c-section advice? - Mothering Forums

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#1 of 14 Old 12-04-2011, 05:59 AM - Thread Starter
 
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Anyone have advice on how to improve the c-section experience?  I have a partial placenta previa and found out this week I will have to have a c-s at 37 weeks - Dec12th, only ONE WEEK away! I was very hopeful that the previa would resolve because I only needed  the placenta to "move" another 1/2 cm, but no such luck. I've been lucky to not have any bleeding and my baby girl is growing well (this weeks estimate is 5 lb 11 oz).  I've also been able to continue to see my midwife, who I love, and "co-manage" with the OB that sees the high-risk patients for the group.

 

So, I'm worried about post-op c-s care - I don't want to be really groggy, I'm worried about getting breast feeding started after a c-s and with a (to my mind) close to premature baby, and I'm worried about pain control (I absolutely hate narcotics - the one time I had a dose of narcotic I puked for 6 hrs) and recovery afterward.

 

I'm going to ask that they not tie my arms down or give me any sedative or narcotics aside from the spinal post-op.  My midwife assures me the hospital nurses will put baby to breast within an hour of surgery.  And I've ordered an abdominal binder/corset to start a few days after surgery.

 

Any other advice?  Anyone else have to have a c-s?

 

Thanks in advance!

 

 

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#2 of 14 Old 12-04-2011, 06:38 AM
 
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Why can't you continue to wait and see if it moves a bit more?  How far off the os is the placenta?  I know someone who kept going until 41 weeks and her placenta went from <1cm off the os to almost 3cm and she was able to have a vaginal delivery.

 

As far as c-section stuff goes I would definitely speak with anesthesia beforehand and let them know that you don't want any additional meds for the repair.  Also talk with the OB and see if he exteriorizes the uterus to suture it (that takes longer and makes you feel more woozy - hence the extra drugs)

 

as far as narcotics for pain relief, you can get Toradol instead - it's a super strong NSAID (like motrin) given via IV that is supposed to work quite well.

 

Find out the protocol for after the baby is out - do they wrap it up and give it to dad who stays with you in the OR?  Do they take it to recovery so dad will have to leave you alone in the OR?  Do they typically bathe the baby right away? (you can decline that)

 

My biggest regret about my first birth is not finding this stuff out - they took my baby away, my husband went with her but he didn't know what to do so he just took pics of them bathing her and doing tests and stuff.  She is crying and cold and then they wouldn't let me have her when i finally got in the room :(

 

 

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#3 of 14 Old 12-04-2011, 06:51 AM
 
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I've had c-sections.. my second was very different than my first.  With my first I was in labor for 36 hours before my c-section was done.. I was exhausted and even though I requested that they not they still gave me something to "help me rest."  I woke up 6 hours after my daughter was born and felt so out of it that I had no interest in holding her or breastfeeding.

 

With my recent c-section I made it quite clear to my doctor before hand what I wanted to do differently this time.  He's an amazing person and listened to and made sure everyone knew what I wanted.  Neither of my hands were strapped down, although at one point I wish they had been because one kept falling off the arm board lol. I wasn't given anything that made me groggy.  My situation is different because I had a 27 weeker that was taken straight to NICU so I didn't get to breastfeed, but had I been able to I was definitely alert enough that I could have done so.  I was given one dose of Toradol for pain relief after my spinal wore off and it was awesome.  It's not a narcotic and it worked great.  You will have to check on safety as far as breastfeeding goes though, because I was on so many medications in the beginning that I had to pump and dump.  Another difference this time was that my dr. closed every layer that had been opened.  I remember hearing the other people in the room tease him that he was taking forever and using too much suture to close.  But I 100% believe this made the biggest difference in my recovery.  After my initial dose of Toradol I never needed ANYTHING for pain.  I wasn't toughing it out (I'm a huge wimp when it comes to pain), my pain really never got above a 2 or 3. 

 

Good luck and congratulations on meeting your new baby soon!

 


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#4 of 14 Old 12-04-2011, 11:01 AM
 
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Thanks, all. I'm writing my birth plan this morning and this information is coming in handy.


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#5 of 14 Old 12-04-2011, 11:23 AM
 
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This might be old news to you, but you might want to check out the International Cesarean Awareness Network http://ican-online.org/ and this link on breastfeeding after a c-section 

http://www.plus-size-pregnancy.org/CSANDVBAC/bfaftercesarean.htm

 

Good luck with writing your birth plan! 


