Let's Talk Caesareans

How can a caesarean birth be the most positive and empowering experience even if unplanned? Plus let me share with you our own caesarean story ❤ WRITE A CAESAREAN BIRTH PLAN

I believe this is important whether you are planning an elective caesarean or a vaginal birth. The caesarean rate is around 25% in the UK so even if you are planning a vaginal birth it is still wise to have a well-thought out Plan B.

DO YOUR RESEARCH

You can still incorporate many things you would have in a vaginal birth into a caesarean birth plan. Examples include:

- your choice of calming music

- low lighting in theatre (although bright lights on your belly so they can see what they are doing!)

- low lighting in theatre (although bright lights on your belly so they can see what they are doing!)

- the screen being lowered so you can see your baby emerging

- ask for a maternal-assisted caesarean where you can reach down and help deliver baby's body yourself - many obstetricians may take a deep breath at this but this woman-centred technique is becoming more common around the world, particularly Australia (see this photo from @tesoromaspreciado taken at a Venezuelan hospital)

- delayed cord clamping and cutting to enable baby to receive as much of the blood still flowing into him as possible from the placenta - it should be routine to wait at least 1 minute except in the unlikely event baby needs resuscitating

- skin-to-skin in theatre (calming for baby, helps regulate baby’s heartrate and breathing, facilitates bonding and breastfeeding) - tell your midwife/anaesthetist you want this as they would need to ensure easy access (your chest bare of your gown and monitoring wires)

- give baby access to the breast if you are planning to breastfeed

- use a towel/blanket you have slept in to put over baby soon after birth, helping to transfer your skin flora to baby (as with skin-to-skin)

GET INTO THE RIGHT HEADSPACE

Understand the rationale behind why you are advised a caesarean and own that decision - it is yours to make after all. If you are unsure of absolutely anything, ask questions and so your own research! Feeling it is the right decision will help you get in the right mindset and be able to fully appreciate the moment of your baby's birth.

USE YOUR RELAXATION TECHNIQUES

Whether the caesarean is elective or unplanned, you may feel apprehensive - you may have concerns about baby’s health or your own and it is a major (although common) operation so somewhat significant! The calmer you are, the lower your stress levels will be (I am talking adrenaline, cortisol...) and the calmer baby will be. Just 3 slow deep breaths can be enough to help you start relaxing.

Do all you can to feel safe and happy will also help you release the feel-good 'love hormone' oxytocin which will in turn pass to baby. This hormone also plays a major role in bonding so the more of it you can have at the time of birth the better! So ask for a kiss, hand or reassurance from whoever is with you 🧡

SHARING OUR POSITIVE CAESAREAN BIRTH EXPERIENCE

I want to share our caesarean story, because it shows that caesareans can indeed be positive experiences, even where you had initially planned a vaginal birth.

This was me moments before walking into theatre for the caesarean birth of our twin girls. I had had to work through some emotion leading up to this day and accept that caesarean was the safest way for our twin babies to be born.

I remember so much of that day. The butterflies in my stomach as we got the train into London surrounded by commuters off to their day jobs – us with our hospital bag packed looking like we were off for a few days of sight-seeing. I remember the excitement that we would meet our girls but the anxiety that they would likely struggle but how badly? I was only 34 weeks pregnant and felt torn over whether it could possibly be right that they be born so soon…

At the hospital, the anaesthetist made me laugh and put me at ease. The obstetricians were so calm and professional and the midwife so matter-of-fact. I felt safe. It perhaps helped that I knew and trusted them all already as worked as a midwife at the same hospital.

The spinal anaesthesia was done in what felt like a second and before I knew it the drape was raised so I couldn’t see in front of me and the surgeons were starting. I could feel touch and a surreal feeling of them rummaging around inside me, but it wasn’t painful. I tried to imagine exactly what they were doing as had seen so many caesareans before and knew the sequence of steps. My husband didn’t have to use his imagination at all as was standing watching the entire thing!

The drape was lowered to reveal the first little head and set of shoulders squeezing out of me. She had a look of shock and disgust on her face as she was brought out into the cold. I felt such relief at her cry, as she was the smaller one we had worried most about. Our second had a similar reaction to being taken out of her warm home and I don’t blame either of them! They were passed to me all bundled up but the first was very soon taken to the special care baby unit due to her small size – just 1.6kg. It felt so wrong when she was taken away.

I was wheeled into the recovery area where I lay skin-to-skin with our second daughter. She started to breastfeed (another relief that she was able to do this) and then she did the most gigantic black tarry poo all over me. My husband had gone to the special care baby unit immediately after the op and didn’t come back for hours as he had felt bad leaving our first. It would be in the evening that I had enough feeling in my legs to be able to get into a wheelchair to make it up to see her and hold them both again.

My recovery was luckily very straightforward, perhaps partly due to the small incision (the obstetrician knew they would be tiny after all!). Walking by myself the following day pushing the other twin’s cot was a bit much as I came close to fainting alone in the lift, but I slowly made it! The greatest challenge in those early days and weeks was producing enough milk for the two, but that story can be for another post 😉

WHERE DOES HYPNOBIRTHING FIT IN?

Hypnobirthing does not promise you any particular birth - any hypnobirthing teacher who tells you this is lying! But it does give you the skills to feel more confident in your decisions, to feel more in control and more relaxed and at ease. It also gives you the knowledge and tools to be able to tailor your original birth plan to any twists and turns - and that includes potentially to a caesarean. Being prepared is everything.

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