[medaroge]

Ok, no flames here, please! I of course, am not planning on needing a c-section, but what if I am in the 5% that need one? With all the planning and thinking ahead that I am doing for my natural birth, I'd also like to be prepared for if things go astray. No way am I going to say "ok" to a section because I have not 'progressed far enough" or am "stuck at 3 cm" (or whatever other excuesses they come up with). I just dont want to be terrified about not knowing what to expect should I need a c-section. Thanks in advance for the supportive anwsers I know I will get here at MDC!

~Melissa

 

[alegna]

First and foremost be prepared to avoid an un-needed one (sounds like you're on the right track!

)

Tips on that-
birth at home if possible
don't be a "good patient"
don't stay in bed
don't have an epidural
DO move around
DO use water (shower/tub)
don't sign consent forms
DO have a doula
DO make sure your wishes are known

Then if a c-section is needed-
NEVER let the baby out of your sight (or your partner's)
try to nurse asap in recovery
don't let them take the baby to the nursery without medical reason

good luck!

-Angela

 

[erikandgregsmom]

and wish I had been more prepared so I would have known what to advocate for.

All of Angela's suggestions seem right on target, but if the worst happens....

You really won't feel anything except pressure (not painful) when they push the baby a bit to move him/her out. Definitely argue to keep the baby with you (I didn't know this could be done). Nurse ASAP, if you are sedated to rest, your baby will most likely be given bottles in the nursery. This happened to me both times, which lead to b'feeding difficulties and ultimately both times my b'feeding relationship failed.

You will need to rest, rest, rest at home more so than a vaginal delivery. Get help if you can, at the very least stock your freezer with easy to prepare meals. I was lucky to be able to afford a postpartum doula for 2 weeks, she was a God-send!!!

Finally, if you have an unplanned c/s, you may have some sad feelings about it. This is common and OK, even if your baby and you are healthy, you may mourn the loss of the birth you dreamed of. Find support here, in a mom's group, thru books....whatever.

I wish you a wonderful, safe, and memorable birth, no c/s!!!!

Janet

 

[~member~]

I have BTDT.
They do not tell you that no ONE is allowed in the recovery room with you.
Make sure there is a separate person to advocate for your baby, as your DP or Doula might be busy with you.
C-section moms are more likely to get harrassed about putting baby in the nursery if you have no one to stay in your room with you 24/7.

Many c-sec moms do breastfeed and their babies have no problems. Make sure to let them know you want to breastfeed so that they do not use drugs that could harm your baby.

Excessive pain is a sign of infection. Do NOT let the nurses blow your concerns off. (That was my mistake, the nurses just kept giving me more pain pills, even though I KNEW somethingw as not right, kwim?) Trust your instincts/gut. You know your body better than anyone.

 

[Houdini]

Quote:

Originally Posted by erikandgregsmom and wish I had been more prepared so I would have known what to advocate for. All of Angela's suggestions seem right on target, but if the worst happens.... You really won't feel anything except pressure (not painful) when they push the baby a bit to move him/her out. Definitely argue to keep the baby with you (I didn't know this could be done). Nurse ASAP, if you are sedated to rest, your baby will most likely be given bottles in the nursery. This happened to me both times, which lead to b'feeding difficulties and ultimately both times my b'feeding relationship failed. You will need to rest, rest, rest at home more so than a vaginal delivery. Get help if you can, at the very least stock your freezer with easy to prepare meals. I was lucky to be able to afford a postpartum doula for 2 weeks, she was a God-send!!! Finally, if you have an unplanned c/s, you may have some sad feelings about it. This is common and OK, even if your baby and you are healthy, you may mourn the loss of the birth you dreamed of. Find support here, in a mom's group, thru books....whatever. I wish you a wonderful, safe, and memorable birth, no c/s!!!! Janet

:

My husband stayed with our babies that had to go to the nursery (one was emergency, one was transfered to a children's hospital immediately for surgery).