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#6 of 14 Old 12-04-2011, 11:36 AM
 
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DDCC to let you know to check out the C-Section forum that was recently added. There are a lot of tips as well as information on what to expect.

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#7 of 14 Old 12-04-2011, 04:44 PM
 
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You could also ask your doc to locally block the incision.  It's like novacaine at the incision so should not affect you systemically.  One of my surgery instructors asked to OB to do this when she had twins and she said it made all the difference in the world.  She also was the biggest advocate for getting us to routinely block the incisions of all our abdominal surgeries...and you can totally tell a difference when those patients wake up compared to others.

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#8 of 14 Old 12-04-2011, 04:59 PM
 
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Crashing, too, to say check out the c-sec forum. 

 

As you can see from my sig, I've had 2 c-secs.  I took nothing for pain post-op after ds1 and only one dose of extra-strength Tylenol after ds2.  You might be surprised at how little post-op pain one can have.  :)

 

And not that you asked, but I would definitely as my doctor why I couldn't wait it out a few more weeks to see if the placenta moved up, even if it meant full bedrest.  GL to ya!


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#9 of 14 Old 12-04-2011, 05:09 PM
 
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I'm really confused. Why a 37 weeks cesarean? There are some doctors (&midwives) who will attend a vaginal delivery with a partial/marginal previa, so long as most of the cervix is clear. They just watch carefully and go to a cesarean if there's bleeding. A 1/2cm is nothing, sounds like they're being extremely conservative. Do you know what grade your previa is? Remember that it's actually your decision, not theirs. If you aren't having any bleeding, there is no reason why you can't refuse a cesarean and wait to see what happens. You can always have surgery later on if there's a problem.

 

As for making a cesarean better, here's a cesarean birth plan you might get some ideas from. I've also heard of asking for delayed clamping (even a couple minutes can make a big difference for the baby) and asking to have the baby placed on your chest while they sew you up again.


mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#10 of 14 Old 12-04-2011, 05:19 PM
 
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Quote:
Originally Posted by Devaskyla View Post

I'm really confused. Why a 37 weeks cesarean? There are some doctors (&midwives) who will attend a vaginal delivery with a partial/marginal previa, so long as most of the cervix is clear. They just watch carefully and go to a cesarean if there's bleeding. A 1/2cm is nothing, sounds like they're being extremely conservative. Do you know what grade your previa is? Remember that it's actually your decision, not theirs. If you aren't having any bleeding, there is no reason why you can't refuse a cesarean and wait to see what happens. You can always have surgery later on if there's a problem.

 

As for making a cesarean better, here's a cesarean birth plan you might get some ideas from. I've also heard of asking for delayed clamping (even a couple minutes can make a big difference for the baby) and asking to have the baby placed on your chest while they sew you up again.


truedat.gif  While 37 weeks is "term", remember that your baby undergoes TONS of development between 37 and 40 weeks in the womb... I'm curious why your doctor is in such a hurry to get the baby out if your situation is not considered an emergency.  A baby who's gestated for 40 weeks might have an easier time during and after the c-section (including being able to latch more easily) than one who's just reached term, plus it's important to note that unless you know exactly what day you conceived, your baby's true gestational age could be off by even a couple of weeks!!  Good luck with your decision, just remember like Devaskyla says, it's your decision.  So do your research. :)

 


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m/c 07/14 and Baby EDD: 5/24/15! Stick, baby, stick!

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#11 of 14 Old 12-04-2011, 07:36 PM
 
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I'm confused as Devaskyla and montessorimama are..... Why in the world at 37 weeks??  That seems so early....

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#12 of 14 Old 12-04-2011, 08:06 PM
 
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I also was in your boat and had placenta previa. I did have issues with bleeding and thus was taken off of work and put on bedrest. However, my doctor was not in the least bit interested in considering a c-section, as he didn't think it was worth even worrying about unless I went into labor prematurely, the baby was in distress, or I was close to 40 weeks along and the placenta still hadn't moved. He told me that in his experience, most cases resolve themselves (especially if they are just partial previa) by 37-40 weeks and felt it was better to wait and see rather than make me panic by even talking about scheduling a c-section before giving the placenta a chance to move. Lo and behold, a recent ultrasound showed that my placenta moved out of the way enough for a vaginal birth...and I also will be 37 weeks on December 12th. But then again, I don't know when they last checked the position of your placenta. :)

 

I know what it is like to be told that you HAVE to do something one way when a medical issue comes up (and considering some issues can sound pretty scary, it can be hard to remember to ask questions, including about other options), but sometimes, just asking about your options will help. Or maybe you can bring someone along with you that can ask questions or speak up for you if you feel uncomfortable or forget to ask something (works like a charm for me, since I do not do well in hospital settings)? 

