A Doula for Your Cesarean Section

Yesterday I had an extremely awkward conversation with my pregnant professor. It was one of those moments where I maybe should have kept my mouth shut, and refrained from spewing the birth-related word vomit all over someone who didn't ask for it. It happens! Especially when the topic of elective cesarean sections come up.

An elective cesarean section is one that is schedule ahead of time by the doctor and mother.

Reasons for this are:
1. suspected macrosomia (big baby)
2. mother and doctor want the convenience of picking the date and time of delivery
3. mother is tired of being pregnant
4. mother is "overdue"
5. baby is breech
6. medical conditions for the mother (hypertension, etc)
7. medical conditions for the baby (suspected deformity, etc)

Birth workers get very touchy when the idea of an elective cesarean section comes up if it is not for reason 6 or 7, above. The first 5 reasons (with some grey areas, like going past 42 weeks) generally create more dangers for mom and baby when compared with spontaneous vaginal labor and delivery.

Having a Cesarean before labor begins on its own increases the chance that a baby will be born premature (as due dates are merely estimates and can be wrong, and ultrasounds in the third trimester are known to be off by up to 3 weeks and 2 pounds). Premature and low birth weight infants, especially those born by cesarean section, have respiratory and sucking problems and spend more time on the ventilator and in the NICU. They also cost billions of dollars in health  care.

When cesarean is elective with no emergency present, the woman's chance of dying from the procedure it self is nearly three times that of a vaginal birth. Moreover, the mother has a much longer recovery period from the major abdominal surgery, which makes caring for her newborn much harder.

When an elective cesarean section occurs for a medical reason, such as fear of uterine rupture (after considering VBAC!), one can still create a Cesarean Birth Plan and Bring a Doula!


Yes, thats right, A DOULA CAN HELP YOU WITH YOUR PLANNED CESAREAN SECTION.
Which is what my birth-related word vomit was all about yesterday - the support a doula can provide for a mom and her partner during a cesarean section.

Informational Support
For a planned or even the possibility of an emergency c-section, a doula can provide a ton of informational support. The biggest of which is helping you to create a cesarean birth plan. How can I plan for a surgery in which I will play little to no part? you might ask. Many people do not know that they have many options and a doula can inform you of these.

Would you like to specify a double suture as opposed to a single suture? Or have your urinary catheter placed after your spinal epidural? 
Would you prefer that the surgeons keep the chit-chat to a minimum? (I have heard stories of women lying there scared and uncomfortable while the doctors and nurses talk about things completely unrelated to the procedure)
Would you prefer that your baby be brought to you (if baby is healthy) as opposed to immediately placed on the warmer?
For more help with cesarean birth plan options, see this post (or talk to a doula! :)

Additionally, a doula can help you and your partner know what to expect with a cesarean section, and also inform you of the newborn options that you are allowed to decline if you wish, and so on.


Emotional Support
The doula can help allay fears before, during and after the surgery. If you are disappointed that you have to have a cesarean section rather than a vaginal birth, the doula is there to discuss your feelings with you and your partner She can help you practice relaxation techniques, and talk to you during the procedure to keep you calm. She can help keep partners calm, especially during prep time, so that they are effective support for mom as well. She can still be your advocate in the ER - remind the surgeons to please describe, or not describe, the procedures as they are doing them, that mom would like to do skin-to-skin as soon after birth as possible, etc.

After the birth, the doula is there for you while you process your feelings about the birth. While in the recovery room, the postpartum room or at home, its great for moms to have someone to talk to. She can recommend resources like ICAN and other support groups.


Physical Support
Just having someone else there can be a bigger help than is realized. If dad wants to photograph and touch his baby while the baby is in the warmer, the mother is left alone on the surgery table. If the baby must go immediately to the NICU, and dad goes with the baby, the mother is also left alone. This can be a scary time to be alone - the procedure continues for around 45 more minutes as the surgeons suture you back up, and you continue to feel discomfort and concern for your baby. The doula can stay by your side throughout all of this, if the obstetrician allows. This varies from doctor to doctor and must be discussed ahead of time.

