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Could use advice about attending a c/s

1056 Views 10 Replies 7 Participants Last post by  momongeon
My client was hoping for a VBAC, but now, at 38 weeks, has a breech baby and a low-lying placenta. They've scheduled her for a c-section. She is still trying to get the baby to turn, in hopes that they would then work with her to still labor for a vaginal birth.

Meanwhile, she wants to make sure she is super-prepared with her c/s birth plan. With her first, they knocked her out, which she doesn't want. She also wants to nurse asap and maybe even have the newborn exam in the room with her.

I have not attended a c/s before. I will be in the OR with my client (her dh is deployed). She will not have anyone else besides me to advocate for her wishes if she should be put under with general anesthesia.

I should add that our town is very regressive in terms of birth. The last birth I attended at this hospital, when my client wouldn't let her baby be taken to the nursery, the nursery nurse called and told her that if her baby's sugar crashed or he turned blue or couldn't breathe, they could not be responsible.

Somehow I am really skeptical that they are down with breastfeeding right away, etc. So where I could use some help is in helping her formulate a game plan to help her try to accomplish her goals. This is hard since I am not familiar with c/s procedures. (I mean, I have the general idea from all I've read and heard, but it's a lot easier to formulate a plan if you have specific experience.

I know there used to be a c/s support thread on Birth and Beyond, but I have had the devil of a time finding good info on planning for a good section.

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There are some good suggestions here.

Also here. (Ignore some of the comments, the birth plan has some good suggestions.)

I know someone who had them remove the screens and her partner held her up slightly so she could see the baby being born and she says it was amazing. also has some good information on planning a family centered cesarean in their white pages.

My first doula client had a cesarean (after a failed three day induction for pre-Eclampsia) and I walked her and her husband through it beforehand (I had one myself, so I knew what to expect). She also discussed with her doctor the elements of her birth plan that were important, and they kept it intact as much as possible. Since your client was knocked out the first time, she might not know what to expect with a c-section under local anesthesia.

You should be able to get a good idea from the ican site (there are probably even videos to watch). What will happen is that she will be taken into the OR to receive the anesthesia. Hopefully they will insert the catheter after the spinal/epidural is in, and not before (mine was before, I had to walk to the OR holding my bag of pee like a purse), she should ask about that. You will stay behind as her support person and you will have to put on surgical scrubs. In the OR a nurse will probably hold her while they administer the spinal. They will put a drape up in front of her, and she will have to hold her arms still so they can take her blood pressure. They will check to make sure her anesthesia worked, and then they will start the operation. At that point someone will bring you in as her support. You will most likely have to walk past her body, so if you are squeemish, avert your eyes. You will sit next to her head and hold her hand. If she wants pictures you will be the one to take them (they made DH stand up and shoot a few as dd was arriving). The baby is generally brought over and taken care of by the baby team. Then the babies leaves (I assume you would go with baby since DH is deployed?) Mom is then sewn up, and hopefully can join the baby in recovery quickly. I managed to get DD on the breast an hour after she was out, but that was a pretty progressive hospital. The best she can do is talk to her doctor and anesthesiologist. I have heard of women being able to nurse while being sewn up but that seems to be very rare.

Good luck!
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Since you are (I assume) not related to her but she does (I assume) want you to act as an actual advocate if she is unconscious, she may want to grant you some kind of official legal power of attorney or something (how this would work depends on your state.) Because the medical staff could just ignore you, as you won't have any legal authority unless she names you as the person to make decisions for you when she can't.
Thank you all...great advice from everyone!

Mamabeakley...that is an interesting point. I will have to think about whether or not I am comfortable with that. You are correct that we are not related. It would be easy enough to get a POA drawn up at JAG. Don't know if she would be comfortable with it either.

But, as you said, they don't at all have to listen to me if she is out.

Lots to think about...
Yeah, I was thinking of the POA issue as well. At least bring it up to her, if neither one of you is comfortable with YOU being her POA, perhaps she should make sure someone else is available, just in case.
Fantastic has turned vertex! My client is no longer scheduled for a c/s!

Now I'm just hoping for her to go soon, so he doesn't have a chance to flip back.
But she's gone from 1cm to 3cm in the past week. She'd been having lots of contractions since he flipped, so that's looking good, too.

Thanks for all the help, y'all. It's always productive to talk through scenarios, cause you never know when you'll be in that position...
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I was reading along here, and just wanted to say WONDERFUL. I was so glad to see the baby has turned. : )
That is great news!

I just want to add one thing, I've had 3 c/s and I love getting pictures of the whole process, but... if you have a client who is having a c/s it can be really cool to put the digital camera on black & white & you can stand up beside her and photograph a bunch of shots of baby just emerging. I found the whole lowering the screen option to be awkward and its VERY hard to see over your own belly. So... the b&w photos are really cool b/c its the baby's birth without all of the blood. What amazed me in mine was how gentle everyone was with him as my baby was being delivered.
Super idea! I'll file that away.

I especially think it is so important to get a few good pictures when I'm with a mama whose dh is deployed.

Though, now that I'm thinking about it, I wonder if I can take pics at the hospitals around here during a c/s. I know that you cannot take them of a vaginal delivery.

Originally Posted by citizenfong View Post
Super idea! I'll file that away.

I especially think it is so important to get a few good pictures when I'm with a mama whose dh is deployed.

Though, now that I'm thinking about it, I wonder if I can take pics at the hospitals around here during a c/s. I know that you cannot take them of a vaginal delivery.
soooo not necessary. People take all kinds of pics at my birthing center (In the hospital). People are so ridiculous.
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