What Should I Expect with an Unplanned C-Section?

Dear Kathy,
 
I am planning for a vaginal birth though my doctor told me a cesarean could be a possible outcome. What would cause me to have a cesarean? And what should I expect during the process?
 
Thanks,
 
Due Any Day Now
 
 
Dear Any Day Now,
 
Unplanned cesareans happen for several reasons:

• Fetal Distress
• Fetopelvic Disproportion (baby cannot fit through pelvis)
• Labor Disorders
• Failure to Wait
• Medical Concerns in Mother (Preeclampsia, HELLP syndrome, pre-existing conditions, etc.)

 
Unless it’s an emergency, you should be informed all along the way of the issue at hand and the steps being taken to correct it.

​If a C-section is recommended, you should be part of that conversation and offered the opportunity to ask all your questions. You should feel that you are truly informed and agreeing to the cesarean without any doubts or coercion. You always have the right to ask for a second opinion.
 
Nurses will ready you for surgery and sterile drapes will be placed over you from the neck down. Your support person can sit next to you behind the drapes and the anesthesiologist will be right by your head the entire time, making sure you’re as comfortable as possible. The doctor (and midwife, if she’s assisting) will be just on the other side of the drapes and can speak to your throughout.
 
There will be times during the surgery where you may feel some slight burning or tingling as well as pulling and pressure. Anesthesia is so interesting — it takes away the pain sensations but doesn’t take away these other sensations.
 
When the baby is born, especially if there has been fetal distress, the neonatologist is usually the first to receive the baby and make sure they are okay. The baby will be brought to you for the rest of the surgery once stable. You and the baby will usually go to the recovery room together, unless the baby needs immediate medical attention, then they are taken to the nursery.
 
If you should have a serious emergency requiring a cesarean, then all of the preparation may take place very quickly with lots of personnel and people doing several things at once. It can be a bit overwhelming, but still remember you have the right to ask all your questions and be a part of the decisions!
 
Warmly,
 
Kathy


Silvie’s Doula Tips
 
Here are some doula tips to ease your mind and better prepare for the possibility of an unplanned cesarean.
 
Mom can prepare herself for the “unknown” (as birth is known to be) ahead of time by training herself in hypnosis and/or mindfulness. This should help ease her mind not stress when birth doesn’t go quite as she planned.
 
There are ways mom can be more relaxed and comfortable during the entire labor and delivery process. Here are a few helpful ideas:

• Have peppermint or lavender scent on hand to relieve nausea and anxiety
• Keep mouth moist to counter act fight flight
• Ask operating team to talk you through everything
• Play music in the OR
• Talk with your doctor and/or midwife on what to expect for recovery
• Discuss breastfeeding options and impediments with the hospital’s lactation consultant

 
Seeding
You should discuss the benefits of seeding with your doctor. When a baby is delivered vaginally, they swallow beneficial bacteria present in the birth canal. Those bacteria colonize their gut, establish their microbiome, and lay the foundation of their immune system. When babies are born via C-section, they miss out on being inoculated with these beneficial bacteria.
 
Before the C-section takes place, a sterile gauze is moistened with saline water. The gauze was then inserted into the mother’s vagina and left to colonize for one hour. It was then removed and put into a sterile cup. Within minutes of delivery, the doctor uses the gauze to wipe and “seed” the baby; starting at their eyes then mouth and down the entire body. With vaginal seeding, it’s believed that a c-section baby can receive many of the same benefits as a baby who has been vaginally delivered, including a strengthened immune system, decreased risk of food allergies, and even a lower chance of developing obesity and type 1 diabetes.
 
Skin-to-Skin with Dad
It has been well documented that skin-to-skin contact with mom after birth is of vital importance; though sometimes it is just not possible to hold your baby skin-to-skin after a C-section. If that is the case, ask that your partner be allowed to hold baby skin-to-skin. Studies have shown that infants held skin-to-skin by fathers after C-sections stopped crying, became calmer, and reached a drowsy state earlier than infants placed in a cot.
 
Read more from Penny Simkin on the “Best Planned Cesarean Possible” (download PDF below).

best_cesarean_possible.pdf
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