Options In Birth: The Gentle Cesarean
As long as pregnancy may seem (especially when you reach the third trimester), I assure you, it will come to an end eventually! As you prepare for the birth of your baby, there are two types of delivery methods.
The first birthing method is a vaginal delivery. When planning for labor and delivery day, the options to consider seem endless. From labor and birth positions to pain relief options to comfort measures... there are so many things to consider and you can usually customize your experience as much or as little as you want to. As long as your labor is progressing smoothly and you are adhering to your provider's policies, you have a wide array of choices in labor and birth options.
On the flip side, as you prepare for your planned cesarean birth, it can seem like those options are next to nothing.
Your pain relief method is chosen for you-- usually an epidural or spinal (unless it is an emergency situation-- then you will go under general anesthesia). You don't have the option to ambulate or move around the room. Additionally, some providers will not allow your partner to cut the umbilical cord since the field must be kept sterile.
Approximately 1 in 3 U.S. babies and 30% of babies in Pennsylvania are born via cesarean so this is a topic that warrants conversation. After all, this is the most common surgery done in America!
Ten Reasons For A Scheduled Cesarean:
1. Elective (Personal Choice)
2. Repeat Cesarean
3. Fetal Position (Breech, Transverse, etc.)
4. Multiple Pregnancy (Twins, Triplets, etc.)
5. Placenta Previa
6. HIV Positive Pregnancy
7. Maternal Herpes
8. Cephalopelvic Disproportion (Small Maternal Pelvis)
9. Certain Fetal Conditions
10. Certain Maternal Conditions
As many "cant's" as there are, with a "gentle" or "family-centered cesarean," you do have options to personalize your experience and have more control over your birth. As long as your cesarean is planned and NOT an emergency, and your baby is not at risk for a low Apgar score, you can customize your cesarean birth.
Here are some things to discuss with your care provider prior to the big day if you'd like your experience to feel less surgical and more personal. Your doula is also familiar with hospital policies, though some things will vary from provider to provider.
Are clear drapes available? If not, can the drape be lowered a bit or can a mirror be used to watch my baby emerge?
Clear drapes will "take away" the barrier between you and your baby while keeping the surgical field sterile. You will be able to witness the momentous moment your baby makes his/her grand appearance.
Is immediate skin-to-skin allowed? I'd like baby to stay with me while the doctor finishes my procedure.
Studies have shown that that the stress hormone cortisol decreases in both the birthing parent and the baby when baby is being held. Other studies show that babies cry less and have a more regulated heart rate and breathing when held skin-to-skin.
Can everyone in the room keep their voices down and conversation to a minimum to create a peaceful atmosphere?
Keeping the room quiet creates less distractions and keeps everyone "in the moment." This is your moment. Any side conversations or extra chatter can feel like an interference.
How many support people are allowed in the operating room with me?
Support matters. Most hospitals allow 1 support person and some may allow 1 support person plus your doula.
Can we move the EKG monitors from on top of my chest to my side or my back? Can we put the IV and blood pressure cuff on my non-dominant hand and have my dominant hand free?
This will allow for you to hold baby skin-to-skin more easily.
Can I have music of my choice playing quietly?
Filling the cold, sterile space with familiar and peaceful music can keep you calm and relaxed.
Can my partner announce my baby's sex?
Even if you already know your baby's sex, the first time it's announced is exciting and special! After much hard work, your baby is finally here! This can be such a special memory for the parents to share.
Great News!
In most of our local hospitals, skin-to-skin care is promoted and encouraged! This applies to the full term and near term newborn delivered via cesarean as long as the infant is medically stable.