AIBU to think that the way c sections proceed needs to be reviewed?

[newmum953]

Just wondered if anyone had any ideas that would further improve the c-section experience? (For instance, I would really have loved there to be no screen at all but have no idea whether this is done - to lower the chance of infection or if it's so that the parents don't have a reaction to what they see or a combination of both?)

worried I don't have any children yet but I have had a fuckload of some urological surgery recently and would say do it after anaesthetic - everyone's going to see everything anyway and anything that makes it hurt less will probably be welcome :)

Thanks 4madboys.

Curtain would be a no-no. For sure. All sorts of reasons for that. I can't imagine a set up where it would work as the table is right in the moddle of room surrounded by all sorts of stuff you know?

Choice always good for some, but lots of people just don't know or say 'whatever you think' adn stuff. Plus I worry that if you aren't in labour and just walked in off the street, it would be hugely stressfull. Like getting the drip in. The amount of people that need some pretty intense support for venflons putting in is amazing, yet then go one to cruise through a section or birth.

Lots to think about - thanks.

Alos, I think section can be an 'ecperience, and should certainly be viewed as birthing. It isn't that long ago that putting the radio on was seen as mega radical, so we have come a long way on this. Things have relaxed a good bit. But anything that helps would be a good thing.

I want clouds painting on the theatre ceeiling but the department manager visably shuddered.

i guess its about making sure the patients know that there can be a bit of choice and flexibility, emergeancies excepted, but even then after health of mum and baby is assured it would be nice to make it as nice an experience as possible, yes safety is first and paramoutn but it is still a BIRTH and such should be a positive experience as much as possible :)

i hated having hte drip in, i have CRAP veins and they always end up really struggling, i just grit my teeth and bear it, but its not pleasant, esp with dd when it took numerous attempts and lots of not very nice bruises afterwards!

worried I had it done in private and my nurse must've been very experienced as I wasn't even aware she was doing it. She shaved as much as was necessary (before the days of Hollywoods and that was fine too.

I'd rather have a catheter under anaesthetic. Let's face it, there's not much dignity anyway and that man in scrubs with the lovely blue eyes is going to shove a suppository up your bum later.

This reminds me of a friend whose husband fainted just as they made the first incision. He went over like a tree on to his nose. Blood everywhere. Apparently everyone rushed over him... And she started screaming " you can't do this to me! This not YOUR drama."

I would always go for less painful over loss of dignity but I suspect I am in the minority.

:(

At least I know what to ask for if I ever have a c-section...

The reason I mentioned the screen particularly as I felt it was a slightly comical situation with the anaethetist (sp?) giving DH a running commentary as they both looked over the screen. Me: lying there not seeing a thing. We did drop screen at time of birth but I saw so much more on the birth video - I am glad we had that so I could see it all. From our angle on the video, we didn't see much that was gruesome due to the angle and also of course, my stomach was big so hid the yucky stuff.
worriedsilly: I cannot remember when it was inserted but by the time I underwent emergency C, I din't care about feeling exposed or how many people were in the room, I just wanted the baby out safely. This is just my experience though. The staff were also wonderfully friendly and professional which made things like the shave not seem like a big deal.
RIZZ0: don't know if it's just me, but found that I really didn't know much about c-sections as wan't prepared for this option and would have benefitted from a briefing. For example what to expect immediately after.
I did do skin on skin - I requested this immediately but they let me do it when they finished sewing me up (think it was 20 minutes) and did a breastfeed too at this time.

This is a very interesting video

It is entirely possible to improve the "experience" from the mother's point of view, without compromising the safety of the procedure. It is worth remembering that "experience" isn't about entertainment value, the mother's perspective on the birth affects her likelihood to suffer from PND, and her ability to bond with and breastfeed her baby. It is already understood that csec mums struggle with breastfeeding more than vb mums, so why not do everything we can to make it better?

I asked for the screen to be lowered at my son's emcs (you don't see anything, there is a bump in the way, remember how you couldn't see your fanjo at the end of your pregnancy, well the incision isn't the other side of the bump) but they refused. I asked then if he could be shown to me, even briefly, as long as he didn't need immediate resus or the like, they told me it would be fine, I would see him on the resuscitaire. As it was all I saw around the resuscitaire was a load of midwive's bums, now I am sure they were very nice bums, but I was desperate to see my new baby, frantically so, feeling horribly helpless, and I had to wait 5 excruciatingly long minutes while they cleaned and measured him. I don't think that was thoughtful or necessary. I did get skin to skin in theatre though, which was good.

I had discussed lowering the screen and was told the reason they had it up was for infection control purposes, they'd like to avoid having to faff around with putting a screen up asap if shit hit the fan and they'd had to put me under GA and also even with a lowered screen I wouldn't be able to see much anyway.

I didn't question it too much, as I rather had a surgical team working on me which was comfortable with their working condition, than them being distracted by my special wishes.

I didn't enjoy skin-to-skin after my cs. I was too shaky, I got P to take DD off me after a couple of minutes.

FWIW I liked chatting with the theatre staff and was quite happy to have their radio station on. I figured they're the ones in charge, let them get on with it.

My XP never really recovered from seeing my insides over the screen. I liked it but he was very queasy.

Newmum - I see, so rather than a review of how the whole thing works, you mean some guidelines on what to expect, and the choices you might be able to make? In which case, agreed. One person's consultant / team may be much more informative than another's.

Glad you had success breastfeeding too. I was worried the milk wouldn't be ready but it was fine!

An elective C/S certainly wasn't what I wanted, but my 'experience' of this major surgery was really good.

