All About Caesareans

As both a woman and a doula, I fundamentally believe it is the right of every woman to make informed choices about her body and the delivery of her baby, without judgement or feelings of guilt or failure.

Whether your baby is delivered vaginally, via elective or planned caesarean or emergency c-section, the important thing is mum and bub are healthy and safe.

Making a decision about the right birth for you begins with knowledge. If a caesarean looks like it might be on the cards for you, the good news is, they’ve come a long way in recent years. Let’s take a look at your potential options, and what you can expect.

Elective/Planned Caesareans

This is where having a caesarean has been discussed and planned prior to labour commencing. You might choose to have an elective caesarean for a number of reasons, including:

  • Pregnancy complications like pre-eclampsia or diabetes
  • Previous complicated or difficult delivery
  • Placenta praevia – where the placenta is blocking, or partially blocking the cervix

You may be advised to have a caesarean if your baby is in the wrong position for vaginal delivery—feet or bum first, or sideways. This can often be resolved by Optimal Maternal Positioning and Spinning Baby techniques which, if successful, may avoid the need for a caesarean. If you would prefer a vaginal delivery a doula trained in these techniques can give you advice on your particular circumstances.

If you are having an elective caesarean, you will likely have an epidural block to numb the lower half of your body, which will allow you to remain conscious during delivery. Your partner or support person will generally be allowed in the room with you.

Maternally Assisted Caesarean Sections

Many women report feeling excluded or distanced from the birthing process when having a caesarean. One way to avoid this is to consider a maternally assisted caesarean (MAC). This is exactly what it sounds like. In the case of planned or elective caesareans, it is possible to assist in delivering your baby via c-section, providing there are no extenuating or complicating circumstances.

Prior to the procedure your medical team will talk you through what is required. You will need to be instructed on surgical scrub procedures, and wear a sterile gown and gloves. Once the doctor has accessed the uterus, they will move the baby into a position where you can safely grasp them and bring them up onto your chest for skin-to-skin contact.

During the procedure you will be able to see what the medical team are doing. There will be blood, and sometimes getting a baby into the right position requires quite a bit of manoeuvring, so you and your partner need to be sure you won’t be distressed by this.

Your medical team will tell you if MAC is likely to be possible for you, and discuss how things may unfold in your individual circumstances.

If you feel assisting is too much, you can opt to simply have the c-section without the usual drape hiding the action, so you can watch as baby emerges from your uterus.

Emergency Caesareans

Sometimes, once labour has begun, it becomes clear a caesarean might be necessary. This may be the result of foetal or maternal distress, or stalled labour.

Having a c-section might not have been your preferred birth plan, but try and remember the only important consideration is a healthy mum and bub. How that happens is secondary, and choosing a healthy baby is not failure.

Emergency caesareans will generally mean you are not able to have skin to skin contact with your baby immediately after birth, since you will probably have had a general anaesthetic. However, once baby has been checked by the medical team, there is no reason your partner can’t have that wonderful bonding experience.

The Role of A Doula in Caesarean Sections

Whether you are having a planned c-section, or you require an emergency procedure, a doula can provide support during pregnancy, delivery and the postpartum period.

A doula will assist with keeping you and your partner calm and relaxed during birth, which can be particularly important during a c-section. They can take care of things like ensuring the music you have chosen is played or taking photos or videos. This allows you and your partner to concentrate on this wonderful experience without distractions.

If it is necessary to take baby to NICU, a doula will stay with you and provide support, while your partner goes with bub, which ensures peace of mind for everyone.

The Right Time

If you are considering an Elective Caesarean, you should think carefully about the timing of the procedure.

If medical factors allow, the optimum time is 39 weeks.[i]

The last couple of weeks of pregnancy is when your baby’s lungs fully develop, and the longer you can leave baby to develop in-utero, the better.

Whilst it is not always possible to wait, studies show baby’s delivered earlier than 39 weeks are more likely to experience respiratory problems, and may also experience learning and behavioural challenges later in life.

The wrong reason to deliver earlier than 39 weeks is because it’s more convenient for the doctor or the hospital.

The Risks

As with any medical procedure, a caesarean section, whether planned or emergent, carries risks you should be aware of. It’s important to discuss these potential risks with your medical team at some time during your pregnancy, whether or not you are planning on a caesarean.

Knowing what the potential outcomes are will help you feel in control of the process, and studies have shown that this contributes to a positive birthing experience, whether baby is delivered vaginally or via caesarean.

Recovering from a Caesarean

However you look at it, this is a surgical procedure. Recovering from a c-section takes longer than recovering from a vaginal delivery. You will need to:

  • Take care of the wound site until the stitches or staples are removed and incision site shows new, pink skin
  • Avoid driving for 4-6 weeks
  • Avoid lifting anything heavy, like washing baskets or older children for 4-6 weeks
  • Avoid heavy housework, like vacuuming for 4-6 weeks
  • Ensure you consume plenty of water and fibre to avoid constipation as straining can cause damage to the wound site

Since recovering from a caesarean is longer than recovery from a vaginal delivery, it’s worth considering the support of a post-natal doula to assist you with chores you can’t undertake, and provide you with advice and nourishing food designed to assist with healing.

If you required an emergency c-section, it is even more important to monitor your emotional reaction in the days and weeks after birth than following an elective c-section or vaginal delivery. A doula can provide a great sounding board for your feelings, and is trained to identify if you are approaching overload.

A Word About VBAC

VBAC stands for Vaginal Birth After Caesarean. Whilst around 76%[ii] of women who have had a c-section for their first delivery go on to have caesareans for their subsequent deliveries, it’s important to know this is not always necessary.

With the right advice and support, it is possible to have a subsequent vaginal delivery, providing there are no complications. This is something you should discuss with your medical team during your pregnancy. If they are in agreement, a doula can provide you with advice on how to prepare yourself.

If you are pregnant and have been recommended to have a caesarean, or are considering one, and would like to chat about your options, please don’t hesitate to give me a call on 0422 258 771 or contact me here.

[i] safetyandquality.gov.au/about-us/latest-news/media-releases/high-rates-early-caesarean-sections-are-putting-australian-babies-unnecessary-risk

[ii] https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/labour-and-birth/method-of-birth