Take Control of Your Cesarean

With the national cesarean rate at about 32 percent, many moms are undergoing surgery to deliver their babies. Because the state’s foremost malpractice insurance provider, Physicians Liability Insurance Co., won’t cover VBACs (vaginal birth after cesarean), Oklahoma mothers who deliver one baby via c-section are highly likely to deliver subsequent babies the same way.

My older son, Isaac, was delivered via c-section. While it wasn’t considered an emergency, it was, after a 17-hour long labor and two hours of pushing, the only way my doctor thought he was going to come into the world. The procedure was pretty scary, but it went well, and, in the end, I got to bring home a healthy baby boy.

When I got pregnant again, I made a deal with my doc: We set a date for a repeat c-section, but agreed that, if I went into labor before that date, we’d try to deliver via VBAC. I hoped and prayed and wished and willed for a VBAC — so much so that I never really planned for a second c-section. Even during the drive to the hospital on the morning of my scheduled surgery, I was praying my water would break.

It wasn’t until I was wearing a hospital gown and waiting for a nurse to lead me to the operating room that I really considered what was about to happen — and became really anxious about it.

The procedure itself was much better than my first — the spinal block was better the second time around, so I didn’t feel as much tugging and pulling and pressure. But I was so much more scared.

My first c-section came at the end of a long labor, so I was completely worn out. Once he was delivered, I nearly fell asleep. The second time, I was a tense ball of nerves throughout the entire procedure, worrying about all the things that could possibly go wrong, wondering what the heck was happening behind the blue drape.

And it seemed to take forever. I found myself making small talk with the anesthesiologist in a feeble attempt to distract myself from my fear and keep myself from counting the seconds.

Afterward, I thought maybe I was crazy. I mean, shouldn’t I be less nervous the second time around?
Shouldn’t I be an old pro by now? I felt better, though, when other moms I talked to admitted to some of the same feelings before and during their second, and even third, c-sections. And my friend Brandi Morrow, who’s a labor and delivery nurse at OSU Medical Center, said a repeat c-section is just as unnerving for moms as a primary, and having done it before doesn’t make it any easier, especially since the first one usually isn‘t planned and can be, depending on the circumstances, difficult to remember later.

For me, the deep-breathing exercises I learned in childbirth class helped calm and distract me during the surgery, but I wish I had done more research and planning beforehand.

My favorite resource for moms who have delivered or plan to deliver their babies via c-section is the International Cesarean Awareness Network, online at ican-online.org. The nonprofit, which has a local chapter in Tulsa, led by Stephanie Shumaker, recently published an article on its website by Michelle Smilowitz called “Planning a Family Centered Cesarean.”

In it, Smilowitz offers ways moms can be more involved in the planning and procedure of a cesarean. She suggests writing a birth plan, just as you might with a vaginal delivery, and specifying your preference of anesthesia, when you’d like the catheter inserted, whether or not you want your arms strapped down, etc. These are all choices moms can usually make, as long as the procedure isn’t an emergency, and can and should be discussed with your doctor.

Also, read up on the procedure so you understand what’s happening. Ask your doctor if, once your husband or partner leaves the OR with your baby, a doula may come into the room in his place to support and comfort you through the remainder of the surgery. (I wish I had thought to do that when Ben was born!)

Practice relaxation and/or meditation techniques beforehand; they could be useful during the procedure. Ask to play some soothing music during the birth (my doctors and nurses had the radio turned to a country station. It never occurred to me to ask for something different, and while I didn’t mind the music selection, I’m sure I could have thought of something a little more calming.)

The whole point is, being involved in your care, knowing what’s happening, voicing your opinions and having a say in the decision-making all go a long way to helping moms feel less uneasy, less apprehensive. The biggest complaint moms who deliver via c-section voice (that I hear, anyway) is that they feel like the c-section was something that happened to them. When they feel like they’re involved and get to have a say in what happens to them and their babies, that feeling subsides a little.

There’s a lot more I’d like to say about this subject, and I’d like to hear from readers, too. So hop on over to tulsakids.com, visit the Natural Mom blog and let me know what you think!

Categories: Infant/Pre-School, Little Ones