My mom was with me in the recovery room after my daughter's delivery and I had several visitors allowed in once I woke up enough.

My husband stayed with my and the last two babies in the recovery room and the babes never left my sight or my husband's sight.

I would call the hospital and see what their policies are. The one local for us didn't allow people or the baby in the recovery. The one in a bigger city near us allowed both one person at a time and the baby (all the time) in the recovery room once you are awake enough.

 

[phoebemommy]

I've had a nagging question about this myself, for the same reasons. I'm homebirthing, but what if I'm the minority who really needs a C? My question is about weighing the risks of epidural vs. general anesthesia (or whatever else they might use to put me out). My back is screwy, and I have to go to the chiropractor regularly to keep it from going bad. The thought of having a needle stuck in my spine and going numb sounds risky and horrible to me, considering medical people have scratched their heads at my back problems and only naturopathic chiros and massage therapists have been able to make heads or tails of it. On the other hand, I'd hate to be knocked out. I'm actually scared of that, too. I panicked when they tried to put me out for my wisdom teeth, and only calmed down when they let me stay awake. Plus I don't want to miss my baby's first hours, the possibility to nurse him, etc. At the same time, if an epidural messes up my back, recovery could be so much worse, and could affect a much longer period of time than the first few hours.

Hope this doesn't hijack the thread, but what about this issue? Which is worse?

 

[maxmama]

Generals carry much higher risks (including death) than regional anesthesia, and the pain control post-op isn't good. If you're planning a hospital birth, I'd ask for an anesthesia consult ahead of time to go over your concerns about regional block. Most of the time, your back status doesn't really matter; back pain is one of the most common complaints in the US and anesthesiologists work with a LOT of people with funky backs. The only time I've ever seen it be an issue is after a deroofing or laminectomy, and even then it depends on where the surgery was.

I hate the idea of spinals or epidurals, but not enough to ever have a general I don't absolutely have to have (and I've had two generals with relatively good experiences).

 

[BookGoddess]

I think it's great you're planning ahead. I wished I had! I was so sure I was going to deliver according to the plan I had in my head that I was unprepared for the sudden turn of events that resulted in my c/s.

First, I would go with a local anesthetic. I had a spinal block. Yeah, not so great. I hate needles and I hate needles near my spine.

Still, I wanted to be conscious. I wanted to know what was going on. I didn't want to be out. I have a good friend who had her daughter by c/s under general anesthesia. She doesn't remember a thing! Even though she came to after the operation she's still very fuzzy on the first day. Everything is a blur to her. Whereas I can remember everything that happened during my c/s. You really don't feel any pain during the procedure. You feel a sense of tugging and pulling as they take the baby out.

Make sure DH or partner can be there with you. Most hospitals allow that now. DH was right there the whole time. He was allowed to stand next to the anesthesiologist and watch the whole operation. I wish he had taken photos but at least he didn't pass out so I'm thankful!

At the hospital we had DD all C/S babies are taken to the NICU for a short period of time for observation. But you can ask that the baby be brought to you as soon as possible. Make sure you tell them no shots or no formula or whatever else your preference is.

Most hospital rooms now have a not-so-comfy couch for the dad to sleep in. DH stayed with me the whole time and my parents got to visit for as long as they wanted. The nurses really didn't pay attention to the posted visiting hours.

The Lactation Consultants at the hospital will come to you rather than you having to go to them. At least that was my experience. They also rent out pumps so be sure to ask if you need one.

You might be a big groggy after the operation so make sure your family knows what you want so that they can advocate on your behalf. And above all I hope you have a safe birth.

 

[gentlebirthmothr]

Melissa,

, to the responses you already gotten from the posters who replied to your thread on this.

 

[JanetF]

I'd like to take the discussion back a step too. I TFed from a hb to a c-sec which I now know was unnecessary. So in the event of your hb MW suggesting TF at all, I recommend that you treat it like you would a CP in the hospital and quiz them extensively as to why they think this is necessary. Unless your gut tells you that you or your baby are in danger be very wary of TFing at all. Make yourself a list of what YOU would consider using a hospy for. This is mine. Basically unless it was for a c-sec I wouldn't go in labour.