The doula can also help with breastfeeding after birth. This is no small feat after having abdominal surgery! The doula can help you figure out how to hold the baby and get the baby to latch, in addition to all the regular breastfeeding support typically provided postpartum.


You will be surprised how much having this kind of support can really help with your recovery!

photo: doula network of fort wayne, which also has on their webpage a story written by a mom who was glad she had a doula at her cesarean section!

So, who knows if I positively informed my professor, and helped her consider the support a doula can provide even for a c-section, or if I just annoyed her with unsolicited advice. Its a fine line we walk sometimes!

My Fifth Baby

"Congratulations on delivering your fifth baby!" is what my mom said on the phone when I told her I was on my way home from a birth. Technically, I did not deliver any babies, but this was indeed my fifth lifetime birth attendance!

This birth occurred on friday morning and it was quite an adventure. Since I was away camping in the mountains for the weekend, I haven't been able to type it up until now. It is the birth story of the Multip who I had just had my first prenatal visit with the evening before, who was worried that she would have the baby while I was gone over the weekend. I had gathered some on-call doula contacts for her to call if she went into labor while I was gone, but we didn't need them!

On the morning of May 7th my phone rang at 6:00 am. Your husband told me that you had been having strong contractions since about midnight, and that your water had been steadily leaking since 2:30 am. You had called your friend to have her come get your sons, and you were wondering what you could do to slow labor until they were picked up. I suggested that you get into the bathtub and I would be on my way to your house!

I pulled into your driveway at 7:15 am and my phone rang. I picked up and said, "I just pulled in!" and your husband said "Oh, we just pulled out!" We must have just missed each other! You were getting out of the bath when your water had broken and you suddenly had the urge to push. You gathered the kids in the car, who hadn't yet been picked up, and rushed off to the nearest hospital. It was not the hospital you had planned on delivering at, but it was too late to drive to the further one. Your husband was amazing - he had me on the phone giving him directions to catch up with him, was helping you, and driving all at the same time! He was reassuring your sons that mommy was ok, she was doing exactly what you have to do to get the baby out. He was rubbing your back and reminding you to breathe and reassuring you that you were doing great. I had him remind you that you were doing it all for your baby, who you would see so soon!

We were 4 minutes from the hospital and we were in slow-moving traffic on a one-way road when your husband saw an ambulance in front of him. You were exclaiming "the baby is coming!" so he pulled in front of the ambulance, jumped out, and asked if they could help you get to the hospital because you were having a baby. I was only a few cars behind you in the lane, so I threw on my hazard lights and ran up to where you were. You held onto me and your husband as the emergency techs prepared a stretcher for you. We reassured you that you were ok and you were almost there! You asked if I could go into the ambulance with you and it hurt me to not be able to... my car was parked in a travel lane and I had to move it! I ran back to my car to find a place to park it, but the ambulance had pulled away already. I got into my car and made my way to the hospital, a few minutes behind you.

In the hospital parking lot I saw your friend standing with your kids at your car so I knew that had been taken care of! I rushed into the Emergency door but didn't see you. I asked at the security desk and he said he'd have to find out a room number before I could get a badge. I told him that you had just come in pushing and probably didn't have a room yet. He sent me to registration, who was also unsure what to do since you hadn't stopped to register with them either. I told her you were brought in by an ambulance, and you were pushing already, could she please just show me the way to labor and delivery?! Finally she said she'd walk me there. Over the loud speaker I heard a call go out for "Any OB in the hospital" and I knew which room you must be in!

I rushed in and found you on the delivery bed with your husband by your side. The room was full of nurses and they had put monitors, an IV, and an oxygen mask on you. They prepared the lower part of the bed for pushing. Your husband and I were holding your hand and reassuring you, listening to you. You were moaning and grunting, but just breathing and resting in between urges to bear down. A nurse shoved me out of my place by your head and said, "Ok now you're going to hold your breath and push as hard as you can and DON'T MAKE ANY NOISE."

