C-section Expectations
The expectation of having a surgical birth may cause some anxiety due to the unknown. I hope this overview of what you may encounter during a c-section will allow you to stay calm and trust the process. Also, it’s a good idea to find out beforehand exactly who can be with you at the birth. Are you permitted to bring your doula and your partner? If not, ask WHY. This may positively affect future consideration for other families.
On birthday, to help you stay confident and relaxed as you await surgery:
Realize that you will be meeting your baby soon!
If you become uncomfortable about anything at all, SAY so. Your care providers are there to provide info and assist you.
Stay relaxed by controlling your breath. Do this exercise with your birth partner/coach: breathe in for a count of 4 and exhale to a count of 8. Release the tension in your face, neck, and shoulders. Focus on relaxing your eyes, tongue, jaw, and hands. Sometimes it helps to do this by squeezing first the face/hands, etc. while breathing in and then exhaling to relax the body part. In addition, try this meditation exercise that is specific to c-sections and can be used in the pre-operative room and even the operating room (OR), if permitted.
This is a sweet time to cherish forever.
If you want keepsake photos, typically you can begin taking photos as soon as your baby is born. Be sure to take plenty more photos in the recovery area too since mom may be woozy or a bit out of it. The photos will memorialize the first meeting, feeding, and skin-to-skin bonding time.
In 2018, Birth Photographers from around the world contributed some of their best works to celebrate Cesarean Awareness Month (April) with this lovely compilation. I dare you not to smile, cry, and awe at the beauty of it all.
Questions for your medical care team:
What are your options for anesthesia (epidural, combined spinal-epidural, general)?
Is photography permitted?
Can the baby be placed on your chest in the OR while the surgery is finishing?
Can you have a mirror to watch the birth?
Can a clear drape be used so you can see your baby’s birth?
What postpartum pain management options are available?
Who will go with the baby if he or she needs special care? Your partner? If so, can your DOULA join you in the OR since “only one person is allowed in the OR at a time”?
When can breastfeeding begin (if desired)?
The baby is born in the first few minutes of a c-section.
The rest of the nearly hour-long procedure is the repair. If your partner goes to the nursery with your baby, you will be alone during this period. Having a doula ready in the wings to step in can prevent you from becoming emotionally overwhelmed or frightened. So if the hospital tells you that only 1 person is allowed to be with you in the OR, you can ask if you may have your doula replace your partner when he or she leaves for the nursery. Your doula can remain with you throughout surgery and in the immediate recovery area.
What to Expect For a Surgical Birth
PRE-OPERATIVE:
After you arrive at the hospital, you will be given many documents to review and sign. About an hour later, you will go into a room or recovery / triage area. You will have blood work done and be given medications to neutralize the acid in your stomach. An IV will be placed in your arm. You may also have part of your pubic hair trimmed, not shaved.
INSIDE THE OPERATING ROOM:
Your abdomen will be scrubbed and the surgical instruments prepared. Drapes and curtains will be placed to prevent infection. Your arms will usually be placed on boards that stick out, away from your body.
SURGERY BEGINS:
The surgery starts by checking to ensure that you're completely numb in the area where the incision will be made. The layers are cut and dissected. These include your skin, muscle, fascia (fat), peritoneum, uterus, and amniotic sac. This part of the surgery is usually fairly quick 5-10 minutes compared to the overall length of surgery.
ACTUAL BIRTH:
You may feel pressure and tugging. Some people may feel briefly nauseated from the pressure or feel pain in their shoulder - this is referred pain. There isn’t much that can be done to alleviate this but it’s still important to tell the anesthesiologist what you’re feeling.
If you want to witness the moment your baby is born, ask that the drape is lowered for the moment your baby is lifted from your abdomen. (Some facilities have clear drapes - just ask.) Your partner and/or doula are usually by your head and can take photos if permitted.
POST DELIVERY:
If your baby is healthy, you can request to have your baby placed skin to skin on your chest with warm blankets covering both of you. Your partner, doula, nurse and/or anesthesiologist can help facilitate this for you. Some babies will latch on in the operating room and others will require some nursing assistance during their first few minutes following their birth. Your partner can go to the warmer while your baby is evaluated. When possible, they will bring the baby back to you after the evaluation.
After the surgery is complete, your doctor will leave the OR and your nurses will move you from the table to a bed. Most people continue holding their baby during this shift, if not, the baby is placed in a rolling bassinet.
RECOVERY:
Your team moves down the hall into the recovery area. Your nurse will monitor you closely and may assist you with breastfeeding if a lactation counselor isn’t present. After 1-2 hours you, your baby and partner will move to the postpartum area where you all will stay the remainder of your time at the hospital which is usually 3-5 days.
To avoid blood clots from inactivity, you will be given special braces to wear that will squeeze your legs post-delivery. Your incision will be sore and most women experience great discomfort when first walking post-delivery. While uncomfortable, walking around will accelerate your healing process by increasing circulation and moving the muscles. C-section recovery is usually longer than that of a vaginal birth.
Following a C-section
It may take longer for your milk to come in compared to a vaginal delivery. Put the baby to breast as soon as possible post surgery and breastfeed often to stimulate milk production. After you’ve returned home should you need breastfeeding help look online for a virtual lactation consultation, support group, or arrange an in-home visit from an IBCLC.
The incision scar is usually about 4 inches and located just above your pubic hairline. It will take about 6 weeks for it to heal. Oozing from your c-section scar should never smell foul, nor should you have red streaks. Ask your nurse how to care for the incision and wear underwear with a high waist that won’t irritate the area.
Bleeding for the first 6-8 weeks following delivery is normal. It is called Lochia (LOW-kee-uh). It will begin as a heavy flow of bright red blood that will gradually get darker and a bit yellowish then back to a normal color of vaginal discharge. Don’t have sex before then and only do so if cleared by your OB at your 6 week postnatal check-up.
When you are ready to engage in any type of sex, you may spray breastmilk if you’re breastfeeding. Your breasts may be tender too so be sure to protect and cover them.
Support For The Parents
It’s important for BOTH parents to seek out support from other parents. In the midst of a world pandemic, many new parents will find themselves isolated from family members and friends. Find a postpartum support group NOW so you know who and where to turn to for friendship, connection, and help.
Best wishes for a great birthday and a smooth transition to parenthood.
To your continued health,
Cynthya