Cesarean Section Birth

There is this nugget of not-so-feel-good wisdom my mom likes to drop on me occasionally which goes like this:
“They say, if you want to make God laugh, tell him your plans.”       – Unknown
Having a natural birth was something I didn’t have to give second thought to. Naturally, it felt like the right and most perfect thing to do for my baby and for my body. No drugs in. No painkillers. I imagined myself tuning in to my body’s commands, obeying them and birthing a beautiful baby at the end. With that being said I’d like to share my original birth plan, avenue I took to get there and additional thoughts. All of the following plans probably had God rolling on the floor laughing.
First, a quote: “Natural childbirth isn’t when you do nothing to prepare for the birth; on the contrary, it only happens when you do many things to prepare.” – Dawn Freeman
In preparation for having my first born I decided to take a 10-week childbirth education course with instructor, Chantal Wilford at Birthways in Sarasota. My mother was in attendance as well seeing how my husband was/is working outside of the country. My soon-to-be-mommy mind expanded to great proportions each week as I learned new and invaluable information, techniques and my rights as a future breastfeeding mom in America. While topics such as breastfeeding, co-sleeping, baby wearing and circumcision were all touched upon, I wouldn’t say this is where I benefited most. Topics that really grabbed me were those in pain management during labor, various birthing videos, making decisions (using your B.R.A.I.N.) in both emergency and non-emerg situations and topics that stressed becoming a more informed patient. I won’t cover 10-weeks of lessons here, but I do suggest moms wanting to have a natural birth take some kind of course if available.
Developing a birth plan was one assignment that proved most beneficial. Here is my exact original birth plan minus some of my personal deets:
  • Allergies to medications: NKA
  • Medical conditions / concerns: Hearing impaired. Please speak up and speak clearly if needed.
  • My support people are: Mother & Husband

I would like to be kept fully informed of my options and be involved in decision making. I am open to suggestions to help me have a safe, healthy baby with the least amount of invasive interventions. Let’s have fun and deliver this baby together!
While at Birthways, I’d like to have the flexibility to try for a water birth if best for baby and mom, but if needed to have the baby outside of the tub. Movement, music, aromatherapy, food & drink, low light are all welcome dependent on my mood. These are things I’d like to go with the flow on at the time of labor. Lastly, in addition to my support team, I’d like for Valerie Joy McClintock-Gipe (Photographer) to be on-site (if available) to photograph my birth story. On the quirky side: I have no desire to keep my placenta, but would like a photograph with me and this amazing organ for keepsakes.

  • If a cesarean is needed, my mother, husband and mid-wife are to remain with me and/or go with the baby.
  • I am aware of my options for pain medications and will ask if desired.
  • I’d like to be up and moving around as much as possible if desired.
  • I prefer to tear than have an episiotomy, unless there is an urgent situation requiring it.
  • I’d appreciate having the room as quiet as possible during the 2ndstage and birth.
  • If baby’s condition is stable I’d like the cord to stop pulsing before it is cut and to have skin-to-skin bonding right away with initial evaluation of baby done with the baby in my arms unless medically needed.
  • I plan to breastfeed and do not want any artificial nipples or formula given to the baby.
  • If the child is a boy, circumcision will be performed at a later date and location. (Note: My hubby and I were divided on the circumsicion issue for a boy even with my showing him all the materials I had from class. Having a girl saved me and the baby this time and I’m hoping to convince him otherwise for any future children.)
  • Vitamin K / Eye Ointment are requested after the baby is born while at the birth center or in the hospital.
  • Student / intern participation is fine, but should be kept to a minimum of one student. Their presence in the room to be re-negotiated if labor should slow down.

Unfortunately or fortunately this birth plan never came to fruition. Having cruised through a fairly low-key pregnancy my baby decided to shake things up a bit and turn at week 36. When I say turn, I mean she went breech, upside-down, a**-backwards, etc. Basically, she wasn’t in the most desirable position for labor and I’m pretty sure I know the exact night she turned on me – Saturday, November 5th.

Coincidentally, this action occurred the same day I had gone in for prenatal acupuncture treatments. The acupuncture was to help with spontaneous labor and with thinning the cervix and so forth. The treatment I received has never been known to turn babies breech and I do not blame the care provider. This type of treatment is practiced quite commonly in German hospitals and other parts of the globe outside of America. Again, it could be one strange coincidence.

In order to remedy the big turn the baby had made I visited a chiropractor to try the Webster technique 3x and I continued to work with the acupuncturist doing moxabustion treatments daily. Both of these techniques are said to have a 80-85% chance at turning the baby and I certainly did feel movements when they were performed. It just wasn’t enough movement to make the full flip. My midwife then recommended I see a OBGYN / specialist in performing external versions.