What?! Preposterous! Don't make any noise?! That doesn't make sense at all. I was so frustrated. I decided that since I didn't know these women and were never going to have to see them again and my job was to help my client first and foremost, I was going to ignore them and give you my own instructions even if they went against the nurses. The nurses were all yelling at her to push push PUSH Harder! And I was reminding her to breathe. When I said "You can do some nice low sounds... Ok blow it out..." that kind of thing, the nurse yelled "DON'T BLOW IT OUT! If you're making noise you're not PUSHING!" GAH!@#%$^!

Why are they in such a rush to get the baby out anyway? A mother having her third baby, with no drugs or epidural anesthesia KNOWS how to birth her baby, how to follow her urges to bear down, she does not need to be directed! And she certainly does not have to hold your breath and remain silent to push! Purple pushing is the WORST. Mom responded to their orders to push, but she took a breath when I told her to as well.

You told me later that you were listening to me and not to them. Your baby crowned quickly and suddenly an OB arrived. She caught your baby, cut the cord, and he was whisked away crying to the warmer. Again, I'm not sure what the reasoning for this was. Your baby was clearly breathing and he pinked up quickly. He received an 8 and a 9 on his Apgars. I grabbed my camera and encouraged dad to go over to see his baby. He took some photos and we showed them to you. Your baby was 5 lb 10 oz born at 8:09 am. You had no tears to repair - yipee! 

The OB began to massage your uterus and tug on the cord a bit to get the placenta to come out. She said, "put your hand down," and you thought she meant onto your stomach. When you put your hand down on your stomach she jerked her hands away and angrily said, "Uch! You touched my glove! Now I have to go get new ones!" because they were contaminated from your hands, and told you in an annoyed voice that you didn't mean put your hand down there! Wow was she pissy. This hospital gets a very bad score in my book. Placenta came out fine a few minutes later. They wrapped the baby and got you settled in bed.

Your baby was handed to you and you were so happy! Unfortunately, because you weren't registered with the hospital, your husband had to run down to the car and all around with your paperwork getting you into the system. I took a ton of pictures. Your friend brought your sons up to meet their new baby brother! This is getting to be one of my favorite parts - when the siblings meet the new baby! 

Luckily all the nurses who tended to you postpartum were very nice. You had the shivers so I made sure the nurses brought you socks and warm blankets. I assured you this was normal and I rubbed your cold feet. We encouraged your new son to latch on at the breast, and he began to nurse very well! I reminded you of a few breastfeeding tips and stayed with you a while until your husband came back. I held your hand while the nurse palpated your stomach to encourage it to contract. I brought you some apple sauce. The nurses waited until you were done nursing and then took the baby to the nursery to do some tests and wash him. Your husband went with him. After your husband returned, you were cleaned up, and moved to the postpartum room, I congratulated you and left. 

This was my third "fast" birth! I am getting all the quickies! And because of my late attendance it doesn't count towards certification. I am grateful for the experience and being able to help my clients. I am also thinking maybe I should only work with first time moms, lol ;] 

Its crazy to think that I only met this client one week ago! I visited them for their postpartum visit yesterday evening. I brought her homemade roasted red pepper and tomato soup, which I looked up the recipe for, to meet her non-gluten/specific carbohydrate diet! I chatted with mom about the birth, held the baby for awhile, discussed breastfeeding, gave her some samples and brochures I have. Dad took a photo of me, mom and the baby together which I can't wait to put up on my business site!

