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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Elcs birthplan?

27 replies

Readytoburst · 23/01/2011 21:26

I'm having an Elcs in 2 weeks and am not sure if I need a birth plan. With my first, I had very clear ideas about what I did and didn't want e.g. my views on pethedine. I felt my plan was really valuable but that was for a 'normal' delivery. With an Elcs I'm not sure what choices I have and whether it's worth doing one. What I do know is that I want skin to skin contact asap but surely I can tell them that? Any advice would be greatly appreciated!

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NellyTheElephant · 23/01/2011 21:36

I had an emergency CS first, then two electives. I didn't bother to actually write a birth plan as everything is very calm and straightforward and you have loads of time to discuss what you want etc, but do be clear in your mind re what you want - i.e. say to them before you go into theatre that you want skin to skin as soon as possible. You need to have thought through how you want things to go, but I didn't feel the need to write anything down as I was very able to speak and say what I wanted (unlike during my 30 hr first labour... although I actually rather wish I hadn't written a birth plan that time either or I might have had my CS about 5 hrs earlier and been a hell of a lot happier - they were fixated on my naive desire, clearly expressed in my birth plan, that I would prefer to avoid intervention)

WillYouDoTheDangFanjo · 23/01/2011 21:45

There's quite a bit and the more you ask, the better it will be for you IME. My 2nd section was a million times better than my first because I realised how psychologically important it is to feel present, listened to and active.

Assuming you will be awake, can you choose some music in theatre? Do you want a partner to hold your hand? Would you like a quiet moment with your partner in theatre (me and DH had a quick kiss and cuddle before any anasthesia). When your baby arrives, do you want them lifted above the screen for you to see (awww that is such a great moment!) if all is well? Your baby will then be taken to a table in theatre to be cleaned & have apgar tests etc - you probably won't be able to see this as there will be lots of people around, but would you like your partner to go and watch over baby or stay and hold your hand?

While the procedure is going on, how much information would you like? I liked hearing what was going on and of course you are free to say "Okay stop telling me now" if you don't like it!

Photos- could your partner take some of the baby being washed & weighed? How about one of you both with the baby (our anaesthetist offered to take one of the 3 of us, it's a very special photo!)

In the recovery room - do they allow visitors and if so do you want any? (A visitor was allowed into the recovery room after my 1st and it really upset me as I was not ready to smile for photos, so have a think about that.)

I had skin to skin after both my sections and it was lovely & no problem but I would say make sure you have plenty of help to get comfy & hold the baby.

Good luck, wishing you a peaceful and happy birth!

Original poster

Readytoburst · 23/01/2011 21:53

So many choices! I feel really cheated by my first birth - I had a retained placenta which masked a 3rd degree tear for an hour and a half then had about the same amount of time in surgery. This meant I had no real contact apart from a few seconds holding dd after I gave birth for a good 3 hours. This time the most important thing to me is having that baby in my arms asap!!

OP posts:

WillYouDoTheDangFanjo · 23/01/2011 22:08

Readytoburst, it's quite possible that you can get an armful of baby in theatre! We didn't think to ask first time round, but for DC2 DH asked if he could lay the baby on my shoulder and it was fine, so I could give a kiss and a one-armed snuggle. You won't be able to fully hold the baby as IME the anaesthetist keeps one of your arms over to the side - you'll have a drip in, plus they like to check your fingernails for colour and monitor your blood pressure. However I didn't really care what my left arm was up to once I had that velvety little face next to mine! :)

Oh and don't be afraid to speak up! I lay there meekly during my first section, but was a bit more gung-ho for my second. I clearly remember yelling "OH WOW Here comes my baby everyone!" I bet that was very informative for the surgeon!

homebirthmummy · 23/01/2011 22:23

There are loads of things you can request in addition to the great things above,

lower lighting as baby being born?
no one talking as baby being born?
finding out the sex for yourself?
baby placed on you after birth?
DH cutting cord?
do you want the cord left a bit longer than they normally do it so the clip doesn't rub on the skin?
do you want to use string to tie the cord and not the plastic clips?
wrapping baby in a towel from home which smells of you?
DH having skin to skin whilst you are getting sorted?
Would you like some support to BF in the recovery room?

