Hire a Doula For a C-Section?

“You’re hiring a doula for a scheduled c-section?… What?! Isn’t a doula for women who want to have natural births? What would she do to help during a c-section anyway?!”

This is a common response from people when they hear that someone hired a doula who is also planning on scheduling a C-section. And that’s a reasonable response. I can totally understand that. You’re also right; doulas are often hired by women who want natural births. However, more and more women are recognizing the benefits of hiring a doula even when they have an epidural or have a C-section. Doulas are utilized for all kinds of reasons and are no longer just for the mamas who want unmedicated births. This is because a doula’s primary role is to provide SUPPORT. And when I say support, this is physical, emotional, and informational support. I firmly believe that EVERY woman deserves these types of support regardless of the type of birth she is planning to have.

As many of us know, the cesarean rate in the United States alone is 32.1%.¹ This means that nearly one in three women having a baby in the U.S. will give birth via C-section. This surgery may be planned or performed during labor as a non-emergency or an emergency procedure. But what are these different kinds of C-sections?

• planned (elective and scheduled in advance)
• unplanned non-emergent (elected but not planned or scheduled far in advance)
• and unplanned emergent (performed because of an immediate medical emergency)

Planned (or elective) cesarean sections are scheduled ahead of time by the doctor and mother.

Reasons for planned c-sections are:

1. this is the mother’s preference
2. mother is past her baby’s due date
3. baby is breech
4. there is suspected macrosomia (big baby)
5. mother is tired of being pregnant
6. mother and/or doctor want the convenience of picking a specific date and time of delivery
7. mother is having a repeat C-section, and her hospital does not accept VBAC patients, or the mother is not wanting a VBAC (vaginal birth after cesarean)
8. medical conditions for the baby (stunted growth of baby, suspected deformity, etc.)

Unplanned non-emergent C-sections are discussed and decided upon before it becomes an emergency situation. This can be done before labor begins or during labor.

Reasons for unplanned non-emergent c-sections are:

1. medical conditions for the mother (hypertension, preeclampsia (toxemia), etc.)
2. failure to progress in labor (not dilating)
3. placenta previa (when your placenta is covering the opening of your cervix)
4. low amniotic fluid
5. water breaks at 36 weeks or earlier in pregnancy
6. chorioamnionitis (there is an infection in your uterus)
7. STD outbreak

Unplanned emergency C-sections are just that: surgeries done in a true crisis. There was no planning or preparation for the c-section; it was decided at a moment’s notice for the health and safety of mother and baby.

Reasons for unplanned emergency c-sections are:

1. baby’s heart rate is rising or falling too high or too low that it is considered unsafe
2. the medical team can no longer find the baby’s heart rate with external or internal monitors
3. uterine rupture

There are so many different reasons why women have C-sections. It’s not always the mother’s preference but can become something necessary. However, sometimes it is what the mother prefers. And that is okay too! Whether you schedule your C-section or have an unplanned C-section, you should still create a cesarean birth plan and bring a doula!

Yes, that’s right, a doula can still help you during your c-section! But how?

As I mentioned, a doula provides SUPPORT to the expecting woman and her partner. Having a C-section is still giving birth to your child and is something that should be honored. It should be an experience you treasure and can look back on fondly because it brought you this precious miracle in your life, your baby. This is exactly how a doula can help with that and provide support during your cesarean section:

Physical Support

You wouldn’t think that there is much a doula can help you with physically during a C-section, but there is! Here are some different things that she can do:

1. She can help you with breathing and relaxation techniques to stay comfortable during uncomfortable procedures like administering an IV or even the spinal or an epidural for your surgery.
2. She can help keep your partner as calm as possible, especially during prep time, since he will not be allowed in until prep is completed. This will help your partner feel more prepared and be a more effective support person.
3. She can be your advocate in the operating room (OR) and remind your doctors and nurses of your preferences.
4. If your partner wants to touch the baby or take pictures while they are in the warmer, he will have to leave your side. This is when your doula can stay by you so you do not feel unsupported as your doctors continue with the repair part of the surgery. She will help you stay as calm and comfortable as possible.
5. Your doula can also take photos of you, your partner, and your baby if desired, particularly after the baby is born. She will know the right shots to take. 😉
6. If your baby needs to go immediately to the NICU, most partners go with the baby to know where they are going and what is happening. This causes them to leave your side for a more extended period of time. This can be a little scary for mom since she is concerned for her baby and is still being operated on. Remember, the procedure continues for around 45 more minutes as the surgeons suture you back up. The doula can stay by your side throughout all of this.
7. Your doula can also act as a liaison between the staff and you to get updates on baby while you are separated.

Emotional Support

If you have an unplanned cesarean section, this is especially when emotional support from a doula is helpful. She can help calm your fears before, during, and after the surgery. Having her there to discuss your feelings with you and your partner is truly valuable during this time. If you have a planned C-section, the unknown can still be frightening. Your doula can help by listening to you and talking you through everything.

After the birth, the doula is there for you while you process your feelings about the birth. It’s nice to have someone to talk to that will listen and give you an unbiased, professional outlook on the whole birth. Whether in the recovery room, the postpartum room, or at home, we all need someone we feel we can talk to. She can also recommend resources like ICAN and other support groups.

Informational Support

A doula can provide a lot of wonderful informational support to the family for a planned or even an emergency C-section. Sometimes your doula can also help you by teaching a cesarean section class for you and your partner. Here are some ways that she can help you by providing informational support:

1. A doula can help you and your partner know what to expect with a C-section and also inform you of the newborn procedures that will occur (what they are and why they are done).
2. She can help you prepare for birth by asking you questions like:
   • Would you prefer that your doctors describe or not describe the procedures as they are doing them during the surgery? Would you like for them to keep the chit-chat to a minimum? (Sometimes, doctors and nurses talk about things unrelated to the procedure since this is just another day at the office. This is still your baby’s birth, so you can speak up if you want the conversation to stop or change.)
   • Would you like to specify a double suture instead of a single suture?
   • Would you rather have staples or have them use Dermabond?
   • Would you prefer your partner to announce the sex of the baby?
   • Would you prefer your baby to be brought to you immediately (if baby is healthy) to do skin-to-skin as opposed to being placed in the warmer?
   • Would you like music playing in the OR while your child is born?
   • Would you like one arm free (usually both are strapped down) so you can hold your baby on your chest once they are born?
3. During the postpartum period, your doula can suggest post-operative comfort measures.
4. She can assist you with any breastfeeding questions you may have and help baby get a good latch.

As you can see, there are many things that a doula can do to help you before, during, and after your cesarean. This is why the idea of using a doula for a cesarean section is no longer unusual. There are many benefits for not only the mother but also the partner from the physical, emotional, and educational support. Everyone having a baby deserves an advocate, individualized care, and love. This is why I hope more mamas planning their C-sections consider hiring a doula. 🙂