Each birth, each client and each postpartum visit creates more things that are new to me and that I have to research. For instance, today she asked me about gas/burping a breastfed baby. My newborn care expertise is spotty, but I was under the impression that keeping a baby propped upright after feeding was sufficient to quell spit-ups and gas, and that in general breastfed babies have less gas and spit-ups than formula fed babies. She seemed concerned that he wouldn't burp after each feeding and then he'd make noises later that sounded like he had some air coming up. I looked it up just now... and found that I was right. Breastfed babies won't burp after every feeding. Sometimes they get gassy one hour after feeding. Generally its just the result of an immature GI tract, and it will get better over time. Now we've all learned together!

While I was at their home, client's mom thanked me for everything I did, saying it sounds like I was a big help. Its so nice to hear that, especially coming from her, because it means that my client told her mom that my presence was definitely appreciated. Also, my client told me that when I rang the doorbell, her 8 year old son looked out the window, saw me, and called, "Its Your Birth Sister!" (my business name), which is just so funny!

Re-Blog: You Buy the Hospital Ticket, You Go For the Hospital Ride

You Buy the Hospital Ticket...You go for the Hospital Ride

from Navelgazing Midwife 

(I originally wrote this in mid-2006. It's just as relevant today.)

Once upon a time, doulas were in the birthing arena to help women achieve the births of their dreams. I distinctly recall telling women I would be a go-between for them between the medical staff and themselves, the laboring couples. At doula trainings and gatherings, I know I heard doulas teaching each other how to be manipulative with the staff, yet soft-spoken and seeming demure and obsequious.

Doulas had code words to use that meant "Time out! Ask the medical staff to leave so you can talk alone (and by alone, I meant with me, too!) before deciding yay or nay." Doulas right in front of my face (was that a mirror I saw?) - and the doctor's - said things like, "Remember when we talked about your birth plan last week and you said no matter what, you didn't want an epidural?" or "Do you want me to remind you of the risks of that position before they put your legs in the stirrups?" or "Doctor, doesn't pitocin rupture uteruses?"

It wasn't a decade before the role of the doula began shifting. Once DONA (Doulas of North America, now DONA International) jumped in and incorporated the concept of a doula into a profession, we'd already heard about "renegade" doulas that commandeered labor rooms and antagonized the staff so dramatically, doulas were threatened with expulsion from labor and delivery rooms around the country. Therefore, DONA grabbed the opportunity to squelch such power-tripping by insisting that doulas not speak on behalf of the client or her family.

Doulas were not permitted to do anything that smacked of medical or midwifery care - no fetal heart tones, vaginal exams or blood pressure checks (something many doulas had been doing for years). DONA snapped the profession's back into sharp attention, kept her hands stiff at her sides and instructed for her (the multitude of doulas) to keep her eyes straight ahead and not look around.

By doing this, DONA saved the role of a doula, if not the very word itself. Doulas began changing their spiels to encompass words such as "supportive," "reminder," and "belief in you" - removing forever, at last in any literature or in public venues, the implication of advocate or director. Accepting that the changes were the only ones that could be made, women were suddenly back in control of their own birthing destinies.

Or were they?

Back to the beginning once again, the issues that brought doula-dom into existence in the first place - archaic birthing practices, patriarchal attitudes towards laboring women and unsubstantiated reasons for a plethora of rules and regulations - remained. What's an enlightened woman to do?

Why, create a birth plan, of course.

Birth plans, in existence long before there were doulas (either in name or in idea), over time, have become more and more explicit and restrictive. I have easily read over 3000 birth plans and can tell you the grand majority of them are the same in 98% of their content.

• No episiotomy

• Allowed to move around in labor

• Allowed to eat and drink

• No formula or pacifiers

• Dad to stay with me the entire time

• No enema (yes, I still see this on birth plans)

• No shaving (unless you live in the backwoods of medical care, this is so absurd to put on a birth plan it is laughable - mostly laughable to those you are speaking to, the nurses in labor & delivery)

... and the litany goes on and on.