Quote:

Hospital Transfer Plan Call the ambulance if there is an emergency; •Cord Prolapse •Unresolved haemorrhage at any time with fainting, dizziness, passing out, or nausea •Seizures (pre-eclampsia) •Baby's hand comes through first with no sign of the head (transverse) •Bleeding during labour, accompanied with severe pains, not contraction pains (placenta abruption, placenta previa, placenta accreta, UR) •Baby is white, pale blue and limp and not breathing. Emergency numbers and our full address, (with the nearest crossroad) are beside the phone. My bag with my Medicare card, clothes and other needed items is in the bedroom cupboard. My partner will travel with me in the car or ambulance. Bring the baby capsule. Our other children will go to their support people's homes. Car Transfer Spread towels over the back seat, and have an empty bucket and some wet cloths available on the floor of the car. Help me into the back seat of the car as fast as possible in between contractions, pausing for contractions. Drive carefully and do not take risks. Ambulance Transfer Do not strap me in on my back. I would prefer to be on my side. (unless you're someone who finds it easier to labour lying on your back) My partner will travel with me. Bring the baby capsule. Do not give any drugs for any reason. I will wait until hospital.

And this is my "in case of surgery" plan.

Quote:

Transfer plan - caesarean •Epidural anaesthesia will be used. There will be no pre-operative medications, especially sedative drugs, and no sedatives after birth either. A general anaesthetic is a last resort and the parents must consent in full prior to administration. •The father and support person will remain with the mother at all times •The mother will hold the baby while the incision is being closed and has the assistance of the father if required. One arm must be left free. *A double layer closure is required. •A lotus birth is required. We can explain this to any staff who are curious but it is not optional for us. We will supply the bag to contain the placenta with us once out of theatre. In theatre an appropriately sized dish is fine. •The baby will be placed straight on the mother's skin, unwashed. A blanket can go over both of them. Apgar and well baby checks will only be done by observation while the baby is on the mother. •No one will announce the baby's sex. •There will be no unnecessary speaking, this is a birth for us, not an everyday working event. •There will be no period in the nursery. Rooming in will be immediate and continuous. Parents and baby will be in the recovery room after delivery. •There will be no separation of mother and baby unless one or other is genuinely seriously ill or unconscious. •If the mother is ill the baby will be carried in kangaroo care style by the father only. There will be no use of plastic boxes with wheels. •The baby will not receive Vitamin K or Hepatitis B injections. In the event our baby is unwell: •Any procedures must be explained in full and informed, written consent must be obtained before any intervention is performed. •A parent will remain with the baby at all times - no exceptions. •The baby will only be fed breast milk. Absolutely no formula feeding or dummy without our written consent. We will use a donor for EBM if none is available and our baby requires more than colostrum until my milk comes in. •Even if our baby is premature, there will be no period in the nursery. Rooming in will be immediate and continuous unless there is a genuine problem with the baby and informed, written consent is obtained from the parents for treatment of the baby. •Kangaroo care and as much skin to skin contact with parents as possible while our baby is unwell.

Remember that ultimately YOU are the one whose body and psyche will have to deal with or carry the scars from what happens to YOU. What this means for me is that no one but ME can make the ultimate decisions about what happens to me and my body and I don't care who gets their knickers in a knot because it took me 2 years to recover from what the hospital did to us when I TFed. I tried to work with them, meet them halfway, that sort of thing. Well since I was the only one with the vagina being violated it clearly wasn't a halfway meeting

So take it from me and don't let your Inner Good Girl make any of the decisions either to TF or what happens if you genuinely do need what a hospital can provide!

