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 who’s planning on scheduling a C-section has hired a doula. And that’s a reasonable response. I can totally understand that! You’re also right; it’s women who want natural births who often hire doulas. However, more and more women are recognizing the benefits of hiring a doula, even when they have an epidural or a C-section.

You can utilize doulas for all kinds of reasons, and they’re no longer just for mamas who want unmedicated births. This is because a doula’s primary role is to provide SUPPORT. And when I say support, I mean physical, emotional, and informational support.¹² I firmly believe that EVERY woman deserves this, regardless of the type of birth she’s planning to have. So, I’ll be sharing an in-depth look at how a doula can provide these types of support during a cesarean section, whether planned or unplanned.

Types of C-Sections

As many of us know, the cesarean rate in the United States alone is 32.4%.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.² Here are the different kinds of C-sections:²

• Planned: Elective and scheduled in advance
• Unplanned non-emergent: Elected but not planned or scheduled far in advance
• Unplanned emergent: Performed because of an immediate medical emergency

But what are the reasons for getting them? Let’s explore these three options further:

1. Planned C-Sections

The doctor and mother schedule planned (or elective) cesarean sections ahead of time.^2,3 Here are the reasons for planned C-sections:^2,3,4,5,6

• This is the mother’s preference
• Mother is past her baby’s due date
• Baby is breech
• There’s suspected macrosomia (big baby)
• Mother is tired of being pregnant
• Mother and/or doctor want the convenience of picking a specific date and time of delivery (though this isn’t always possible)
• Mother is having a repeat C-section, and her hospital doesn’t accept VBAC patients, or she doesn’t want a VBAC (vaginal birth after cesarean)
• Medical conditions for the baby (stunted growth of baby, suspected deformity, etc.)

2. Unplanned Non-Emergent C-Sections

You and your doctor discuss and decide upon an unplanned non-emergent C-section before it becomes an emergency situation. This can be done before labor begins or during labor.^2,7 The reasons for unplanned non-emergent C-sections are:^2,5,8,9,10

• Medical conditions for the mother, such as hypertension, preeclampsia (or 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’s an infection in your uterus)
• STD outbreak

3. Unplanned Emergency C-Sections

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.² Reasons for unplanned emergency C-sections are:^2,5,7,11

• Baby’s heart rate is rising or falling too high or too low that it’s considered unsafe
• 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 the mother’s preference, but it can become necessary. However, sometimes it’s what the mother prefers. And that’s okay too! Whether you have a planned or unplanned C-section, you should still create a cesarean birth plan and bring a doula for support.

How Can a Doula Help With a C-Section?

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 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 C-section:¹²

Physical Support

You might not think there’s much a doula can help you with physically during a C-section, but there is! Here are some different things she can do:¹²

• Provide coping mechanisms: A doula can help you with breathing and relaxation techniques to stay comfortable during uncomfortable procedures like administering an IV or even spinal anesthesia or an epidural for your surgery.
• Support your partner: Your doula can help keep your partner as calm as possible, especially during prep time, since they won’t be allowed in until prep is completed. This will help your partner feel more prepared and be a more effective support person.
• Advocate for you: She can be your advocate in the operating room (OR) and remind your doctors and nurses of your preferences.
• Stay by your side: If your partner wants to touch baby or take pictures while they’re in the warmer, your partner will have to leave your side. This is when your doula can stay by you so you don’t feel unsupported as your doctors continue with the repair part of the surgery. She’ll help you stay as calm and comfortable as possible.
• Take photos: Your doula can also take photos of you, your partner, and your baby if desired, particularly after baby is born. She will know the right shots to take. 😉
• Support you if baby goes to NICU: If your baby needs to go immediately to the NICU, most partners go with the baby to know where they’re going and what’s happening, causing them to leave your side for a more extended period of time. This can be a little scary for Mom since she’s 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.¹³) The doula can stay by your side throughout all of this.
• Be a liaison: Your doula can also act as a liaison between the staff and you to get updates on baby while you’re separated.

Emotional Support

If you have an unplanned C-section, this is when emotional support from a doula is especially helpful. She can help calm your fears before, during, and after the surgery.¹² Having her there to discuss your feelings with you and your partner is truly valuable during this time. If you have a planned cesarean, the unknown can still be frightening, and your doula can provide support 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 who will listen and give you an unbiased, professional outlook on the whole birth. Whether in the recovery room, in 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 wonderful informational support to the family for a planned C-section or even an emergency cesarean. Sometimes, your doula can also help you by teaching a cesarean section class for you and your partner. These are some ways that she can provide informational support:¹⁴

• Help educate you: A doula can help you and your partner know what to expect with a C-section. She can also inform you of the newborn procedures that will occur (what they are and why they’re done).
• Prepare you for birth: 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’re doing them during the surgery? Would you like for them to keep the chitchat 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 to have your baby brought to you immediately (if baby is healthy) for 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’re born?
• Offer postpartum support: During the postpartum period, your doula can suggest post-operative comfort measures. A postpartum doula can also assist you with any breastfeeding questions you may have and help baby get a good latch.

Hiring a Doula for a C-Section

As you can see, there are many things a doula can do to support you before, during, and after your C-section. 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 due to the doula’s 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. 🙂