Interestingly, there are dozens of websites and hundreds of baby-oriented books that make a birth plan into a formula for folks to fill in the blanks. How creative of them! It is extremely frustrating getting a cookie-cutter birth plan - as mentioned above, so many are exactly alike, why does anyone write one at all? I'm all for using one of the pre-planning birth plans as a template so your own needs and desires can come out of hiding. Sure, if you don't know what your options are, how will you know what to choose? But, my point is, once you have chosen, dump the look-a-like and create your own plan... with your own words... your own personality.

And make the thing SHORT. I mean short short. A 3x5 card on one side. Double-spaced.

(I can hear the ruckus even now. "But, you're just saying you don't like them because it limits you!" or "You would say that, you medwife person. You don't want anything individual interfering with your care." Bull. I'm telling it like it is to save your butts in labor and delivery! I'm trying to help you understand how tired they are seeing birth plans, how they never read them [unless you get some alien nurse who happens to be in midwifery school] and how it is a waste of your energy to write the same same same same same same same same thing as every other person that comes onto their floor. Dispense with the extraneous and write what matters!)

• I will ask for pain medication. PLEASE DO NOT OFFER IT TO ME! (Make a pretty sign and tape it to the outside of the door. Make a couple in case it disappears.)

• Please, keep lights low unless it is crucial to my life or that of my child's. (Another great door sign.)

• Please KNOCK before entering (Door again.)

• Risks, benefits, consequences of refusal and alternatives are to be discussed before EVERY procedure on myself and my baby. (I learned that "informed consent" does not legally mean discussing risks and benefits. Watch that blanket form you sign upon check-in!!! It allows them to say they obtained informed consent.)

It’s important to remember you attract more flies with honey than with vinegar; be kind, but be direct.

So, looking at that list, doesn’t that set the stage for retaining autonomy and letting the providers know your wishes? It’s also important to be open to listening to what they have to say. They absolutely might have something valid to share. It's been known to happen. If the above points aren’t your hot button issues, make your own points - but make them succinctly.

I believe the main reason for a birth plan is to facilitate communication between the parents... allowing them to see how each other feels about such important things like pain medication, circumcision and even vaccinations. Birth plans are great for everyone talking to each other. If it worked with the doctors and nurses, all the better, but it usually makes for some pretty antagonistic and stiff discussions in a prenatal visit and a bunch of rolling eyes in labor.

Once again, if you buy the hospital ticket, you go for the hospital ride.

If you buy a house and stand inside your palatial mansion saying to the builder, “But, I wanted a log cabin!” - the builder might wonder what the heck you were thinking going to a master-palatial-home-builder instead of a log cabin specialist.

If you want soy milk, don't milk a cow.

Why... why oh why... if you want a "home-like birth inside the hospital" aren't you considering a home or birth center birth? If you want control, why go where egotistical birth is the norm? If you want autonomy, why go where lawsuits and defensive medicine are the rule?

Ohhhhhh, because it's safer? Is that what you think? Oh!! I see. Well, if you believe hospital birth is safer and that's why you want to be there, then BE THERE - with all it has to offer... in all its guises... in all its paranoid glory. Why would you try to manipulate a hospital's/doctor's/nurse's actions any more than you would try to manipulate the car mechanic's? If they aren't good enough for you, find another! (This is, of course, where choice is an option. I don't live in a dry well.) You're hiring someone to do the best they know how to do. LET THEM DO IT.

It is so funny hearing me say this. I really did used to be the doula who could get it all for her client - I am a great doula and monitrice - but it is more frustrating than words can say when a client says things like, "No drape between me and the incision during my cesarean because I want to watch." How the heck are you going to see your pubic area? You even can't see it when you are standing upright and leaning over! The curtain isn't just because you might not want to see the surgery (if you could remotely see down that far in the first place), but it is also in case you projectile vomit into your incision.

Note: Hospital rules are not in place to annoy you. Some are really important to the life and health of you and your child. Do people forget that? (Yes.)

