Scared to ask - but does anyone have a birth plan for a c-section

Don't be scared to ask. Not everybody here is going to "approve" of you having a c-section and will harp on you to do something else, but that's their issue, not yours.

I know it's tough to make peace with it (I'm in the same boat) but in the end sometimes you just gotta do what you gotta do and move on. Hopefully you will still wind up with a vaginal birth, but if you are facing the possibility of a c-section it's certainly best to be as prepared as possible.

Things you will probably want to include in your birth plan are whether you want the drape removed at the time of birth (or a mirror in place) so that you can see, a request to have your arm or arms free, having the baby brought to you as soon as possible after birth for breast feeding, etc...

Also, if the baby is to be out of your sight at any time you may want to specify that your partner be always with the baby, and to have your partner hold the baby in skin-to-skin contact rather than putting baby in a warming bed.

You may wish to decline some of the standard procedures like bathing and eye goop in order to speed the process of getting baby to you.

There are some detailed c-section plans posted around here somewhere...

THANK YOU for the suggestions. Dh will not be here for the birth so he can't follow the baby around.

I have NO idea what goes into a c-section - other than what I've seen on A Baby Story - why on earth would they tie down your arms?

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I'm having a repeat c/s with this babe. Here are some things I'd include, as someone who's both an L&D nurse and has had a c/s before:

-Demand/insist that the catheter be inserted AFTER your spinal is in place. If they tell you they can't do that, they're LYING. Hospitals where I've worked that the catheter is inserted before anesthesia is merely out of convenience for the nurse. Having BEEN the nurse, I can tell you it's no big deal to have to wait to insert the doggoned catheter, so tell them to chill, and do it AFTER the spinal.

-Request that versed not be given unless you are in extreme distress. Versed is an amnesiac, and it tends to wipe out any memories of the birth.

-Ask for morphine in your spinal for pain control afterward. It really makes a huge difference.

-I personally HATED my p.c.a. (pain med pump) because it didn't do much for my pain, and just sedated the crap out of me. I had them take it down within an hour after my section. Oral pain meds, a combination of motrin and narcotic, helped me the best. You may find that to be true also.

You can pm me if you have any questions you're shy about posting. I understand.

ETA: your hands are tied down because sometimes women instinctively grab for their belly during surgery (totally normal instinct), which risks contamination of the sterile field. Some patients are really freaked out by having their hands strapped down, and you can request you have a hand free, especially to touch your baby after s/he is born. It personally didn't bother me, however that's because I do it for a living and knew what was happening. I can totally understand how it scares some people.

I think having a birth plan for a c-section is an excellent idea. I naively thought through my pregnancy that I wasn't going to have a csection (unless truly necessary).. I did not prepare at all, and then ended up being coerced into one at 40+weeks due to "big baby". My birth was completely robbed from me, as all the things that I had in my birth plan (no vit k, delayed cord cutting, holding baby right away) didn't happen because of the c-section. I think if your care provider is telling you that you might need a c-section you should talk to them about these things, and find out what will be "allowed".
I think you said that DH couldn't be there, will you have another support person to stay with you and follow the baby around? I really wish that I would have asked my doula to be present at my scheduled c-section, that way she could have stayed with me while DH went off with the baby. Also, ask about being able to hold your baby and nurse while they are stitching you up. I have heard that this has been possible for some women.
www.ican-online.org has some excellent information, their white papers can tell you what to expect as far as the surgery goes, and about recovery.
I really hope that you don't end up with a c-section, but I am glad that you are preparing in case you do.

I second the recommendation to check out ican-online.org, good info there. Also agree with finch on these tips

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Wish I'd known that one!

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this would have helped me too - Pain control afterward is critical, if you get behind on it, it's hard to catch up. My recovery was unnecessarily difficult in the first week, and probably longer, because of not getting adequate pain relief the first couple days.

