What to Expect During a C-Section

Cesareans can partner with some pretty complex and intense emotions. Not always, of course—some mamas are in and out and can move on in a snap. But for a large number of mamas, just having a c-section can be pretty emotionally fraught. These moms can feel like they’re riding a windy road of conflicting and confusing emotions. Fear, guilt, elation, relief, disempowerment, love, disappointment, pain, failure, joy. They might shift in and out of these feelings moment to moment, day to day…even year to year.

But what if all mothers had the opportunity to know more about what to expect from a cesarean before it happened? What if they had already been taken through the details and shown what their options really were stage by stage?

My guess is that these mothers’ cesarean birth experiences might be a little less scary and a little more empowered.

This past week I was listening to one of my favorite podcasts The Longest Shortest Time, and I was thrilled to hear about something that might help do just that. (Side note: if you haven’t heard of The Longest Shortest Time, go straight to iTunes and subscribe. It’s fantastic—and it really helped me through some tough parenthood times.)

Chicago doula and childbirth educator Amy Catania, CD(DONA), created what she calls a “c-section simulation class,” where she takes parents through what happens during a cesarean. She takes her class through the five senses of the experience—what parents might feel, see, smell, and hear each step of the way.

How it works:

Amy chooses a volunteer—usually a dad or a non-gestational mom. She asks them to lie on a massage table (acting as the operating table). She puts a surgical gown over the volunteer’s clothes, and then takes it off immediately. This can be a bit unnerving for the volunteer, strange as that might seem because the volunteer still has clothes on, but the idea is to show that everything below the waist is about to become a sterile surgical field. The hospital gown becomes irrelevant.

She then turns on the overhead lights to make the room brighter, like it would be in the OR, and turns on the cold air.

Then she puts on scrubs and a bonnet. She puts a bonnet on the volunteer and might even take off their glass if they’re wearing any.

She tells the volunteer how loud the OR can be, how many nurses and doctors are buzzing around, what their jobs are and what they might be talking about. Clue: Netflix, golf, maybe what they had for lunch. And she explains why this can be unsettling for many moms, but that the more comfortable the surgical team can be the better of mom and baby are.

Then Amy places a baby doll wrapped in a blanket on the volunteer’s belly, sets up a couple of tables on either side of the “operating table,’ and puts the volunteer’s hands on either table. Once the volunteer’s hands are pretend-restrained on the side tables, Amy puts up the drape (or surgical tent) which goes across the volunteers chest, a few inches from their face and blocks the lower part of the body from view. She explains that everything below the drape is now a sterile field.

This is when the birth partner joins the volunteer (whose roles would be switched in an actual cesarean). Amy advises the partner to look for their loved one’s face, focus in, and try not to look below the drape. She explains that it’s okay, even great, to reach down and kiss mom’s face, to hold her hand during the surgery and to tell her she’s doing a great job.

Amy explains that once the birth partner comes in the baby will most likely be born within 10-15 minutes, and that while the surgery is taking place, they can expect to smell a burning smell. This is the incision being cauterized, burned to prevent further bleeding.

She explains that the volunteer can expect to feel cold, shaky, and out of breath—some moms even have the sensation that they cannot breathe at all.

She tells the volunteer where the incision is, just below the bikini line, and describes what it might feel like as the doctor pulls the baby out—intense rocking, tugging and uncomfortable pressure, like the doctor is suddenly standing on your abdomen. This is obviously NOT what actually happens (or what Amy does in her simulation)! That would be nuts. But I have heard moms explain that that’s what it feels like.

At the moment of birth, doctors lift the baby up over the drape for the parents to see, cut the cord and put baby on the volunteer’s chest for a little sweet get-to-know-you-skin-to-skin time.

So the volunteer kisses on baby, talks to baby, bonds with baby, and while this loveliness is happening, the volunteer is being “stitched up,” which usually takes somewhere between 15 to 30 minutes. It’s also a possibility that if the care-provider isn’t comfortable with skin-to-skin in the OR, baby will be taken to the warmer an anterior room (or to do skin-to-skin with the partner). In this case, which is honestly much more common here in Tulsa, it’s great to have a doula. Doulas can stay by mom’s side while her partner goes with the baby, and can help explain what’s happening both with her surgery and with baby.

It wasn’t mentioned in the podcast, but I imagine she also talks to her class about what to expect following the surgery—the recovery, the discomfort, the future possibility of a VBAC, and the red flags to call your doctor about.

If you want to learn about ways to make a possible c-section a better experience, check out my blog post called 18 Tips for a Great Cesarean Birth. It’s really got everything you need for a more personalized (and amazing) c-section experience.

And please, please go back and listen to episode #71 of The Longest Shortest Time which features a childless man, who is also the host of another podcast called How to Do Everything, as the volunteer. After you’ve listened to that, go back and check out each of the previous 70 episodes! Do it to it.