I do understand that a number of women don't have a choice about where they deliver... there aren't midwives, the doctors are all the same, hospitals won't let them do VBACs... I do understand. However, in that case, I have found that going along for the ride makes for a much better experience instead of fighting the whole way. I don't want that to be a rape or abuse analogy at all, but one of "if that's what I have to have, then let me be gentle about it and see how good the experience can be."

I have seen women who go in without pre-conceived plans have far better birth experiences, with less tension and worry, than women with elaborate desires and wishes written down or vocalized. Women tend to be treated more kindly if they seem to be on the same page as the nurses' and doctors' agendas. This might be wrong or unfair to some, but is the truth.

So, how would I counsel someone who medically needed to be in the hospital? I would encourage remaining open to what the nurses and doctors had to offer. If they offer something the woman doesn't want, say, "No thank you." Simple. Concise.

I’ve been to births where my clients had no scripted birth plans and who had beautiful hospital births - ones where the nurses were respectful and we were left alone a great deal of the time to talk and laugh and spend time with each other.

My concern, and the reason for writing this piece, is in unrealistic expectations - across the board... with the client, her family, the doula, the childbirth educator... even midwives. Sure, docs and nurses also have unrealistic expectations, of another sort; many (most?) believe every woman has to have an epidural to have a happy birth experience, or that no one should have a VBAC. Those untruths are as incorrect as the ones that say if a woman has a birth plan she'll have a better birth.

I simply do not see that as realistic - or even close to happening in real life world. Far more often, I watch as hard worked-for plans fall away and women feel more and more guilty and sad for the draining away of their desires. What if we worked on changing the reality of those desires? What if doulas and birth assistants and childbirth educators bluntly laid things on the line and said, "Just because your doctor agreed in the office doesn't mean it's going to happen in real time. You might never see your doctor again. Your doctor, after listening to your birth plan in the office, might know he will have to convince you once you are in labor that his/her way is the way to go.” It is almost impossible to tell what someone will do (midwives included) until after the fact.

Doctors often say there is no such thing as normal birth except in retrospect. The same can be said for a provider doing what they say they will do.

Maybe if we (doulas, childbirth educators, midwives, nurses, doctors, etc.) all got real with women, they might make different choices altogether. Maybe they would get really cranky and start demanding more humane births instead of the lip service paid, touting million-dollar renovations in lieu of hiring more nurses with compassion and a gift for listening to women in labor... not just wanting to get them drugged and quiet.

I don't know what the absolute answer is, but I do know it can't keep going the way it is... everyone fake dancing that each side is listening. Really, knives are stabbing each other, scalpels cutting bellies, women medically paralyzed, drugs given to women begging for natural births - doctors and nurses working in a haze of "what will this look like in court?" and really, really believing they are doing the best thing for the health and safety of the mother and child.

Someone needs to just speak the truth. And it starts with me.

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.

You shouldn't 'Try' to have a 'Natural' birth

"Satisfaction and fulfillment in birth do not depend on an absence of medical intervention; they do depend, however, on the degree to which other essential but intangible ingredients - human values - are present."  - Penny Simkin 



You shouldn't try to have a "natural" birth, you should prepare to have an empowered birth!

The most important thing is not whether or not you succeed in birthing without any help or medical interventions. If you make that your most important goal for your childbirth experience, then you will feel even worse if you feel you've failed.

Your goal should be to adequately prepare for every possibility - know how you feel about every single medical intervention or care provider rule and keep your mind open to how your feelings about them may change once you are in labor. The key is being informed.

If you don't know your options, you don't have any.

Ideally, one should remain flexible. It is important to realize that things don't work out how you've envisioned, whether you're a first time mother or a mother 10 times over! Each labor experience will be new and different. And no one will deny that childbirth is challenging.

If you prepare for flexibility you will 1. be fully knowledgeable of all your options ahead of time, 2. be able to make informed decisions should some turn of events occur, 3. feel much better emotionally after the birth.