I've just had my second baby - freebirthed at home - and because my MW dumped me the night before I went into labour, I needed to TF after the birth for some stitching and synto for a PPH. Once the baby is out, it's a whole other kettle of fish so while the staff were certainly better than last time, I was also a lot more clued in about what I wanted and how to achieve it. Any time someone says to you anything with "hospital policy" just give them a big smile and say, "That's ok, but I'm not a hospital so it doesn't apply to me!"

Then tell them EXACTLY how it will be. A MW tried telling me I *had* to let them do something in the hospital and finished it with "Now you had your first baby in a hospital so you know how it works..." to which I replied, "Yes, and I spent two years recovering from PTSD as a result of what that hospital did so no, it WON'T be happening this time!" And of course, I smiled

You probably won't need any of this rambling advice

but speaking as an old hand now, it's my duty to you as a birthing sister to share it with you. I hope you have a stunningly beautiful birth!

 

[gentlebirthmothr]

Quote:

Originally Posted by JanetF I'd like to take the discussion back a step too. I TFed from a hb to a c-sec which I now know was unnecessary. So in the event of your hb MW suggesting TF at all, I recommend that you treat it like you would a CP in the hospital and quiz them extensively as to why they think this is necessary. Unless your gut tells you that you or your baby are in danger be very wary of TFing at all. Make yourself a list of what YOU would consider using a hospy for. This is mine. Basically unless it was for a c-sec I wouldn't go in labour. And this is my "in case of surgery" plan. Remember that ultimately YOU are the one whose body and psyche will have to deal with or carry the scars from what happens to YOU. What this means for me is that no one but ME can make the ultimate decisions about what happens to me and my body and I don't care who gets their knickers in a knot because it took me 2 years to recover from what the hospital did to us when I TFed. I tried to work with them, meet them halfway, that sort of thing. Well since I was the only one with the vagina being violated it clearly wasn't a halfway meeting So take it from me and don't let your Inner Good Girl make any of the decisions either to TF or what happens if you genuinely do need what a hospital can provide! I've just had my second baby - freebirthed at home - and because my MW dumped me the night before I went into labour, I needed to TF after the birth for some stitching and synto for a PPH. Once the baby is out, it's a whole other kettle of fish so while the staff were certainly better than last time, I was also a lot more clued in about what I wanted and how to achieve it. Any time someone says to you anything with "hospital policy" just give them a big smile and say, "That's ok, but I'm not a hospital so it doesn't apply to me!" Then tell them EXACTLY how it will be. A MW tried telling me I *had* to let them do something in the hospital and finished it with "Now you had your first baby in a hospital so you know how it works..." to which I replied, "Yes, and I spent two years recovering from PTSD as a result of what that hospital did so no, it WON'T be happening this time!" And of course, I smiled You probably won't need any of this rambling advice but speaking as an old hand now, it's my duty to you as a birthing sister to share it with you. I hope you have a stunningly beautiful birth!

Melissa,

, to what Janet F said to you and mostly it likely the same will be after my reply to here.

 

[annekevdbroek]

I had an unplanned c-section. Since then I read "What if I have a C-section." I really wish I'd had it beforehand. I thought I was well-read and educated on the topic, but still ened up with a section. Anyhow, despite the books title it has loads of information on avoiding a c-section - it is a quick read and I thought helpful.

 

[aisraeltax]

great advice from Jen.

with re: to what to expect afterward, expect the nurses to tell you you aren't strong enough to do this or that.....
expect them to want to take your baby.
just refuse. and dont sign anything before reading the whole thing. and let your dh know you will kill him if he does!!!
you will be sore. bf'ing will hurt a bit more than with a natural delivery.
the worse thing about a c/s (other than the risks to you and the baby and the fact that its done too much) is the recovery. you really will need someone to help you out after you get home. walking will be a huge problem. getting up from the bed will be a huge problem.
i was totally amazed after ds3 when i had a natural delivery at the difference in life after a c/s and life after natural birth.

good luck..hopefully it wont come to that. and your wishes will come true.