Lots of choices and things for you to choose!

Good luck!

Mittler · 23/01/2011 22:26

Only thing I had re. ELCS "birth plan" was wanting to hold DD as soon as she came out. In the event, my blood pressure dropped and I felt terribly sick, so I handed her over to DH pretty quickly!

Original poster

Readytoburst · 24/01/2011 09:41

Can my husband still cut the cord then? Would he have to go round and look at the wound? I don't think he'd like to see that!

OP posts:

homebirthmummy · 24/01/2011 13:22

If all is well (like any type of birth) it is an option available. It's worth asking at your next appointment all the details (eg can they cover you up a bit for him to do it!)

Original poster

Readytoburst · 24/01/2011 13:56

Next appointment? I got booked in at 34 weeks and turn up in 2 weeks time for the op! Should I have another appointment?

OP posts:

OhCobblers · 24/01/2011 14:06

i told them very clearly what i wanted 2nd time round.

missed out on so much with DC1 as was too busy throwing up after EMCS - went into shock and didn't even get the photo in theatre holding him, nor did DH. also didn't think about skin to skin which i regret.

2nd time round with ELCS - gorgeous photos (my fab anaesthetist took a lovely one of the 3 of us plus DH took one of DC2 emerging!!), skin to skin and everything else that i wanted.

i think if i had known about a "natural" CS which i've since read about on MN, i would have asked for that too!!

good luck!

homebirthmummy · 24/01/2011 14:23

Sorry I forgot you said you were having your baby in 2 weeks! Stick it in your plan and discuss when you got to hospital.

Good luck, I am sure it will be an amazing experience!

LilRedWG · 24/01/2011 14:25

Hang on - I'll copy and paste mine for you. Pretty much the same as when DD was born...

LilRedWG · 24/01/2011 14:32

Here you go. Hope this helps in some way. :)

Before birth:

We would like to meet the midwife who will care for me in theatre if at all possible.

We would like my husband to stay with me throughout, including the administration of the spinal.

If I should need a general anaesthetic for any reason I would like my husband to stay in theatre so that he is present at our baby?s birth and can hold him/her.

If I should need a general anaesthetic I would like to meet our baby in his or her newborn state. I do not want our baby washed and dressed whilst I am still asleep.

During birth:

We would like a commentary of what is happening up to and including the birth.

We would like to have the curtain dropped for the moment of birth.

We would like photographs taken of the birth by my husband if possible.

We would like the theatre to be as quiet as possible at the moment of birth.

We would like to discover the sex of our baby ourselves.

My husband would like to cut the cord, if possible.

If it is not possible for me to have skin-to-skin in theatre we would like my husband to instead.

Please do not exteriorise my uterus for stitching.

Will you use dissolvable stitches or staples to close the wound?

We would like our baby to stay in theatre for the duration of the operation, if possible, and not to be weighed until we are in recovery.

If the baby needs to go to special care, I would like my husband to accompany him/her and I would like to be taken to him/her as soon as possible after the operation.

Post natal:

I would like to be offered pain relief which does not conflict with my desire to breastfeed. I react badly to pethedine and codeine makes me very sleepy.

I am allergic to...

I would like to meet with the physiotherapist as soon as possible after theatre to discuss management of...

We do not want our baby to be given any formula milk without our permission.

I intend to breastfeed and want the baby to be given the opportunity to suckle as soon as possible after birth.

I would like my husband to be the one to dress/bathe the baby for the first time.

LilRedWG · 24/01/2011 14:36

DH wanted to cut the cord but they would not let him the other side of the screen, so they cut the cord long and DH trimmed it to the correct length. A lot of it is about communication and compromises.

SlightlyTubbyHali · 24/01/2011 14:40

Incidentally, if you did have a general they might not let your DH stay in theatre (they booted mine out) but the MW took the baby directly from the paed to DH so she was never "alone" and had skin to skin with her daddy well inside 10 minutes of being born.

