Everything You Need To Know About C-Sections: Planned. Unplanned. Recovery. Emotions.
In 2014, over 32% of birthing women had a cesarean section. This statistic is at a scary high level in our country, which ironically has an increasing number of maternal deaths each year as well as a rising medical intervention rate. The World Health Organization recognizes that these numbers must come down, and has raised the full-term label from 37 weeks to 39 weeks in hopes that inductions will stop occurring so early. It has been proven that a woman who has an induction is more likely to receive an “emergency c-section” than a woman who goes into labor naturally. (source)
There are times when a c-section is absolutely necessary and is a life-saving surgery for mother or baby. For some women with pre-existing conditions, a c-section actually allows them the ability to carry and give birth to a baby.
While we are working on bringing these numbers down, we cannot deny the fact the c-sections are occurring often. Whether they are planned or unplanned, they have become common practice and pregnant women need to know what to expect if they choose or unexpectedly receive a c-section.
I will openly admit that I teach natural childbirth classes to try and prevent a c-section from occurring with my clients. I have worked with a handful of couples who did end up on the operating table, and by understanding their options and knowing how to handle the surgery, they still had very happy births! I have also worked with couples knowing they would receive a c-section due to health complications or prior birth issues. They all truly wanted a peaceful, calm, loving birth environment. They got it. When you are educated on all of your rights – even during a c-section – you can still have a peaceful birth!
What is a c-section?
Warning, this video is of a cesarean surgery. I am not asking you to watch it to scare you, but instead to inform you. You need to watch to understand that it is an abdominal surgery that will take time to recover from. You want to watch to know exactly what is happening to your body so that you can discuss with your surgical team your desires and hopes.
How should I prepare?
While pregnant, take a birthing class that includes information on c-sections. It is probably not part of your birth plan, but if something happens that you end up needing surgery, you will want to know every detail of what is going to happen. You may even include a small blur in your birth plan on what you would like if a c-section is necessary.
If you know that you are having a c-section, you have time to process a lot of the emotions beforehand. Taking a birthing class will still be helpful, as you will learn about the process of birth. Agreeing to a c-section does not mean that you are agreeing to give up on the birth you dream of. Read about peaceful c-sections and explore your options. Talk to your doctor about procedures such as lab work and others that will need done before surgery. Pack a detailed birth bag so you can be comfortable for your hospital stay.
What may I request in the operating room?
Remember that this is still your birth. You can feel in control. Do your research and know what you want. Options that are still available with a c-section:
- You may have an option over the type of anesthesia. Talk to your doctor and know your options.
- Delayed cord clamping: This is possible for most cesarean births. Some practitioners practice it without being asked, but the benefits are huge, not only for baby but for you as well. Delayed cord clamping enhances placental transfusion and increases the baby’s blood volume at birth.
- Vaginal Seeding: Early studies show that swabbing a mother’s vagina and transferring it to her baby’s mouth, eyes, and skin immediately following surgery may stimulate microbiome development similarly to babies being born vaginally. This may even protect from health issues later in life.
- Skin-to-Skin: Caesarean birth is known to reduce initiation of breastfeeding, increase the length of time before the first breastfeed, reduce the incidence of exclusive breastfeeding, significantly delay the onset of lactation and increase the likelihood of supplementation. By implementing immediate skin-to-skin following a cesarean, increases the successful rate of breastfeeding. Here is a video about skin-to-skin in the operating room.
- A clear curtain: If you would like to see as much as possible, you may request a clear sheet be draped over you instead of the typical colored one.
- Baby Procedures Can Wait: Ask that baby not leave the room – or even your side – to be weighed and measured, or cleaned. That can be done in your recovery room with you being able to witness it all.
- Baby stays with Mommy: As long as everyone is healthy, you can request that your baby never leaves your side.
What happens after surgery?
As long as mother and baby are healthy after surgery, you will both be taken (together) to recovery. Make sure to practice skin-to-skin and breastfeed as often as you can while in recovery. This will help strengthen your bond, heal any emotional scars, and increase a successful breastfeeding relationship. You will likely have visitors, but this is up to you. Take each hour as it comes and treasure the moments with your newborn, but remember that major surgery will not leave you feeling like you can sprint home. You will be offered medications, it is up to you to accept them. Do your research and hear your body.
Advice from real moms about recovery:
- Drink a ton of water and all the Colace they give you.
- Use the abdominal binder.
- LAUGH as much as possible. The less anxiety, the better you feel.
