All About Cesarean Birth
So let’s talk Cesarean... Today at least 30 percent of pregnant women end up having a Cesarean (AKA C-Section, Belly Birth, or Surgical Birth), which is when your baby is delivered through a surgical incision in your abdomen and uterus. In Mississippi- our cesarean rates are far higher than 30% and many women feel unprepared about their upcoming procedure. Support for these mothers in many cases is unfortunately sorely lacking. Being a new mom is hard enough! Major abdominal surgery in addition? These women need a village more than anyone so that they can rest, recover, and bond with their new addition.
For moms who are possibly facing a cesarean delivery- here are some basics and some little known facts to help you prepare!
Why You May Need a Cesarean
"Every woman should prepare herself for a C-section before she goes into labor," says Dr. William Camann, associate professor of anesthesia at Harvard Medical School. Many Cesarean Deliveries are planned in advance for reasons such as breech/transverse birth, placenta previa (placenta blocks the cervix opening), pre-eclampsia, low amounts of amniotic fluids and placenta abruption (the placenta starts to give way from the uterine wall), but the majority of Cesareans are non-elective (sometimes for some of these same reasons discovered later in pregnancy).
Because of all of this, and the potential for complications during a normal vaginal delivery, I generally discuss cesareans with all of my clients. I like them to know the myths vs facts and know that even if the decision to have a C-Section is made- they still have options!
Some facts about Cesarean Delivery
- You will get an IV- the IV is used for fluids, pain medications and more during your surgery.
- It shouldn’t hurt, but you will feel something during surgery if general anesthesia is not used- Except for extreme cases of emergency C-sections, you will be awake during the procedure. Typically, a single spinal injection is delivered by the anesthesiologist to numb the area from midchest downward. "It's a nerve block, so very little medication gets into the blood stream," says Dr. Camann. "You won't be sleepy and the baby gets very little effect." It is stronger than an epidural and takes away every sensation, except for some tugging. With an epidural you can still move your legs, but with a spinal you will not be able to move anything.
- Nausea- You may be hit with a wave of nausea, you may get the shakes and you also may start getting cold. This is a result of low blood pressure–a very common side effect of anesthesia. The doctors monitor your blood pressure very closely and administer medications to correct any issues if they occur.
- Catheters- a urine or Foley catheter is placed once your anesthesia has taken effect. This is because you will not be able to get out of bed for many hours to go to the bathroom!
- You will get a bonus leg massage- courtesy of the hospital! After surgery (or sometimes before!) your doctors may bring in contraptions called sequential compression devices (SCDs), which work to improve your circulation and prevent blood clots. They might even slip them on when you’re asleep and numb after surgery—so if you wake up to find them on you, don’t be alarmed. They kind of look like space boots and may seem a little weird at first (since they inflate and deflate repeatedly), but the sooner your blood gets pumping all around, the sooner your doctors will take them away.
- Recovery- You will be sent to a recovery room for about an hour to monitor your progress as you begin to come out of anesthesia and possibly have your wound redressed. Your baby will usually be with you the whole time and skin-to-skin contact and breastfeeding are encouraged in most hospitals.
During this time shivering and shaking is very common. The IV fluids are colder than body temperature so they can make you feel cold. Also, small pieces of amniotic fluid can seep into the blood stream during surgery and cause shivering or shaking. This usually passes in a few hours at the most.
How about Recovery?
All women’s bodies are different, therefore they all will handle recovery a bit differently- but generally speaking:
- Your catheter is typically removed the morning after surgery. Yay! You can now get up to pee again!
- You can usually walk around and take a shower within 24 hours after surgery assuming there are no complications. Sometimes sooner.
- Stool Softeners are going to be your new best friend! Pooping can be a major problem post c-section, since it's tough to push when your abdomen is tender and sore after surgery. Taking stool softeners after delivery will ease you back into your routine again—and make you a pretty happy camper in the process. Just remember to drink lots of water, and walk around as soon as you can, to keep your bowels awake.
- You should be able to walk around fairly comfortably about two weeks after surgery- this varies for some women and complete recovery takes longer.
- One to two weeks after surgery, you should be done with the pain meds. Some women choose to stop taking them sooner under the guidance of their physician.
- You will be able to start exercising again around six weeks post surgery. It is important to start slow and get the ok from your provider before you get back to an exercise routine. I highly recommend postpartum fitness classes that ensure you are protecting your core muscles during the healing process.
To boost your rate of recovery and lower the risk of infection, it's important to get up and walk as soon as possible after your surgery. Too much bed rest can lead to blood clots, so be sure to walk around as much as you feel comfortable with.
How A Doula Can Help
When you meet with your doula, you form a bond that you can feel comfortable with. You can contact her with questions that can arise during the pregnancy. She may attend doctor’s appointments to form a great working bond with them, too. You will go over an extensive plan that will include some different situations that may arise during and right after your surgery so that you will be prepared and not shocked IF/WHEN baby would get transferred to another hospital for medical reasons. A doula will help you deal with any emotions you may have about the surgery in general and will be able to offer reassurance and answers to your partner on what to expect. If your partner decides that surgery isn’t for them- and they absolutely do not think they can handle being in the operating room, your doula can typically take their place as your primary emotional support during the surgery.
A doula can inform you about your options before during and after your cesarean, provide evidence based information for your birth plan, assist with skin-to-skin and initiating breastfeeding (if that is how you choose to feed!) during recovery when you are laying flat on your back and need some help holding baby, even stay with you in the Operating Room so that your spouse can go with baby to the NICU it baby isn’t doing well. (Assuming your provider allows doulas in the operating room! Be sure to ask beforehand about this. Regardless- doulas can do a ton before and after the actual surgery)
Bottom line on having a doula in your corner for ANY birth... Is that the doula works exclusively for you- not for a major medical facility. A doula provides emotional not just physical support. Her concerns are your concerns and your satisfaction is her number one priority. You will have one on one support at all times with your doula. You will also have someone to vent to, ask questions without having to Google search and even someone to complain to when things aren’t as you expected. Oftentimes, your doula will have great suggestions when you were just looking to vent to make your life during pregnancy, birth, and postpartum a much easier more pleasant experience.
Have more questions? Contact me today!
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