Monday, March 29, 2010

Prenatals and Cesarean Birth Plans

This past week I did three prenatal meetings. It was really fun to stretch my doula muscles, do some educating and (one of my my favorite things) talk about birth!

One of them wasn't quite as organized as I would have liked - I felt I could have "led" a little more because mom went off on tangents and used up a lot of our time. I'll have to cram a lot into our second prenatal now.

Another went really really well and I am so glad I took these clients on, even with my close EDD's, because they are so so sweet. I had the best prenatal with them, getting to know them and discussing their birth plan.

Here are some birth fears that came up: More pain than they can handle, Being out of control, Waking up in the middle of the dark of night in a lot of pain, Being 'late' and having to be induced, Tearing (and pain, recovery associated with that), an emergency Cesarean section.

I am a big believer in being prepared, and that is why I always bring up creating a Cesarean birth plan. Another reason is that the United States has a 32% (1 in 3) C-section rate, so it is a very real possibility that one should be prepared for.

I know that many pregnant couples do not like to think about or even mention the possibility of a Cesarean section if they are trying for a vaginal birth, especially if their pregnancy has been low-risk. They fear that simply "putting the possibility out into the universe" will somehow cause it to definitely happen. Learning as much as you can about a C-section ahead of time can only benefit you in the event that your birth reality diverges from your birth plan. Things can change in a second and you may find yourself uninformed and unprepared.

Fear is often associated with the unknown and the inability to have an effect on outcome. You DO have options when it comes to a Cesarean birth. 

I mentioned C-section birth plans in my post And KABOOM! Here's Your Baby!
Here are some options that you have for a planned or unplanned Cesarean section delivery:

Timing of Planned Cesarean: After labor begins vs scheduled before labor begins

Participation by Mother: Mother watches delivery of baby (no screen or lowered screen); anesthesiologist or OB describes events during surgery; no description or watching

Anesthesia: Regional (spinal or epidural); general anesthesia

Postoperative medications: Only at mother’s request (you can refuse sedatives); medications for anxiety, trembling, or nausea at anesthesiologists’ discretion

Presence of partner or others: More than one support person or father only; partner seated at mother’s head; partner stands and watches or photographs; partner not present

Stitching: Single vs. double suture

Environment: Soothing music and quiet talk; aromatherapy; no preference

Contact between baby and parents: Held by partner soon after birth where mother can touch and see; baby held by mother during surgical repair of incisions; baby taken to nursery for observation; if baby goes to NICU, partner goes with baby or remains with mother? A second partner stays with mother?

For more on fear associated with Cesareans, such as about anesthesia, coping and recovery, check out this post at Vita Mutari and Everything I wish I had Known Before my First C-section.

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