- Get a postpartum girdle. It will make all the difference in the world for recovery.
- Ask for a family centered c-section.
- Take your time in healing, it is not a race.
- Ask for help around the house and with baby.
Emotional Healing: Reach out to support groups and talk to others about your experience. Write about your birth story and find all the good in it. If you had an unplanned or emergency cesarean section, it is ok to grieve the loss of the birth you desired. Do not let anyone tell you otherwise. Please join the ICANN network and process your feelings and emotions with healing help.
Here are a few C-section birth stories to read and smile over, because in the end, a healthy family is all that matters.
My birth story didn't go exactly as we would have liked, but in the end Will is healthy and that is all that matters.
My water broke at 6:30pm on Wednesday, August 20th. Contractions started about 9-9:30pm and were really mild and spread out until about 12:30am. About then they started getting a little bit stronger, but still really irregular. About 2am I hit transition and wouldn't you know it…I threw up. Twice. At this point I think William started to get a little nervous because he realized where I was in the process, but my contractions were still really irregular. About 3am they went from really irregular to about 2-3 minutes apart with the intense urge to push. We finally decided to go to the hospital.
At the hospital everyone was very nice, but they clearly thought I was a first-time mom overreacting to the pain of my contractions. When they did the exam and realized that I was 10 cm and pushing things got a little crazy.
They hooked me up to the fetal monitor and couldn't get a read at all on Will's vitals. At that point the doctor wanted to take me back for a c-section and William had some strong words with her. She put an internal monitor in and his heart rate was low, in the 80's and dipping down into the 70's. I labored for somewhere between 30 minutes and an hour at which point his heart rate was still pretty low so they took me back for an emergency c-section.
There are a couple of things, looking back, that I wish I had been more prepared for. First, make sure that your wishes are known. Since we got to the hospital when I was already pushing it got really chaotic, really fast. We never had an opportunity to give our birth plan to anyone. Thankfully William was an amazing advocate for me because I was in no place to advocate for myself. I sort of turned inside myself and was so focused that I didn't really recognize what was going on around me. William was my voice.
Second, remember that you have the right to say yes and no. You are the patient. Our doctor threatened a c-section several times (in what seemed like a scare tactic). When we said we didn't want a fetal monitor so that I could walk around between contractions we were threatened with a c-section. When we said that we weren't really comfortable with an internal fetal monitor we were threatened with a c-section. Again, William was the hero here and made her explain her reasoning each time that she wanted to do something. He also had her wait several times to see if with a little bit more time would turn thing around. In the end, we did trust her judgement and agreed to the c-section when she felt that things had gotten really serious. But, her constant threat of something that we were trying to avoid really marred the experience for us.
Third, make sure that your husband has a support network for his needs. I went into surgery at 5am and wasn't out until a little bit after 6am. It was too early to call family and too early to call friends. At that point only four people knew that I was in labor (you, two of my best friends, and my boss). I wish that William had reached out to more people so that he didn't have to spend that lonely hour shuttling back and forth between the nursery and the surgical suite.
Fourth, do a little bit of research and have a plan in place for what to do AFTER the birth. I woke up and honestly didn't know where to begin. I felt MASSIVE guilt. I hurt and even small movements were difficult. I have a really high pain tolerance so I toughed it out so that I could hold Will, change him, feed him, etc. Have a close friend on speed dial who has had a c-section who you can call. I didn't know anyone and just felt a little bit overwhelmed. Thankfully my nurse had basically the same situation with her child so we talked a lot and she was really, really helpful.
Finally, do what you need to do to work through the pain/guilt/frustration/trauma that you feel after the birth. Writing my story helped and talking to friends who understood my desire to have a natural birth helped me. I also found a new doctor who is on board with natural birth and really supportive of VBAC's.
