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 normal response. I can totally understand that. You’re also right, doulas are mainly 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 are having a c-section. Doulas are hired for all kinds of reasons now and are no longer just for the mamas who want unmedicated births. This is because a doula’s main 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 at just under 33%. 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 in advance or it may be performed during labor as a non-emergency or as 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:
- this is the mother’s preference
- mother is “overdue”
- baby is breech
- there is suspected macrosomia (big baby)
- mother is tired of being pregnant
- mother and/or doctor want the convenience of picking a certain date and time of delivery
- 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 a cesarean)
- 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:
- medical conditions for the mother (hypertension, preeclampsia (toxemia), etc.)
- failure to progress in labor (not dilating)
- placenta previa (when your placenta is covering the opening of your cervix)
- low amniotic fluid
- water breaks at 36 weeks or earlier in pregnancy
- chorioamnionitis (there is an infection in your uterus)
- STD outbreak
Unplanned emergency c-sections are just that, surgeries that are done in a true crisis. There was no planning or preparation, it was decided in a moment’s notice for the health and safety of mother and baby.
Reasons for unplanned emergency c-sections are:
- baby’s heart rate is rising or falling too high or too low that is considered safe
- the medical team can no longer find the baby’s heart rate with external or internal monitors
- uterine rupture
There are so many different reasons why women have c-sections. It’s not always a preference of the mother, but can become something that is necessary. However, sometimes it is what the mother prefers. And that is okay too! Whether you are scheduling 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 before, 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 that 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:
You wouldn’t think that there is a lot that a doula can help you with physically during a c-section, but there actually are! Here are some different things that she can do:
- She can help you with breathing and relaxation techniques to stay comfortable during uncomfortable procedures like the administration of an IV, or even the spinal or an epidural for your surgery.
- 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.
- She can be your advocate in the operating room (OR) and remind your doctors and nurses your preferences.
- If your partner is wanting to touch the baby or take pictures while he/she is 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.
- Your doula can also take photos if you desire, particularly after the baby is born, of you, your partner and your baby. She will know the good shots to take. 😉
- If your baby needs to go immediately to the NICU, most partners go with the baby so they know where he/she is going and what is happening. This causes them to leave your side for a longer 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.
- Your doula can also act as a liaison between the staff and you for getting updates on the baby while you are separated.
If you are having 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 are having a planned c-section, it can still be a little frightening of the unknown. 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 really nice to be able to have someone to talk to that will listen and give you an biased, professional outlook on the whole birth. Whether you are in the recovery room, the postpartum room or at home, we all need someone that we feel that we can talk to. She can also recommend resources like ICAN and other support groups.
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 even 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:
- 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).
- She can help you prepare for the 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 completely 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 as opposed to a single suture?
- Would you rather have staples or have them use Dermabond?
- Would you prefer your partner announce the sex of the baby?
- Would you prefer that your baby 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 he/she is born?
- During the postpartum period your doula can suggest post-operative comfort measures.
- She can assist you with any breastfeeding questions you may have as well as 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. It’s obvious that 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 who are planning their c-sections consider hiring a doula. 🙂