I think that having more advance information on what actually happens in a cs situation would help.

I have had 2, and will have another next year. first one was an emcs - had been in labour for 36 hours already. I had a general, and didn't really care what happened (must say, I was abroad, had had no antenatal care to speak of, and so was not in any way prepared for anything childbirth related anyway). all was fine, dd1 arrived safe and well, and we got on ok.

dd2 was in the UK - I had a spinal. but again, no real info on what would actually happen in theatre - re: how long it might be before I saw/held the baby, how many people etc. I had the stats on safety, and the consent forms. I had the talk on local vs general, and was told I could have the screen lowered if I wanted (err, no thank you for me). but no info on what really happens, iyswim, in the minute-byminute sense.

overall I remember it as positive - dd2 was certainly tucked in beside me while still in theatre, but can't remember if it was before/after stitching. dh is always the first one to hold them, and he hovers about (probably making anuisance of himself ) while they do the weighing/cleaning stuff. I am happy to know that the baby is ok, and relax and wait. but of course, I have no watch on, and no comforts at all, so it feels like a very long wait.

I ahve just had my pregnancy pack from my GP, and here is nothign in it at all re: cs. I've booked in with the midwife, have discussed previous sections, and agreed I will have another section this time, but still no info. I think that is an area that could be improved, tbh. I will be at another new hospital (we move around a lot ), so no idea of the protocols/set up.

it would be actually that all mothers are given the basic info on what to expect with a c section and some ideas on choices they can make providing it goes smoothly, ie skin to skin etc. just a little list, a bit like the one you get when you are going to be induced (or i did) detailng what should happen if all goes to plan.

in the same way that in my birth plan i had a small list of i would like this...but if i cant then. it would be good to be able to say that if i ended up with a c section i would like so and so to happen (providing there is no medical reason why not) and we should be informed of those choices in pregnancy as no one knows if htey will end up with a c section.

silverfrog you mention not having ante-natal care, we had covered sections in detail in our ante-natal classes. I wonder if it's why I was so relaxed (ish) during mine. I knew what the team were doing and asked what all the machines did, what was being stuck in where, they told me everything even during my emergency one.

I even asked them afterwards if they'd put in the morphine supository (I was scared of the pain kicking in), the nurse said yes they'd done it. I'd forgotten I wouldn't be able to feel them doing it .

Didn't want my dc's passed to me straigh away either, I wanted the staff to check they were ok first. I wasn't in a position to decide.

I'm a bit uptight really.

Actually as great as it was overall - I would have liked to have known about the operating table being 'tilted', as I was feeling a bit anxious already without feeling like I may fall on the floor.

Also, it would be great if everyone didn't come at you at once with BP armstraps and instruments etc the second you sit down on the table. Or at least to be warned that the pace is so fast once you go in.

The anaesthetist should also not try to be "down with the kids", claiming that every song on your birth cd is in his collection (after asking what it is)

see we didnt have anything about c-sections in our ante natal classes, i had nhs ones with ds1 and no mention other than you may end up with one! and the nct didnt cover them.

yes, meglet, no antenatal care. and then when pregnant with dd2 I was not offered any since I was already a mum (despite me sayign I had never had any), and again now - it's become a running joke, tbh

oh well, I might ask when I tour the maternity unit.

I am not at all bothered by my sections, btw - as I say I rememeber them as mostly positive. and, as othe rposters have said, i am happy enough to have a team that are working the way they want to (obv within general dignity and decency/good practice boundaries). I can't say I care too much either way when the catheter is put in - I know it has to be done, and I know no one is doing it for fun (so to speak), so get on with it as and when suits, really.

dh is always very keen and asking questions. and telling me I shoudl see X or Y (over my dead body, tbh )

I had an emergency section after a 52 hour labour. Although the labour was very badly managed (so much so that I'm still not over it!) the section was managed very well. DS wasn't breathing when he was born and antibiotics an hour later, but I still got skin to skin within a minute of him being medically stable and am still breastfeeding 7 months later. He was tucked into my gown and stayed there until he crashed again and was then taken to SCBU.

The section itself couldn't have been handled better. I do wish though, that someone had warned me that I could see everything in the bloody mirror-lights above me though!

It would appear 'experience' varies greatly from trust to trust.

Oh Noodle, 52 hours!

Completely relate to mental (and physical) trauma following a badly managed VB compared to an efficient C/S.

I chose an elcs for DC2 after a traumatic forceps arrival with DC1 left me with ongoing health problems.

It was lovely. I was really wanting to be as involved as possible to lower the PTSD risks for the birth (after DC1's effect on me), before the date the anaethetist spoke to me at length about the whole proceedure, why they did what they did, why I couldn't have skin to skin immediately etc (cold in theatre and the checks needed as someone said above) and by the time 39 weeks arrived I was just so bloody relieved DS hadn't started me off in labour that I didn't care. It was about taking back some control after appalling care in labour first time round.

I was told I could ask for the screen to be lowered, I like gory bits and was quite intringued by the whole seeing my insides, but sadly they were out of some piece of equipment so my screen was made by gaffer taping a sheet onto a drip stand Not really feasible to just lower it quick so I waited happily. DS yelled coming out so the MW showed him to me and I got to talk to him (stopped his yelling when he heard me) then he was cleaned, warmed, wrapped and back by me in DH's arms. We had skin to skin as we were wheeled into recovery, he fed there happily and snoozed on me for some time.

Oh and as far as the catheter question - after pain relief please! I had plenty of catheters done post DC1 for bladder trauma and they were extremely painful, if you are pumping me full of drugs then do whatever needs doing AFTER they have taken effect!