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Planning a Positive Caesarean? Tips to turn Surgery into Birth

Not all women can achieve a vaginal birth, for their own specific reasons. Birth is a sacred life event, be it surgical or vaginal, and most mothers would appreciate it being treated as such. Below are a few ideas to enhance a mothers' experience of caesarean birth and help to reduce the clinical aspect out of a surgical delivery. They have all been tried and tested by women the world over. Some or both are applicable to planned or emergency caesarean section.

Before the Birth

Acknowledge your Feelings

Each woman will react differently to the prospect of her baby being delivered into the world via surgery. Try to take the time to examine your own feelings, fears and expectations of a caesarean section. Keep a journal, read caesarean birth stories, talk to other women who have experienced caesarean. Maybe listen to CD's or see a counsellor about releasing fear. Maggie Howell's 'Preparing for a Caesarean' Hypnotherapy CD is available through www.soulbirth.com and is great for facing fears.

Maintain a Healthy Pregnancy

Do your best to keep healthy through a balanced diet, regular exercise and a positive attitude. A caesarean section is major abdominal surgery- good health will help you both recover more quickly

Learn about Caesarean Section

Read about caesarean birth in pregnancy/birth books. Your hospitals antenatal classes often include a section on caesarean. Talk to other women about the procedure. Ask your obstetrician to talk you through all aspects of the birth. Community Midwifery WA and With Woman Collective run Positive Caesarean workshops here in the metro area see www.cmwa.net.au, www.withwomancollective.org 

Make a Birth Plan

You have choices in the caesarean birth of your baby. A plan will enable you to communicate you needs and preferences about your birth and your carers. Talk to your carer about your birth plan and have several copies to give to everyone involved. Hospitals and obstetricians have different routines on how things are done e.g., whether the baby stays with you in recovery after the operation. Do not assume that your birth wishes will be performed automatically. You need to let your carers know what you want. If a hospital refuses your requests then make sure they give you an acceptable reason.

Arrive on the day of the Birth

You can request that preoperative blood work be done as an outpatient. Then you may be able to arrive on the day of the birth rather than stay in unfamiliar surroundings the night before.

Start Labour Naturally

You can request that you begin labour naturally before the caesarean is done. You may wish for the baby to decide the day on which it is ready to be born avoiding any problems with prematurity and for you both to reap the benefits of your hormones. If you are in labour when you arrive in theatre you may request an 'internal'- you could be 10cm and ready to push! Other benefits of having labour before the caesarean include less breastfeeding difficulties and less respiratory difficulties for baby (Michel Odent)

Be Assertive

When making you requests to the Ob/hospital. 'Can I' or 'Will you let me' will probably lead to a 'No' answer. Using phrases like 'I understand you have procedures to follow, however, I have some requests of my own' and 'I would like to implement some ideas to make this experience unique for me and my baby' will get a much more positive result and hopefully put the ball in your court.

Photos in the Theatre

Usually only 1 support person is allowed in the operating theatre with you and most women choose their partner- he may be busy with you or the baby. The theatre staff are usually willing to take photos for you, especially with notice allowing your partner to be more involved in the birth. If you need a general anaesthetic, your partner may not be allowed in the theatre.

Write a Letter to your Baby

Tell them your hopes and fears for them in their new world, and how you will protect and care for them. This is a wonderful way to connect with your little one, and writing down your feelings is a great way to release any built up emotions.

At the Time of Surgery

Walk into the theatre!

Think about walking into the theatre instead of being wheeled in. You will see the reality of the room instead of glaring lights and upside down peoples heads.

Choice of Anaesthetic

A spinal/epidural anaesthetic is a better choice than a general anaesthetic as you will remain conscious during the operation, and can participate in the birth of your baby. If a general anaesthetic is needed, try to get your partner involved in the baby's post natal care with as much skin to skin as possible. If you want to be the first person to know the gender of your baby, when you wake up you and your partner can have the pleasure of finding out together.

Baby and Mum go Naked

Consider being naked underneath the surgical greens and request your baby is placed on your chest unwrapped with a towel placed over to keep baby warm- this allows you great skin to skin contact with your first, important cuddle. Your gown can be removed from underneath the greens before surgery.

The Moment of Birth

Ask the theatre staff to respect the moment your baby is born. Dimmed lights, your choice of music, a hallowed silence, or a verbal description of the birth may be asked for. You may have felt left out of your past caesarean as your body and labour may have been discussed as though you weren't there.

Watching the Birth

Babies tend to appear from behind a screen and you may find it hard to accept that they are your child. You may like to request to have the screen lowered or a mirror positioned if you would like to view the actual birth. There are women who have actively helped to deliver their child from their belly.

Once Baby is Born

Skin to Skin

The Australian Breastfeeding Association realise that immediate skin to skin contact is the best way to help establish the bonding of the mother and baby, thus aiding successful breastfeeding. By asking to have the APGAR score performed with the baby on your naked chest will initiate the bonding process. It may even resolve a few inner conflicts faced after the birth.

Breastfeeding in Theatre

Consider giving it a go. A midwife is present during the operation so she can assist you. Even a lick or few seconds of suckling is a big positive step towards successful breastfeeding. If you have a general anaesthetic then the midwife could encourage breastfeeding shortly after the baby is born.

Looking at the Placenta

Requests to view the placenta, and for either parent to cut the umbilical cord are now commonplace. How about asking the surgeon to leave the umbilical cord long and allow the father or mother a chance to cut it. That way the parents don't miss out on the sensation or their own right to tell their story of cutting a cord. Maybe you could request the placenta and cord remain attached until mum and baby are reunited.

Request Baby Stays with You

You can request that your baby remain with you at all times. Separation after the birth may seriously affect your bonding with your child. Request that the baby stays with you in recovery. If the recovery area is used for surgical patients and this is not feasible, then request that you recover back on the labour ward in your room. This is common practice in European countries; it's time to make that adjustment in Australia too. You may need to request this with the hospital before your surgery to enable appropriate staffing. If this is not possible, encourage your partner to provide as much skin to skin contact as possible while you recover.

Despite all our preparations and expectations, we are not in control of everything in labour and birth. We must take a leap of faith and trust- trust our body, our baby, our partner, caregiver and support people.

We do not pass or fail we give it our best

Birthrites hopes your birth is everything you wish it to be: that you and your baby reap the rewards of planning a better birth experience both physically and emotionally.

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