so happened to be someone I knew, and he was encouraging me to talk to DS, and kept holding the drape to shield Carter from the lights there in the OR (something I didn't ask him to do but was something I very much appreciated, and made everything seem calmer and quieter). I think I held him the whole time I was being sewn up (I had staples), and DH was with him briefly as I moved to a transitional recovery area, and he was brought in as soon as I was in there so I could nurse for the first time. I had DH and a recovery nurse help me get situated comfortably to nurse, and got started right away with it! DH also knew that I would feel much more a part of the birth if I had pictures of his birth-and he took wonderful ones for me (something I don't have for my girls and their vaginal deliveries) so that's something I'd also suggest for a mama who is having a medical necessary c-section who wants to feel more connected with what's going on. And DH stayed with me the whole time so that DS could room in with me the whole time. We were together and had very little contact w/hospital staff.

It's not the birth experience I imagined (I was planning on catching DS as he was born prior to things that happened that necessitated a c-sec), but I tried to find empowerment and enjoyment in the things that we did to make it feel a bit more hands-on--sorry for the book and I know it's the VBAC forum...but saw this thread and just wanted to share things that I did-because I also had never imagined anything but a vaginal birth, and had to totally reframe and rethink things when it turned out I HAD to go the c-section route.

[~Megan~]

If this is nosy forgive me but, why is she having a c-section? The only reasons I can think of a scheduled c-section would be for placenta previa or a medical condition that my child has that would make vaginal birth impossible.
I'm curious because I had a c-section for my first baby because she was breech. I wish I had sought out other options.

[txgal]

She is having a Csect. because her placenta has 2 lobes, with a thin area between the two lobes. The cord is attached to the thin area, and apparently not very well. Her docs are afraid that the stress on the uterus from contractions will cause placental abruption or the cord to tear away. I haven't seen any research on this particular issue, but I think she is comfortable with her decision. She had a friend who lost a baby at 36 weeks due to placental abruption, so the issue hits close to home for her. Thank you for all the great links, it has really given her lots of good info and things to ask for.

[aprilushka]

I would reiterate being clear about nursing right away-- the stupid anesthesologist kept saying I couldn't and she was just wrong, so it's better to have that straightened out before hand.

Also maybe request that they don't small talk during the op if that's likely to bother her. Fortunately in my case they mostly discussed my anatomy (rather than the Super Bowl or whatever) but I would have been pissed if they started talking about their Bahamas vacation. Of course, if I had known who was going to do it all I would also have requested not to put the OB and anesthesologist together since they have a penchant for catfighting each other, but that's another story and not a predictable one...:lol

[hkjg]

There is some great advice here, and the only thing I can add is she should know she will be totally numb from probably her collar bone down. It was probably just me, but I didn't realize I would not be able to move my legs, and be numb- it totally freaked me out. I think if I had known that ahead of time, it would have helped. Best of luck to your friend.

[OnTheFence]

There is some great advice here, and the only thing I can add is she should know she will be totally numb from probably her collar bone down. It was probably just me, but I didn't realize I would not be able to move my legs, and be numb- it totally freaked me out. I think if I had known that ahead of time, it would have helped. Best of luck to your friend.

This depends on the type of block you have. With a spinal this is more likely to occur. Your friend can request, ask, demand for an epidural - which will not give her as a dense of a block, she could still move her legs and she would only be numb from the waist down. However she will feel pushing and tugging. I've had two epidurals and for me, they are the only way to go!

Kim

[~Megan~]

Good point Kim. When dd was born I had a spinal and so I had to wait quite a while to hold her.

[Storm Bride]

I third (fourth?) that she should nurse the baby asap.

Also, warn her ahead of time that even if her dh is there for the surgery, he may (probably) not be allowed in while she's being prepped. That came as a very nasty shock to me with my second section. I was already in a hellishly bad mood, and being unexpectedly separated from dh didn't help...not to mention that they almost forgot to go get him!