Best of luck to you

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Sorry to derail, but do you think they'd give any weight to prior c-section experiences in deciding things like this? I'm having a repeat with the same OB who did my last section, and she should know that I didn't freak out or try to move my arms or anything last time. I'd like to think that would help convince her I don't need to be tied down this time, but I haven't met with her and asked yet.

I had a c-section birth plan for my VBAC, just incase.
Honestly, I think everyone should have a c-section birth plan no matter where or how they're planning to give birth. I wish I would have the first time around. There were a lot of things I would have changed

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Don't feel bad. I know exactly how you feel... I've been just beside myself about the idea of having a c-section. I had such a nice, wonderful, natural birth the first time... wrapping my head around this has been very hard for me. The control thing is *exactly* it -- with natural birth I felt like it was my body doing what it was meant to... with a c-section so much is out of my hands. Now I'm just trying to roll with it and own the birth as much as I can. It's been tough, but I'm almost there.

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Yeah, actually, that sounds reasonable, and I'd think any reasonable OB would take that into consideration, and that's a very good point. They may insist you have one arm strapped, for the BP cuff, since it goes off so frequently during surgery and will malfunction if your arm is moving at all, so that's something to prepare yourself to hear. They really DO need to monitor your bp closely and frequently during surgery, and electronic cuffs are very touchy, and even if the OB says both arms can be free the anesthesiologist may insist that the bp cuff arm remain strapped.

I'm making a birth plan for a c-section, though I'm planning a homebirth. I'm going to include my wishes for the baby after birth like I would include in a regular hospital birth plan (circ, vit k, eye goop, testing, etc) as well as request that someone be holding the baby at all times if my DH and I are unable to do so, and to ask that my DH be present if I have to go under general anesthesia (he works in an Operating Room so he knows what to do and not to do). For you, you may want to make sure that you have a support person available and that they will be allowed in the OR with you in the same way that your DH would. For me, especially if I have to go under General, I want another person in the room who will able to help me remember what happened, drug amnesia or not, and having someone there just to sit with me will reduce my anxiety 100 fold. I've attended about half a dozen sections or so, and I know what generally happens, but I'll still be freaked out without a friend at my side.

I just want to mention that another reason to tie down a mom's arms is in case of involuntary twitching due to side effects of the medications, or in the case of you reaching for your abdomen if the anesthesia wears off and you start to feel something. Also, if you're looking at a section as a necessary option at this point, you may want to ask to meet with an anesthesiologist (some will, some won't) to ask questions about what kind of drugs and policies that hospital uses.

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or just the teensiest bit distracted?

My breech birth plan had an "if c/s is unavoidable" section and I've actually annotated the whole thing (look for the "bolds"). I was "granted" a lot of things from my primary birth plan during the section (eg. a "natural" [yeah right, natural] third stage) that I never would have thought I'd get. I'll paste it in here below in case it's of use for you.
xo robin

BIRTHING PLAN

Dear Anne-Marie, Dr. P and Hospital Staff: Thank you in advance for your support and sensitivity for our individual needs and wishes. We have educated ourselves in the birthing process (including breech delivery and caesarean birth) and if there are no direct medical contraindications, would like the following preferences to be honoured throughout all stages of our baby's birth and during our hospital stay.

IN THE EVENT OF AN EMERGENCY: In the event that the situation becomes life-threatening for either Robin or our baby, we will, of course, yield to any request for life saving intervention, upon the briefest of consultation. In the strong likelihood that we have the natural vaginal birth that we are expecting, we ask that you refrain from any routine interventions or measures that we have not previously agreed upon. We do not believe that vaginal breech birth is an emergency, but rather a variation of normal, and deeply appreciate your support in this.

OUR ENVIRONMENTAL PREFERENCES:
·As we did for our first birth, we will be using self-hypnosis for the management of labour discomfort, and for this reason we will bring soft music, use dimmed lighting, and ask for the staff to please use a low voice. Please avoid references to "pain", "hurting" or "hard work." These words are disruptive to our hypnosis process, and we thank you for respecting our unique needs. Please do not offer us drugs.
·Support: our Midwife, and name or name, will attend the birth, and are authorized to be present during any examinations or procedures.

