Happy Cesarean Section Awareness Month! Did you know 1 in 3 birthing women in the United States deliver via a cesarean section? Even if you’re planning and manifesting a vaginal birth, education is empowerment! Birth can be complicated and unpredictable, so it’s prudent to be prepared and learn about what to expect during a cesarean section, just in case.
Preparing for a Cesarean Section Delivery
Do you know you’ll be a cesarean section delivery ahead of time? Whether it’s by choice or due to medical necessity, the good news is elective cesarean sections have a lot of benefits over vaginal births. There is a lower risk of incontinence and sexual dysfunction after birth and a lower risk of the baby experiencing trauma or being deprived of oxygen.
Have you been presented with a choice about cesarean section? There is a trend, one study shows an increase in 8%, of women requesting cesarean sections. Know your risks and benefits- there is a higher risk of complications with cesarean sections and they require longer hospital stays. Women are also more likely to repeat deliveries via cesarean section once they have one.
What the Delivery Room is like for a Cesarean Section Delivery
This information is pre-Covid protocols so check with your physician or midwife for up-to-date procedures regarding the delivery room set up. Usually, the pregnant individual will be assessed by an anesthesiologist prior to delivery, whether or not they are having a planned cesarean section delivery. When it’s time for delivery, the birthing person is brought into a surgery suite. It’s not a birthing room- there are no water tubs or encouragement for walking around. It’s a real deal surgical suite complete with bright lights, stainless steel everything, and everyone is covered head to toe in protective gear.
At this point, the pregnant person is usually without a partner present and will be placed on a surgical table to receive the anesthesia. The anesthesiologist administers the medication via a needle in the back, or epidural. The pregnant patient bends forward to allow access to a region in the spine, and the needle is inserted. Typically, this feels like a quick pinch. This medicine causes complete numbness to the bottom half of the body. The person is then assisted to lie on their back. Their arms may or may not be restrained. Oxygen levels are constantly monitored and the anesthesiologist remains in the surgical suite monitoring the patient and ensuring their comfort for the remainder of the procedure. Levels of numbness are checked many, many times to be sure it is safe to have the surgery.
At this point, one person- be it Dad, Mom, partner, parent, or whomever the birther chooses, can join in the suite. This person will be fully clothed in surgical protective clothing including booties, cap, tops, and bottoms. He or she will likely be screened by a nurse to check for the likelihood of passing out. There may even be a staff member assigned to watch to be sure there isn’t fainting.
You’re Still Empowered
During a cesarean section delivery, there is often a barrier placed between the pregnant person’s face and the incision site. Some birthing hospitals are beginning to offer to remove this barrier. Before the procedure begins, it is a good time to remind a nurse of any wishes you have. For example, maybe you’d like to see the sex of your baby first so “please don’t shout out it’s a girl or it’s a boy” should be acknowledged. These medical providers are likely not the ones you have gotten to know over the course of your pregnancy and may not be aware of your situation and birth wishes.
Cesarean Section Delivery
The birthing person should not feel anything during the surgery. There may be a tug and pull sensation as the baby, or babies, are pulled out of the uterus, but there should be nothing felt during the incision. Your doctors will be sure of this and, of course, speak up if you feel pain. Organs like the intestines are moved around and an incision into the uterus is made. Depending if the surgery was planned or a true emergency, the incision may be horizontal or vertical. The incision may be about 5-6 inches and close to the pubic bone. The baby will be pulled out and likely just shown to you over the barrier. The baby will be brought to another part of the room, cleaned, and quickly evaluated. Some hospitals are skipping this step and allowing the baby to be placed directly on the parent’s chest after birth.
After surgery, assuming the baby and parent are healthy, they will room together. The surgical site, lower abdomen, will be checked regularly by a nurse to make sure it is not infected. The attending nurses will begin to encourage the woman to stand up and walk very soon after the surgery. This can be painful, and scary. Take it slow, but be brave and try to follow the nurses’ recommendations.
It is important to have a bowel movement soon after surgery, especially a surgery like a cesarean section which moves the intestines to take the baby out. The first bowel movement can be painful because pain medications are constipating. Laxatives may be recommended and remember to drink lots of water.
The 4th Trimester
After 4-5 days in the hospital, the birthing person usually can go home. Instructions for care of the incision, including changing gauze regularly, will be provided. The birthing person may be on a prescribed, or over-the-counter pain medication. They will likely be recommended to avoid going up and down stairs for at least a week and avoid holding or carrying anything heavier than the just-delivered baby. A follow-up with the surgeon will likely be scheduled 4-6 weeks after the surgery.
Besides the physical healing, there may be emotional healing to manage after a cesarean section. Some cesarean sections are trauma-filled as they may occur when vaginal birth fails.
Reaching Out For Help
There is a great organization to know about if you or someone you love is going through a cesarean section. I-CAN- International Cesarean Awareness Network is a “non-profit organization whose mission is to improve maternal-child health by reducing preventable cesareans through education, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC).” Check it out for local and online resources locally.