Joey's Story - Preeclampsia and HELLP
First pregnancy - everything was going great up until a little over 32 weeks - went to dr. for a scheduled appointment and my blood pressure was higher than normal for me - my doctor was not highly concerned so she told me to go home and come back in 2 days for a recheck. 2 days later I went back and my blood pressure was still high so my doctor told me to do a 24 hr urine test- I was also unable to sleep laying down for 2 days -I had to sleep sitting up on the couch because I had a very bad pain on my right side under my right breast by my rib cage- but I had not mentioned this to my dr because it was my 1st pregnancy and I thought it was just a normal pregnancy pain - so I collected my pee into a big jug for 24hrs and then brought it back to the doctor’s office so they can check my protein levels. After returning my jug of pee to the doctor for protein test the nurse practitioner took one look at me and said "you do not look good" so she checked my blood pressure and at this point it was sky high and I told her about my pain I had been having for 2 days - she called the doctor in and he told me I needed to go to the hospital NOW - My husband and I were scared and had no idea what to expect. At this point I was 33 weeks 6 days- When I got to the hospital I was hooked up to monitors and it turns out I did have protein in my urine and also due to my pain I was having I also developed HELLP syndrome (H: hemolysis (breakdown of red blood cells) EL:elevated liver enzymes LP: low platelet) My organs were shutting down and I was at risk for a stroke way to help me was to deliver the baby. I was immediately put on magnesium sulfate - this helps prevent seizures- I hated being on it and I hated how I felt being on it- I ended up being on it for 3 days. Being first time parents this was all very scary and overwhelming and not how I pictured the birth of our first baby to go down- I had the NICU dr come in and talk to me the night before my c section to tell me all the things that could happen being that I was delivering 6 weeks early and the babies lungs were not fully developed- . At 34 weeks the next morning I had an emergency c section and gave birth to a 4lb 14oz baby boy!- everyone was amazed at his size and when he let out that first cry I cried with him and felt a little relief come over me.I was unable to hold him for 24hrs!- all I could do was see the pictures on my camera my husband kept taking for me- I was in the hospital 5 days and Joey stayed in the NICU for 14 days and he was dealing with none life threatening issues - he was on oxygen for 24 hrs and he had jaundice and he had to learn how to maintain his body temp and he had to learn how to suck, swallow and breath all while eating and for 12 days he had a feeding tube down his nose - For me the healing process was a little rough- Since Joey was in the NICU for 14 days I needed help getting to and from the hospital since I was not allowed to drive- and some days I over did it-I couldn't sleep in my own bed because it was too hard to get up and down- I had to sleep on the couch- I guess you don't realize you just had major surgery! but I felt like by the time he got home I was ready for him and healed enough to get up and down better and take care of him.
3rd pregnancy - easy breezy - until 34 weeks 3 days - I had a regular scheduled appointment on Friday and everything was great and going smooth- woke up Saturday morning at 8am to major abdominal pain- thought maybe whatever I ate the night before did not agree with me - still had major pain at 10am- at this point it was just me and my middle daughter at home- my husband took my older son to baseball. I called my mom and she came over and she said call your dr - gave my dr a call- since it was Saturday the on call staff had to page her and I would have to wait for a call back - 30 min later she calls me back and I tell her what my issue is and she says maybe a UTI come to the hospital for testing and monitoring - my husband is still not home and my mom had to stay with my middle child so I called my sister to come take me to the hospital and my husband would meet me there. My sister could not stay so I got dropped off alone - I didn't think anything of it because my dr did not seem concerned - I got hooked up to monitors at 11am and was still in a ton of pain - well it was contractions - every 2-3 min and intense! They gave me 2 bags of iv fluids hoping it was just because I was dehydrated - still alone at the hospital- and now there is talks about a c sections - my mind was all over the place --- oh my god...I am alone! where is my husband! oh my god another 34 weeker! Still hooked up to fluids still have major intense contractions and I can feel something is not right! - Next contraction and I feel it...a pop!-- I felt like my insides were exploding - I buzz the nurse yelling I need help! 5 nurses come running in ...babies heart rate dropped to below 100 for over 3 minutes! I was being pulled every which way --I was given oxygen- all these nurses around me trying to calm me down - they call my dr she gets there says she does not like what is going on and to prep me for a c section- and my husband is still not at the hospital - this was very scary to go through alone - my dr waited for my husband to get to the hospital before she did the c section - 5 hrs after getting to the hospital I delivered a 5lb 11oz baby girl at 34 weeks 3 days --- what a big preemie! . My dr told me as soon as she cut me open I was already torn- I had ruptured which is why I was in so much pain. Jacey stayed in the NICU for 14 days with none life threatening issues - no jaundice- needed oxygen for 24hrs and needed a tube to be fed until she learned how to suck swallow and breath while eating. It was very overwhelming to have a baby in the NICU and 2 other children at home- I was being pulled in all different directions and I was healing from surgery again- which the 2nd time was way better than the first- I had a few breakdown moments while Jacey was in the NICU because we wanted so bad for her to be home .