DURING LABOUR:
Labour Management
·Labour, delivery, and preferably recovery, should happen in the same room if at all possible.
·Robin will walk around and assume any position that is comfortable for her both for labour and delivery including standing, squatting, sitting, or kneeling.
·Robin will eat and drink lightly during labour as she needs to.
·Vaginal exams should be limited, and performed by our midwife.
Please avoid:
·Augmentation of labour or any use of synthetic hormones.
·Artificial rupture of the membranes.
·Shaving, enemas, or "disinfecting" of the pubic region. They did not shave me for the c/s, she sewed up again "around" my hairs.
·IV. If necessary, we will accept a hep lock to facilitate a later IV if it becomes needed.
·Please do not allow students or other unexpected strangers into the birthing room. If additional staff is required, please speak with Stephen in advance.

Fetal Monitoring
·We strongly prefer intermittent manual fetal monitoring with doppler.
·Please avoid electronic fetal monitoring, particularly internal fetal monitoring.

Pain Relief
·We are using self-hypnosis techniques for management of labour discomfort. Please keep voices low and calm.
·Please avoid any suggestion of artificial pain relief including oxygen, IV or oral drugs, or epidural. They took this so seriously they were reluctant to discuss pain relief with me after the surgery.

BIRTH OF OUR BABY
Pushing and Delivery
·If possible, we would like our midwife to deliver our baby with the support and guidance of Dr. P or the OB on call.
·Robin will deliver in a position that feels natural to her and will allow her pelvis to open completely, understanding the need for a breech baby to "hang" with chin tucked during delivery.
·Please facilitate mother-directed pushing. Coached pushing interferes with self-hypnosis techniques. If the baby remains breech, Robin will be happy to accept guidance when it is time to push out the head, and would appreciate perineal support to help minimize tearing.
·Please do not perform a routine episiotomy. As proven by our previous birth, Robin's tissues stretch easily. Please attempt any necessary manipulations first, without cutting an episiotomy. Should an episiotomy be necessary, please speak to us before making the cut, and explain what it is you need to do that cannot be done without it. Should episiotomy be unavoidable, we prefer a diagonal cut to vertical.
·We are willing to have one or two (only) additional staff in the room for breech-delivery training purposes. These people should be introduced in advance of transition, by name. Please speak to us before we reach the pushing stage to ensure this is still OK. We reserve the right to ask any of these non-essential staff to leave the room at any time.

Handling the baby
·Please place the baby on Robin's abdomen or chest and facilitate immediate skin-to-skin contact, covering us both with blankets. We will dry and wrap the baby ourselves. There was no room between my chin & the drap so DH did the immediate skin-to-skin.
Please defer any newborn procedures (such as weight and length measurements, eye drops, Vitamin K shot) until we have had an opportunity to get to know each other. Apgars may be performed while Robin holds the baby.
·It is important to us that the umbilical cord be left intact until it has stopped pulsing. They did this w/ the c/s - baby on my belly, and they waited, and allowed the placenta to detach by itself.
·Robin, Stephen, or Robin's mother will cut the cord.
This was allowed - dh was gowned & gloved and reached over to cut the cord. It will be included in my next "if unavoidable c/s plan"
·If the baby is ready, Robin will nurse the baby during the 3rd stage of labour.

BIRTH OF PLACENTA:
Please avoid active management of the third stage of labour, and facilitate a natural 3rd stage. This includes the use of medication or synthetic hormones, cord traction, or heavy pressure on the abdomen. If bleeding is considered excessive, please allow us to try nursing the baby or to use nipple stimulation first to stimulate natural production of oxytocin. This will be included in my next "if unavoidable c/s plan"
·Please do not dispose of the placenta, as we want to take it home with us.
·Robin will hold or nurse the baby during the 3rd stage of labour.

