Complications & Cesareans | having a C-section is one of the last things you want to think about

Just in Case of a C-section

Meghan Rodberg never expected that her second labor would end in a Cesarean birth. After all, her first child had been born vaginally. But just in case, Rodberg, of Boston, Mass., included preferences for Cesarean in her birth plan. She was glad she did. “When my arms were strapped down in the OR, I was too drugged and exhausted to protest,” Rodberg says. “My husband and doula remembered that I’d specified in the plan that I not be strapped down. They pitched a fit until I was unstrapped.”

When you’re planning your baby’s birth, having a C-section is one of the last things you want to think about. And if your baby’s health is in jeopardy, you won’t care about your birth experience. But most unscheduled Cesareans aren’t done because the life of the baby or the mother is a danger, says Dr. Bruce Flamm, practicing OB/GYN with Kaiser Permanente Medical Center in Riverside, Calif., clinical professor at UC-Irvine, and author of Birth After Cesarean.

When you’re planning your baby’s birth, having a C-section is one of the last things you want to think about.

“Most of the time … it’s because the labor has slowed down, progress is not going sufficiently, and then there’s usually no emergency,” Dr. Flamm says. If your labor comes to the point where, no matter what you do, your baby just won’t come out vaginally, having a plan will help you have the best Cesarean birth possible.

“Think about it early on in the prenatal care,” Dr. Flamm says. “It’s not a bad idea to think about this even when you’re 3 months pregnant … when there are a calm setting and time to talk.”

Cesarean Considerations

Here are some issues to consider as you think about your needs and preferences:

  • Support people. Having your husband there can be a huge comfort. “He was the one person there who was totally focused on me and my needs,” says Theresa Lansberry of Peoria, Ill. You might also want your doula to stay with you.
  • Arm restraints. During a Cesarean, the mother’s arms are usually strapped down with wide Velcro restraints. For many women, this is the most unpleasant part of the Cesarean birth experience.
  • Cesarean Section Diagram Anesthesia and IV tranquilizers. Most women receive a spinal or an epidural so that they can be awake for the birth. Some get sedatives in an IV line as well. “I really wanted to be awake,” says Gretchen Humphries of Stockbridge, Mich. “I didn’t want them to give me anything beforehand to calm me down, and I didn’t want them to give me anything afterward to help me relax.”
  • Watching the birth. Some doctors will lower the sterile drape at the moment of the birth; others may set up a mirror.
  • Photographs or recording the baby’s first cries. “That’s a sound I’ll never forget but would like to hear again,” says Kira Smith of Clearwater, Fla. Most hospitals will have no problem with someone taking still photos, Dr. Flamm says. If you want to videotape, you may have to do some more negotiating.
  • Breastfeeding and bonding with the baby in the operating room or the recovery room. “The 45 minutes that they took closing me up went so fast because I had my babies,” says Humphries. “I really wasn’t paying attention at that point to what else was going on … I was just totally involved with my children.”

Making a Cesarean birth plan

Planning for a Cesarean

Once you know what you want, you need to find out how your doctor and hospital typically handle Cesarean births. “We asked specifically about things like premedication, what kind of anesthesia they routinely use, what they do with the babies, and do they routinely give tranquilizers after the surgery,” says Humphries.

If parts of your plan are against hospital policy, remember that policy isn’t written in stone. In some cases, requests “could be brought up in a meeting and an exception could be made,” Dr. Flamm says. “That would save a lot of headaches if a Cesarean became necessary.”

Once you and your caregivers have agreed on a plan, you’ll write it up and have it filed in your hospital chart. Remember that dozens of different people will be involved in your care. Not all of them will have read your plan. Make sure your support people know what you want. If things aren’t done according to your wishes, they can step in and gently remind the staff of your plan.

No amount of planning can guarantee you the birth that you want. But including Cesarean preferences in your birth plan can help you have the best birth possible under the circumstances. “I was able to not worry about the details because they had been taken care of,” says Lansberry. “I could focus on the joy of Elsie being born.”