I think when I made an emcs plan the main things I was after were immediate skin-to-skin, the screen to be dropped so I could see the birth and the baby not to be taken out of my sight (or my DH's). I had a real hang up after DD1 was born that she'd been off across the room and I couldn't see her. Since I ended up with a crash section my MW stepped in and got us the next best thing.

Speak to the docs and ask if they can put the monitors under your arms instead of on your chest to make skin to skin easier while you are bing stitched, and whether the apgars can be done while the baby is on your chest.

SlightlyTubbyHali · 24/01/2011 14:42

Lil - I think that's pretty normal re the cord. even with a natural cs they cut it long and then you can trim it down once the baby is out of the sterile field.

We should all look on the bright side. My SIL had emcs in Germany and they strapped her arms down and would not put the baby on her chest. That would have really upset me.

homebirthmummy · 24/01/2011 14:42

What a great birth plan.

It is all about communication isn't it. I bet that was a great experience in which you really felt like you had a part in the decision making process.

Original poster

Readytoburst · 24/01/2011 16:26

Wow, thank you all! I absolutely don't want the screen dropped, but I'll have a good think about all the other stuff! Where can I read about a 'natural' section?

OP posts:

SlightlyTubbyHali · 24/01/2011 16:47

If you google "natural caesarean" you'll find articles (in the Guardian) on it. AFAIK it is only done at Queen Charlottes in London but that doesn't mean other hospitals can't try it (or elements of it). If I ever have a third I plan to go private to QC if they're still doing them.

As for the screen, because your bump is in the way you can't see anything gory - the incision is right round the other side. It just means that you see the baby sooner.

WillYouDoTheDangFanjo · 26/01/2011 14:25

Hmm, SlightlyTubbyHali I don't think that's a given... although the bikini line cut is fairly standard these days, it can still be possible to see quite a bit from the top depending on how the surgery is performed. DH noticed a huge visual difference between my 2 sections.

I can say more but only if ReadyToBurst wants to hear it :)

Original poster

Readytoburst · 26/01/2011 15:06

I don't mind if people are interested. There are NO circumstances that would make me ask for the screen to be lowered!! Seriously, none!

OP posts:

Sparklies · 26/01/2011 17:37

Just wanted to say what a useful thread this is for my planned ELCS in 12 weeks. I was the one who posted recently asking about "natural" c-sections so it's good to see what people are actually putting in their birth plans to get close to that.

CrapBag · 27/01/2011 10:29

I wasn't going to bother with a birth plan but I think I will after reading this. I want skin to skin asap and the consultant went through briefly what will happen with me last week but he said DH and the baby leave theatre whilst I am being stitched which takes aup to 45 minutes. I don't want to be away from them for that long. Can I request that DH and the baby stay next to me?

Zimbah · 27/01/2011 21:36

Crapbag, definitely request that baby and DH stay with you - if there's room for your DH to be in the room during the op I can't see any reason why there's not room for him to stay in the room during stitching, and he can hold baby (if you're not). After my ELCS with DD1 DH had to leave theatre with her for about 5 mins and wait outside towards the end of the stitching and it felt like forever, I hated not being able to see her.

I'm taking notes from this thread, had ok ELCS with DD1 (breech) but some things I would have liked didn't happen, now facing possible ELCS again as DD2 currently breech and I'm not hopeful she'll turn even though I've got ages yet.

CrapBag · 28/01/2011 10:25

What would you have liked that didn't happen Zimbah?

I don't see why DH has to leave theatre whilst I am being stitched (unless there is a problem obviously) and I am confused as to why the consultant said that is what will happen. Last thing I want is to be laying there for up to 45 minutes whilst they are outside.

I had a 3rd degree tear last time and had to go to theatre and recovery so was away from DH and DS for well over an hour (stitches took a while!). I didn't like it at all and was deperately looking and waiting for them to appear in recovery.

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