 

[wifeandmom]

Quote:

Originally Posted by phoebemommy I've had a nagging question about this myself, for the same reasons. I'm homebirthing, but what if I'm the minority who really needs a C? My question is about weighing the risks of epidural vs. general anesthesia (or whatever else they might use to put me out). Hope this doesn't hijack the thread, but what about this issue? Which is worse?

General anesthesia is MUCH riskier for a very pregnant woman, which is why it is typically ONLY used as a last resort.

If there is a choice to be made, the risks of spinal anesthesia for c/s is much preferable in terms of risks when compared to general anesthetic.

Unless mom already had an epidural in place, it would be unusual to do an epidural instead of a spinal. The spinal provides greater, more thorough, numbness and is the anesthetic of choice for c/s when there is time to get it in place and working properly.

In a true emergency though, where either mom or baby are in severe trouble, it is much more likely that she'll have to go under general anesthetic as time is of greater importance. This can also be the anesthetic of choice if mom's platelet count is too low (risk of bleeding into spinal space with epi or spinal) and/or with severe scoliosis or other pre-existing back conditions that make emergent placement of a spinal impossible.

My DH does anesthesia on pg women and loathes to put one to sleep unless it's a matter of life and death. It's a whole lot easier for the anesthesia provider (in general terms) to knock them out, but the risks just aren't worth it.

 

[wifeandmom]

Quote:

Originally Posted by BookGoddess First, I would go with a local anesthetic. I had a spinal block. Yeah, not so great. I hate needles and I hate needles near my spine. Still, I wanted to be conscious. I wanted to know what was going on. I didn't want to be out. I have a good friend who had her daughter by c/s under general anesthesia. She doesn't remember a thing! Even though she came to after the operation she's still very fuzzy on the first day. Everything is a blur to her. Whereas I can remember everything that happened during my c/s. You really don't feel any pain during the procedure. You feel a sense of tugging and pulling as they take the baby out.

I can ASSURE you that having a c-section under a LOCAL anesthetic is the LAST option you'd ever want. You WILL be in pain, significant pain at that, and no anesthesia provider in this country would willingly go for a local alone during c/s unless there was simply no other option (I'm talking complete lack of meds necessary to knock you out or to do a spinal, complete inability to get needle in for spinal and/or get you intubated, or if there is nobody from anesthesia available to do your anesthesia and baby or mom is dying, then local is all you're going to get). And you think you've heard horror stories of c/s before....a local is NOT EVEN CLOSE to sufficient for pain control during major abdominal surgery.

 

[wifeandmom]

MANY of the things I am reading here vary so much from hospital to hospital.

With this baby, it is not a question of whether or not I'll have a section, it will happen. And I could choose from pretty much any hospital in town, so I got on the phone and started asking questions. Calling the L&D unit is where I found the most helpful information.

It is much easier to have a pleasant experience in some hospitals as their policies are already very mother/baby friendly. One very important thing to remember though is that if you and/or your baby are in serious life-threatening trouble, you can hang it up with all these suggestions of 'written consent' and such. They will take your baby to the NICU in a heartbeat, never asking your permission for a thing, if your baby is dying. They will do chest x-rays, insert IV's (often in baby's scalp), and do a whole lot of other things to save your child's life, and they honestly will not give a moment's thought to what you happened to WANT when they are dealing with an unstable baby.

I say that not cause I think it'll happen, not cause I'm naive enough to think that's the ONLY time they act that way, but for everyone to realize that there are times when even the best birth plan must be put aside for the sake of saving the baby. You need to be in a place where you TRUST that they know what they are doing to be comfortable with this whole idea.

You must also realize that in a life or death emergency, your surgical team simply isn't going to have time to read over what you want and don't want. They have more pressing concerns, and whether or not your baby gets a Vit K shot or not is the least of your worries if either of you are in SERIOUS trouble.