I read in a recent post on interventions at Stand and Deliver:

"The prominent theme in these four sets of birth stories is that the women who felt the interventions were necessary and welcome, rather than unnecessary and traumatizing, freely chose the interventions on their own--on their own request, on their own timetable, and on their own initiative. They knew it was time for assistance. They were the primary actors in their births, rather than recipients of others' agendas. They held the locus of control, even when that meant asking others to do things for or to them at some point (IV, epidural, Pitocin, or c-section)."

This reminded me of something I learned about in my doula workshop...

Studies on women’s long-term perceptions of birth demonstrate that the way women are treated by birth professionals determines how satisfied they are with the experience. A study by Penny Simkin, in particular, demonstrated that the women who felt in control of their situation, instead of being treated as ignorant or powerless, had the most satisfying birth experiences. Her study showed that women did indeed remember their birth experiences in detail even twenty years later, and they very much had an impact on their psychosocial health. 

I found that if particular factors were present, women are more likely to feel long-term satisfaction... The women with positive feelings today recall being well cared for and supported by the doctor and nurse, whereas those with negative feelings today tend to recall negative interactions with staff...


Control over what was happening to them and the decisions about their care were important factors in long-term satisfaction. Women whose doctors and nurses said and did things that they did not want still feel anger and disappointment...


The way a woman is treated by the professionals on whom she depends may largely determine how she feels about the experience for the rest of her life. (Just Another Day in a Woman's Life? 1991)

These are more reasons why it is great to have a doula by your side. Your doula can help you feel powerful, in control and supported. She can help you maintain this even if something unexpected comes up and you must alter your birth plan and be a little flexible.  She will have helped prepare you for all possibilities, remind you of your options, and you will feel much better for having empowered your birth experience!

And KABOOM! Here's your Baby!

If you've never seen a cesarean section and want to watch one that doesn't actually show the incision and the blood, you can watch the one that was shown live on the Today Show this morning.

I like when someone says "happy birthday!" to the baby :)  Too cute.

"What percentage of deliveries are by c-section?" Note that the doctor says 25-30% and recall how the World Health Organization says anything higher than 10% is bad for moms and babies. Also pay attention to how she lists "baby too big" as a reason to do a c-section, which is actually something that they tell moms to get them to do c-sections.  In reality, guessing a baby's weight is done by ultrasound and is frequently inaccurate. Furthermore, many women have successfully given birth to babies of even 11 lbs or more vaginally!

The doctor also lists "if the mother has had a cesarean section before" as an indication to have a c-section, and then when asked "if she gets pregnant again and the baby is a normal size she can have a vaginal delivery?" and the doctor says "absolutely, absolutely."  Hmm... that seems like mixed messages.

In case you didn't know, to sew up the uterus they actually take it out of your body and place it on your abdomen.


Did you notice how she went over to the mom and said to her "its very easy to get left behind... and everyone forgets about the mom."? How sad! She's just stuck to the table behind a sheet while doctors are inside her body and they don't even give her the baby to hold! They take it away for a really large amount of time to do suctioning and tests which they could definitely do while the baby was with mom.

This is a great reason to have a doula. The doula can tell mom what's happening, where the baby is and what they're doing to it, request that mom be able to hold her child for a bit, etc. She can stay with mom while the is being sewn up for the next 45 minutes, especially if dad has to go be with the baby in the nursery.

This brings up a great topic: a C-section Birth Plan.  Dou-la-la wrote a really great post about this recently in which she wrote:

Why bother with a birth plan if you're having a c-section because you don't really have any say in what happens, right? Wrong. Even when you are expecting a c-section, there are still choices that you can make during and/or after the birth. Knowing what your options are can help you feel more a part of the birth experience rather than just an observer. While researching your choices, you will become better informed on what your doctor and hospital's expectations are and what you can/cannot do in a hospital setting.

I suggest going to read the post at the link, because she makes a good case for thinking about a c-section birth plan even if you never in a million years think you'll end up with one. There are also some awesome suggestions for things to include in just such a plan!