There are multiple reasons why a woman may have a cesarean birth. It could be planned (either by medical necessity or preference/choice) or unplanned (an emergency). If you prefer to have your baby via c-section rather than vaginally, you will have time to plan it out and become prepared for the big day. If your baby is breech or if you have placenta previa, you will have a few days, maybe a week or two, to mentally prepare. But if an emergency happens, like placental abruption or cord prolapse, you won’t have the time to plan and prepare at all.
If you’re anything like me, I always like to be prepared no matter what situation may occur. This is why I think every expecting mama should take the time to review what might happen during her birth, understand her options every step of the way, and decide what she would prefer to happen, before, during, and after the operation.
Once you learn and understand more about what you can expect and what your options are, you will probably have preferences on what occurs. It’s always easier to tell your medical team to ignore certain aspects of your birth plan (if you can have a vaginal birth) rather than making on-the-spot decisions about what you want to happen as you go along. This is why it’s a good idea to have a cesarean plan on your birth plan.
So if you want to become more prepared for a cesarean birth, whether planned or unplanned, here are a few things to think about when you’re deciding what kind of experience you want.
- Do you want a regional anesthetic (like an epidural or spinal) which numbs your belly and legs and means you can stay awake for the operation? (This is usually womens’ first choice.)
- Do you want to have a general anesthetic, which means you will be asleep during the operation?
- Do you even have a choice in the matter of what type of pain relief you can receive during a c-section? Certain health conditions can make regional anesthetics riskier for the mother. These conditions include:
- Bleeding disorders
- Blood clotting disorders
- Blood infections
- Skin infection on the lower back
- Neurological problems
- Severe scoliosis
- Severe preeclampsia
- Cardiac diseases, such as aortic stenosis or hypertrophic obstructive cardiomyopathy
For mothers with one or more of these conditions, a general anesthetic may be preferable.
- Are you okay with the medical staff adding sedatives or tranquilizers to your anesthesia if necessary? Would you want to be asked or (if you are incapacitated) your partner to be asked for permission/consent before administering?
- If you have a regional anesthetic, your partner should be able to join you once they are ready to begin the operation (not during the prep), and they should be able to stay with you through the end of the operation. Do you want your partner in the room with you or a family member or a doula?
- If you are under general anesthetic, the obstetrician probably will not allow your partner into the operating room. (Be sure to ask your doctor, though.) If your doctor says no, ask if your partner can be just outside the O.R. door so they can hold your baby as soon as possible, if that’s important to you.
Other People in the Room
- Are you okay with any students, interns, etc., watching or participating during your c-section? Sometimes they will assist and even perform the entire operation. This is why you should be aware and ask your doctor and let them know your preferences.
- Would you want your doula or a birth photographer to join you during the operation and post-birth?
- Do you want a running commentary from the medical staff about how your operation is going?
- Do you want music playing in the background to relax you and take your mind off the operation?
- Do you want the staff and the operating team to be quiet so that the first voice your baby hears is yours or your partner’s voice?
- Many doctors routinely tie down both of your arms to make sure they are controlled and do not touch the sterilized drape or knock down the screen. Are you okay with that? Do you prefer one arm to be untied so you can hold your baby, or do you prefer both to be free?
- Do you want warm blankets during your surgery?
- Do you want the screen to be lowered a bit or have a mirror provided so that you can see your baby being born are see your baby immediately after birth?
- Do you want the screen to be kept raised until your incision is sewn up?
- Do you want someone to take photos or video once your baby is born?
- Do you want to discover the sex of your baby for yourself (not have the medical staff say) or to be told by the medical team? (Some of my clients like to see the baby be raised and have the partner announce the gender.)
- Would you like to have immediate skin-to-skin contact with your baby, or would you like to wait for your baby to be cleaned/ wiped down before you cuddle?
- If you want immediate skin-to-skin, APGAR testing can be performed while the baby is on your chest.
- Do you want to breastfeed your baby as soon as possible, or do you want to wait until you are in your recovery room or postpartum room, or would you prefer your partner to bottle feed your baby while you recover?
- Would you like the nurse to put your baby’s footprints inside a baby book that you provide?
- Do you want your baby to remain on your chest or in your arms throughout suturing, recovery, etc.?
- Would you like them to repair your uterus and use dissolvable stitches and steri strips or Dermabond instead of staples?
- Once you are in your recovery room or your postpartum room, do you want to have your baby with you or your partner at all times, or would you like for the baby to go to the nursery?
- Do you want your partner to stay with you if your baby is admitted to the NICU (neonatal intensive care unit), or do you want your doula or family member to stay with you?
- Would you like to breastfeed on demand and have help doing so (by seeing an on-staff lactation consultant), or would you like help with formula feeding?
- Are you okay with the nursing staff giving your baby a pacifier or supplement your baby with formula while you sleep? (If you do not want to be woken up.)
- If you were under general anesthesia, who would you like to introduce your baby to you? Your partner, your mother, your doctor, your nurse?
- Do you want to give your baby their first bath? (Obviously, with assistance during the process.)
- Sometimes mothers have to request their oral post-op medication while they are at the hospital. Would you like your orders to be written for you and to be woken up for timely doses, or would you rather have them wait for your request?
- Do you want to be given a binder to wear for abdominal support? (I highly recommend it!)
- Would you prefer your partner to stay with the baby at all times if you can’t be there?
- Do you want the pediatric exams to be done in your room or the nursery?
I hope these questions brought to light some of the things that you may want to consider and specify during your c-section (if you have one). Be sure to check out my birth plan post and print out my birth plan template, which also has a c-section plan and NICU plan on it.