All that said, the way we handle my sections is to have DH with ME at all times. He's an anesthetist that could recover me himself, and I'm much more likely to be in trouble than the baby (which he knows little to nothing about neonates anyway, except for putting them to sleep). He is with me in the OR regardless, although that would not be possible ordinarily if I were under a general anesthetic. Since he does anesthesia though, they would let him stay regardless.

Anyhow, we have a person assigned to the baby as well. Sticks to baby like glue if baby needs to go to the nursery or NICU for whatever reason. Knows what we would LIKE to see happen (nursing in recovery, no Hep B at birth, etc), and she also knows when to step back and let them take over if baby is in trouble.

If I were to end up in surgery for hours on end (always a possibility with a c-section), she knows that I'm not going to freak out if they feed the baby a bottle, as I'd prefer that over baby being hungry in the meantime. I'm not one to freak out over pacifiers either, none of my previous children had a bit of nipple confusion, and I'd prefer them to 'hold off' feeding if possible with a pacifier vs. going straight to formula. All of this is worst case scenerio though, as all three previous babies were nursing within half an hour in recovery.

It never hurts to put down your thoughts/wishes in writing, but it is also important to realize that if someone is dying, they are going to take over, do their thing, and ask questions later. Your life and/or your baby's life depends on them doing just that.

 

[Emilie]

how often is someone dying during a natural birth? Do you have stats?
I must say that we are all in agreement that during those circumstances- of course- save our lives. Unfortunately- what is the cut off point- and who deems it neccesary?

 

[BookGoddess]

Quote:

Originally Posted by wifeandmom I can ASSURE you that having a c-section under a LOCAL anesthetic is the LAST option you'd ever want. You WILL be in pain, significant pain at that, and no anesthesia provider in this country would willingly go for a local alone during c/s unless there was simply no other option (I'm talking complete lack of meds necessary to knock you out or to do a spinal, complete inability to get needle in for spinal and/or get you intubated, or if there is nobody from anesthesia available to do your anesthesia and baby or mom is dying, then local is all you're going to get). And you think you've heard horror stories of c/s before....a local is NOT EVEN CLOSE to sufficient for pain control during major abdominal surgery.

What I meant by a local anesthetic was the spinal block that I had. Isn't that considered a local? Perhaps I used the wrong terminology.

With the spinal block I was able to feel from my waist up. I just couldn't feel anything from the waist down.

 

[jane-t-mommy]

I had an unplanned C-sec, and in my case, it saved my baby's life. But I wish I had been more open to info about the possibility of a section. I had a bad reaction to the meds they gave me during surgery and I was very nauseuos (sp) and shaky. Rattling the IV towers shaky. I didn't want my baby to stay in the OR any longer than necessary, so I sent him and dh back to the room. There my dh took off his shirt to hold ds close and give him the skin to skin contact that I couldn't give. (funny when ds rooted and tried to nurse from daddy!!) I brought a boppy (or had someone bring it???) and that helped tremendously with nursing. I also insisted on keeping ds in my room the third night when dh had to return home and I was alone with the babe for the first time. It was weeks (3) before I could get out of bed with out a major production, so I was not ready to hop around and change diapers, but I just called a nurse if I needed anything and we were fine (lucky to have a mom/babe friendly hospital). I second the freezer full of food. And as much real help as you can gather. And feel fine with giving yourself time to heal. My doctor said I was clear to drive at 2 weeks pp, but I could still barely walk without holding on to my belly. But healing does happen! I wish you a beautiful birth and a beautiful babe.

 

[BetsyS]

Quote:

Originally Posted by wifeandmom Unless mom already had an epidural in place, it would be unusual to do an epidural instead of a spinal. The spinal provides greater, more thorough, numbness and is the anesthetic of choice for c/s when there is time to get it in place and working properly.

This is one of those things that differs from hospital to hospital. Some places prefer spinal because it is easier to make sure you get it, and it works quickly. Some places I've been have preferred epidurals because they have the option of adding medication during the c-section in case it lasts longer than expected.