AFTER THE BIRTH:
·We would like time alone as a family as soon as possible after the birth.
·We will be breastfeeding, and therefore ask that the baby not be given water, supplemental feeds, or any kind of pacifier.
·Please do not bathe the baby. We will do this at home.
·The baby should be accompanied at all times by Robin or Stephen. Please do not take the baby anywhere or perform testing or procedures of any kind without one of us present.
·We would like to be discharged as soon as possible. If it is necessary to stay overnight, we would like our baby to "room in" with Robin at all times.

SHOULD AN EMERGENCY CAESAREAN BIRTH BE UNAVOIDABLE:

·Stephen and our midwife should be in the operating room with Robin.
·We prefer epidural or spinal anaesthetic to a general anaesthetic.
·Please insert the urinary catheter after the epidural or spinal is in place and functioning.
·During and after the procedure, please do not administer any "extra" medications including sedatives or analgesics without express permission from Robin and/or Stephen. Realistically, I have no idea what was in teh cocktail they gave me except that there was morphine, and they did a top-up that looked after pain relief for the first 24 hours or so.
·Please "narrate" the procedure so that Robin knows exactly what is going on at all times. My MW did this, but not in enough detail for me in retrospect. Be clear about how much detail you want.
·Please drop the curtain for delivery so that Robin can see the birth. this didn't happen, and we have no pictures of this moment. I may never stop being sad about this.
·Please give the baby to Robin immediately after delivery (barring a requirement for emergency care for the baby) and facilitate skin-to-skin contact, covering us both with blankets. It is very important to us to hold our baby in true "new-born" state, so please do not "clean off" or dry the baby before passing her to Robin. We will do this ourselves. Apgars may be performed with Robin holding the baby.
this didn't happen. I'm short waisted and there was NO room for the baby on my chest because the drape was right below my chin. So DH did all of the immediate skin to skin and wiping/wrapping, then brought the baby to rest right beside my face until I could get off the table.
·Please do not take the baby to the nursery, she should stay with Robin at all times unless emergency treatment is required.
·We would like to take still photos of the birth itself and during the time immediately following the birth.
·Please defer baby weight and length measurements and other newborn procedures (eye ointment, Vitamin K shot, etc) until we are out of recovery.
·Please do not dispose of the placenta, as we want to take it home with us.
·Robin would like to hold or nurse the baby while the incisions are being closed, and to nurse while in recovery.
·Should the baby require emergency care, Stephen will accompany the baby and Anne-Marie will stay with Robin.

AFTER THE BIRTH:
·We would like time alone as a family as soon as possible after the birth.
·We will be exclusively breastfeeding, and therefore ask that the baby not be given water, supplemental feeds, or any kind of pacifier at any time during our hospital stay.
·Please do not bathe the baby. We will do this at home.
·The baby should be accompanied at all times by Robin or Stephen. Please do not take the baby anywhere or perform testing or procedures of any kind without one of us present.
·We would like a private room as soon as one is available.
·We would like our baby to "room in" with Robin at all times. Robin will ask for help if this is interfering with her recovery.
·As much as is possible (depending on Robin's recovery), please assist Robin and Stephen to be our baby's primary caregivers while in hospital.
·We would like to be discharged as soon as possible.

One other note. Everybody was so eager to make sure breastfeeding got started, they were all so tense and upset and hovering over me because of what happened. the best thing anybody could have done was to help me turn on my side - I wasn't a FTM, I knew how to nurse already, but trying to latch a newborn on when you're lying on your back SUCKS. Get somebody to help you turn on your side. I don't know why it didn't occur to me or anybody else to do that one simple thing that would've really helped.

Oh, one more. consider asking for sutures, not staples, especially if you're prone to developing keloid tissue. It takes a little longer but every single staple forms its own keloid if that's what your body does. And be sure to ask for double-layer closure of your uterus to help prevent UR in future pregnancies & births.