Emotionally healing after Jacey was hard - I had a vbac 14 months before I had Jacey and my dr said that is what lead to my rupture-I was told I needed to wait at least 5 years to have another baby and that if I did get pregnant again my dr would not allow me to go past 34 weeks - I had a hard time dealing with another preemie and wondering why my body hates me when I get pregnant - I also think I had a case of PPD because I was an emotional mess for a year- I was lucky enough to have friends I could talk to and family that was here for me whenever I needed them - Even now I don't think I am ready to give up on having a 4th but I have to put my health first and it makes me sad to think I will not be having anymore children. --but I know some women are not as lucky to leave the NICU with a premature baby or actually still have the option of having another baby down the road - I am lucky enough to have great doctors and that my babies were in a great NICU and got the best care possible.--always listen to your body!
Isabella and Ruben’s stories
I have two experiences , with my first child I was young and didn't know about my birthing options. My son was 3 weeks past due so they called me to the hospital to get induced. After 48 hours of no progress , they convinced me that I was in need of c section because my baby could be in danger . So off I went into the scary OR all alone because they wouldn't allow my husband in the room until they completed my epidural which took 7 tries. Once my hubby came into the OR they began the c section and 25 minutes later I was blessed with a beautiful and healthy baby boy. Fast forward to 12 years later I became pregnant with a baby girl . My husband and I were so excited. I decided to go back to the same ob/gyn who delivered my son and my goodness the whole staff changed but I decided to still follow up with the doctor and discuss my birthing plan. This time around I educated myself & had a great plan , before I even muttered a word the doctor said so we are doing a repeat c section . I was stunned and I corrected her and said no we are doing a VBAC ! She said NO and proceeded to tell me that no one will perform a VBAC on me , it's too risky. So I left that practice and went back to my regular OB/GYN and told him I wanted a VBAC and he seemed to be on board. But as the months went by he became very neglectful and absent minded. Towards the last 3 months we reviewed my birthing plan again and he then informed me that he can't do the VBAC at my hospital so I was back to square one. On October 15th,2013 it was time for the c section and I was so sad and scared. But I was determined to deliver a healthy baby girl. I got prepped and off I went , 45 minutes later Isabella was born. I asked my husband to make sure he implemented the rest of birthing plan which included delaying the bath, and keeping the placenta for encapsulation. I asked them to breastfeed while in the OR and they did fulfill my request. 5 minutes later my baby was whisked away with my husband and I was left in recovery for 2 hours without seeing my baby , which was very heartbreaking. Once I got back to my room I grabbed my baby immediately and began the skin to skin method. All was well until I was in excruciating pain. I then paged the nurse and asked for assistance with my baby and she proceeded to tell me I need to get up and do things for myself , she continued to say someone should have stayed at the hospital if I needed help. I just fell to pieces and cried. It became so bad that they told me I could be released the next day and I took them up on that offer because my baby and I were not being cared for properly. Mind you c section patients are suppose to stay for 72 hours. So I signed my discharge papers and went home without any pain meds because the doctor couldn't give me a script ! So I went home in severe pain but I didn't care I just wanted to get home spend time with my angel and start working on my placenta encapsulation. All in all my birthing experience with my daughter was very Emotionally scarring. If I could do it all over I would have gone to a birthing center and I would have not let anyone dictate my birthing plan . Since my experience I have been able to inspire many woman and I hope to become a doula in the near future so I can help women and their babies have a beautiful birthing experience.
There is beauty in pain
Grant was a emergency c-section baby. I was induced with him. The reason my dr chose to do so, was I had group b strep and he wanted to ensure I had the bag of antibiotics in me before I delivered. I delivered Ella so fast that the dr was afraid if I went on my own time, I wouldn't get the antibiotics needed. I progressed quickly after being induced. G's heart rate dropped greatly and they had had to stop the iv of meds inducing me. They gave me epinephrine to raise his heart rate. I had to lay on my side the whole time because when I rolled to my back, his heart rate dropped. The dr came in and I pushed and pushed and nothing. They could see something on top of his head. The dr quickly realized it was the cord and rushed me down to the or. The cord was over his head like a bonnet and preventing him from coming out. It was like a bungee cord. One thing I wish I knew, a lot of women get sick when they are moving and shifting all your parts. I wasn't prepared for that. I tossed my cookies. I wish I would've listened to the dr and followed directions and taken care of myself but I had a toddler and Cole at home and pushed myself to do too much and ended up in a good amount of pain. I wish I would've listened to my body telling me to slow down, but I didn't. Not a very exciting story, but I learned that just because you have a birth plan and you've done it a couple times before, doesn't mean it will happen the same way again. Basically to sum it up...sh*t happens!!