I met with him the week of Thanksgiving and after a review of my ultrasound the Doctor explained the likelihood of the baby turning. He said chances were slim, but that he could try. It was my job to go home that night and think it over. I felt like this was a test, like if I attempted the external version it would prove how stubborn I was and how much I wanted a natural birth. Given the risks involved with the procedure and that it would need to be done the day after Thanksgiving, I decided to pass and plan for a C-section.
Having my mind locked in on a planned C-section with spontaneous labor gave me the opportunity to try to make the best of things. Of course I needed to revamp my birth plan and here is how the new one went for the section:

Thank you for being a part of the birth of my baby. I appreciate your expertise and experience during this incredibly important day – the day I meet my baby. I would like to be kept fully informed of my options and be involved in decision making. Please remember I am hearing impaired and may need you to speak louder at times and/or repeat yourself a number of times. With that in mind, we (my mother and I) have a list of preferences that we would like respected whenever safely possible. Let’s deliver this baby together!
Environment

  • Please refer to us by our first names, Adrienne & Sharon.
  • Please refrain from having side conversations in the OR during the surgery.
  • We would like to play our choice of music during the surgery.
  • We would like Sharon to be with Adrienne during the surgery.
  • We would like either Sharon to be with Adrienne at all times before and after the surgery when necessary.

Surgery

  • We prefer not to schedule our cesarean but rather wait until Adrienne goes into labor naturally.
  • Please narrate the surgery.
  • Please lower the drape so we can see the baby as soon as possible.
  • We would like the cord to remain unclamped and for the placenta not to be removed and kept with the baby. Please put the baby skin to skin on Adrienne’s chest with the wrapped placenta. We would like the cord to be clamped and cut after it has stopped pulsating.
  • Sharon would like to cut the umbilical cord.
  • We’d like to delay newborn exam until after Adrienne and the baby have some skin-to-skin contact and time to bond.
  • We’d like to try to initiate breastfeeding while in the OR.
  • Please use a double-layer suture to repair the uterus.

Recovery

  • We’d like to avoid any separation of mother and baby and for the baby to be with Adrienne in the recovery room.
  • We’d like a private recovery room.
  • We’d like to be fully informed of the risks and benefits of pain management drugs.
  • I plan to breastfeed and do not want any artificial nipples or formula given to the baby.

Misc

  • If the baby is a boy, we do not want him circumcised at this time.

Again, thanks for being part of my special day. –Adrienne
I actually stumbled across a sample C-section birth plan from the local ICAN group here in Tampa and used their sample to guide my own.
[Note: there’s a Facebook group for ICAN of Sarasota too.]
Now that I’ve shared all my plans, let me tell you how it all went down and offer some unsolicited advice.
My water broke shortly after 1:00 AM the morning of Monday, November 28th. I had just gone to bed about a hour before after my usual Sunday evening routine. I had been camping in my mother’s room the last few nights in the event that I went into labor or started feeling funny (this was the final stretch) and woke her to let her know the water had broken. At least I thought it to have broken given the contents in the loo. My mother readied herself for the trip to the hospital as I was slowly gathering last minute items and meditating through contractions. We were at the hospital by 3:00 AM or so.

We checked in at Labor & Delivery, informed the nurses I was in labor and that my baby was breech. This basically meant: sound the alarm and let the Doc know a C-section is needed. One of nurses checked things out with another ultrasound and confirmed what we had stated. I was still feeling the contractions and I felt like water was leaking everywhere. It was not a pleasant feeling. They prepped me for the section, gave me the spinal tap and the Doctor came in shortly after. Before I knew it the baby was delivered. Bada-bang. Bada-boom. I had skipped ‘GO’ and collected my $200 or baby without the trouble of pushing, panting and doing it the natural way. As supremely bummed as I was the last couple weeks leading up to the C-section, I sure wasn’t bummed when they announced I’d had a baby girl.

I wanted to cry, but my eyes were so itchy from the anestesia that the tears didn’t fully form. Still a well of joy filled in my throat. I felt speechless, blessed and beyond words to see God’s latest work of art in my hands. Once I returned to my room for recovery I proceeded to breastfeed and bond with my baby girl skin-to-skin.

It wasn’t how I had imagined it, but things happen for a reason, plans change and it all works out in the end. Just go with it, be prepared, be flexible and and be happy with the outcome. This was the watered-down mantra I sorta said to myself. My advice to self for the next baby and for other moms who are open to it is the following:

  1. Don’t tell people your birth plans. Don’t get into discussions about natural vs. un-natural labor unless you are in a supportive and flexible environment of like-minded individuals. In the long-run the baby will ultimately decide how it wants to be born and no one needs the added pressure of trying to adhere to a plan that may no longer work for them or the scrutiny afterwards about why original plans didn’t stick.
  2. Be flexible. Be informed. Know your rights inside or outside of the hospital.
  3. Be happy.

Lastly, I went back and looked over my C-section birth plan. I didn’t get everything I wanted, but I had most of it. I’d say about 80% and most of the super important stuff at that. My mom did the best she could in helping to be my advocate, but I’d probably hire a doula for future labors and would recommend that as my final piece of advice. Husbands, parents, sisters and friends are all great support teams, but when your emotions are running as high as theirs it is sometimes better to have someone detached from all of that and focused on one thing – your health and your birth plan. A doula can’t make everything desired happen, but I will be looking for one next time for certain.
That’s my plan and I’m sticking to it.