 

I agree that if you aren't bleeding and your baby isn't in distress, 37 weeks sounds quite early for a scheduled c-section unless there are other issues going on...from what I hear from my friends in similar situations, most doctors around here won't schedule a c-section that early...

But either way, if you do still end up having a c-section, definitely talk to the hospital about their policies and maybe take a tour if you can (the hospital here offers tours of the birthing center on a regular basis, for instance). Maybe also talk to your birthing partner about your worries and expectations for the experience so that they know what to do to help both you and your baby be as stress-free as possible. Of course, this also applies to vaginal birth as well, so perhaps you already knew this and I'm just rehashing things. :P

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#13 of 14 Old 12-05-2011, 06:14 AM
 
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My midwife has told me great stories about how her backup OB handles cases that end in c-sections; I wish I had taken more mental notes to remember what it is that he does that she raves about.  I would second an earlier recommendation to go over exactly what your concerns are and what you want to happen with your OB.  He/she may or may not do some of the things you request by default.  Or they may be perfectly okay with some of the things you are requesting.  Will your midwife or someone else be there to back you up, in the event that the hospital staff tries to do something that you had previously requested NOT be done?  Give your support person a copy of the birth plan that you have gone over with your OB ahead of time, and make sure they are comfortable going over things with the nurses/surgery staff.  When you get to the hospital, immediately request a consult with the anesthesiologist, if you can't get one a few days ahead of time, so that you can go over any anesthesia requests as well.  (They may have to set up differently/order different meds than they normally would.)

 

At my most recent birth (in hospital, with midwife), as soon as the nurses came in the room to get the warmer going and whatnot for the baby, she made them stop, look at her, and told them that I would be getting the baby first, if he was breathing and otherwise fine, and they were not to rush me, they were not to do anything to him without checking it with me first, etc.  It was very comforting to know that, in the thick of things, someone firmly expressed my wishes and actually made them stop what they were doing so she could be sure they had her full attention.  I would request the same thing if this baby ends up in any kind of hospital intervention.

 

The thing that I always try to remember, when going into any hospital experience, is that there is a way that most procedures are normally done.  And sometimes that way is more for the benefit of the medical staff than it is for the patient.  It's not inherently BAD, it's just the way it is.  So you need to make sure that anyone involved in your care knows if you are planning something different from the status quo, as far in advance as you can, so they can prepare accordingly.  And to not be disrespectful or rude about it, acknowledge that this may not be the way things are normally done, but it is what you would prefer.


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#14 of 14 Old 12-10-2011, 10:13 AM
 
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Quote:
Originally Posted by MadelinesMama View Post

I've had c-sections.. my second was very different than my first.  With my first I was in labor for 36 hours before my c-section was done.. I was exhausted and even though I requested that they not they still gave me something to "help me rest."  I woke up 6 hours after my daughter was born and felt so out of it that I had no interest in holding her or breastfeeding.

 

With my recent c-section I made it quite clear to my doctor before hand what I wanted to do differently this time.  He's an amazing person and listened to and made sure everyone knew what I wanted.  Neither of my hands were strapped down, although at one point I wish they had been because one kept falling off the arm board lol. I wasn't given anything that made me groggy.  My situation is different because I had a 27 weeker that was taken straight to NICU so I didn't get to breastfeed, but had I been able to I was definitely alert enough that I could have done so.  I was given one dose of Toradol for pain relief after my spinal wore off and it was awesome.  It's not a narcotic and it worked great.  You will have to check on safety as far as breastfeeding goes though, because I was on so many medications in the beginning that I had to pump and dump.  Another difference this time was that my dr. closed every layer that had been opened.  I remember hearing the other people in the room tease him that he was taking forever and using too much suture to close.  But I 100% believe this made the biggest difference in my recovery.  After my initial dose of Toradol I never needed ANYTHING for pain.  I wasn't toughing it out (I'm a huge wimp when it comes to pain), my pain really never got above a 2 or 3. 

 

Good luck and congratulations on meeting your new baby soon!

 


ddcc to add that i managed pain last c-birth with toradol and will do so happily again if this babe turns out to be another c-birth.

i did get to bf and they told me it was fine with breastfeeding.  it worked well for us.  good luck to you!

 


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