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Childbirth

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

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Original poster

Quick question about a birth plan for elective Caesarean

46 replies

Gem13 · 08/02/2004 20:24

Just realised I hadn't written a birth plan for this birth and wondered if anyone had done one for an elective?

If so, what did you write? Can only think of writing DH's name down and the fact that I want him to tell me whether we have a DD or DS.

(BTW - it has been advised due to full 3rd degree tear, etc.)

OP posts:

Are your children’s vaccines up to date?

Set a reminder

aloha · 09/02/2004 11:07

Re Ghosty's thread, I would aso have really liked for there not to have been a screen. It made me feel mildly claustrophobic and I wanted to see what was going on and to see my son come out. I remember trying to see and being told not to touch the screen.

mears · 09/02/2004 11:20

I think the difference is there because the baby does need to be removed from the sterile field. It is really important not to contaminate the surgical area to avoid the introduction of infection. At the point you see your baby there is a bleeding abdominal wound plus uterus, and the afterbirth is being delivered. It is the point of the operation where most bleeding takes place. At a vaginal delivery there isn't the same urgency as the placenta does not usually delivery for another 10 mins. I have never seen a baby delivered straight onto the mum's chest at C/S. I know that the operating table is much narrower than a normal bed and often women feel a bit sick just prior to or after delivery of the baby. I would be scared the baby would slip off to be honest. I'll think about it more closely at the next C/S I am at and see what is feasible

SueW · 09/02/2004 11:38

This reply has been withdrawn

This has been withdrawn by MNHQ at OP's request.

aloha · 09/02/2004 11:40

I didn't feel sick at all, and did have ds on the bed with me. My consultant was very senior at Kings and he actually suggested delivering him onto me...ooh, I feel a feature idea coming on...
Maybe c-sections need the same kind of rethink as happened with vaginal births re maternal choice. Did you see that Ghosty didn't have a screen? I would so have liked that.

aloha · 09/02/2004 11:41

Feeding's important too. I would have liked more support for no formula.

mears · 09/02/2004 13:13

It is really thought provoking. I think that as it is a really medical procedure there is a real paternalistic approach to a C/S delivery - i.e. we'll decide what is good for you. I feel another campaign coming on myself

nutcracker · 09/02/2004 13:23

I was actually holding dd when i started to feel sick and they omly just about removed her before i threw up. The stuff they give you to get rid of the sickness works immeidiatly though, could of done with it when first pregnant

squirmyworm · 09/02/2004 13:28

very interesting all this...I can see the point about the sterile area and that explains a lot mears, thanks. If I have another I'll probably try to have a vaginal birth but won't be too fussed if it doesn't work out. Nothing, nothing that happened or didn't happen could alter the closeness I feel and felt immediately with my baby and and I have such warm and wonderful feelings about our time in hospital. It shines out as a really good experience from start to finish. I think we hear too little about when NHS care can just transform your life - as a first time mum I NEEDED and welcomed the support and friendly advice I got in a hospital environment. Night two, huge rain storm beating on the windows, quiet ward (I know!) the midwife helped me to feed ds and then I held him and whispered to him about the storm and he looked at me as if he was taking it all in - one of the best few hours of my life.

aloha · 09/02/2004 13:38

I had a really positive experience too - I think the urge I had to grab my son indicates there was no problem with instant bonding However, there were things I would have done differently if I'd had a choice and I agree with Mears that because it is a 'doctor' procedure rather than a midwife led process, there is not enough choice for the mother. Of course there will be variables that mean a c-s birth plan might not be able to be followed,but that applies to natural birth too!

Original poster

Gem13 · 09/02/2004 13:41

Thanks everyone for contributing to this. I will definitely give this some thought now... before Friday!

Last time round, traumatic delivery, 3rd degree tear, bit of a fuss, etc. DS was given straight to me and I was able to hold and feed him (? well he snuggled) before being taken to theatre. I wanted DH with me until I realised DS would be on his own so he sat cuddling him for an hour while I was stitched up. In that bizarre hour I remember thinking it was unfair that I couldn't be with them and was panicked that DS might be given formula. The midwife in the theatre kept nipping out and told me they were both fine though. When I was reunited with them DS was sucking on DH's little finger and he looked so thrilled that I wasn't upset about missing out on that time. This time round I would like to have them with me.

It sounds like I will have to be quite specific about things and make sure DH is clued up too. I appreciate what Mears is saying about the weight (I was desperate to know last time) but it can't matter if it's done later. It does make it sound that if you are having a C-section you forgo your rights re your child's birth.

It's interesting that like Mears says there is a certain attitude towards Caesareans and I have been waiting to be told what will happen rather than having any input into the procedure myself. I didn't know that I could ask for the lights to be dimmed or the screen to be down (not sure about that one!) but I was expecting they would give me the baby to be held at some point but now I know I will want to get my hands on him/her immediately.

OP posts:

Original poster

Gem13 · 09/02/2004 13:42

squiryworm - don't write things like that when you know pregnant women are reading! Sniff, sniff.

Can you tell I can't wait to get my hands on this little person?!

OP posts:

squirmyworm · 09/02/2004 19:58

ooh yes gem and I hope it's every bit as good as it possibly can be - lots of love and luck. it's a very special time

mears · 10/02/2004 00:02

Gem13 - lights dimmed is not an option in theatre. If you bled you would sue the pants off us

Original poster

Gem13 · 10/02/2004 19:34

I thought it sounded rather unusual Mears! I was getting concerned the doctor wouldn't be able to do neat stitching. I don't want a patchwork quilt!

OP posts:

MeanBean · 10/02/2004 19:49

One thing I forgot to do when my first was born, was breast-feed him. Literally because he didn't cry, and with all the excitement of it, and visitors coming in (the Caesarean had been scheduled for 9am and it didn't happen until 2pm, so everyone thought he'd been out for hours), I just completely forgot to feed him. And there's a school of thought that says if you feed in the first hour after birth there will be far fewer latching on problems, etc., afterwards. I have to say, it took nine weeks to get to a stage where he was feeding happily, so I wished that someone had reminded me! Next time round, I asked them to remind me and they did - not that it made a blind bit of difference as it turned out, but it might be helpful to you Gem13

Original poster

Gem13 · 10/02/2004 20:19

Thanks MeanBean - I'm not sure whether I fed DS or not in those first couple of days. He snuggled and I cuddled and he slept and slept and slept.

It was only a few days later as he guzzled away that I wondered if he'd gotten anything at all.

I only finished feeding him 5 months ago but it's very strange to think about feeding a newborn again. I'm hoping it's like riding a bike!

OP posts:

mears · 14/02/2004 15:50

Well, gave it some thought and tried out skin to skin in theatre after C/S. By skin to skin contact I don't just mean babies face touching mums, I mean naked baby (nappy on) placed on mums chest.
Baby was pretty small so didn't take up too much room however, she kept sliding forward and got wedged under mum's chin My other problem was that she was in danger of getting scratched by mums ECG leads (heart monitor). Mum was also getting choked by her gown - I was more desoerate to get the baby in there than she was I think She did look really cute snuggled in there for a short while though.
Incidentally parents couldn't wait to get her weighed - wanted that done first

highlander · 14/02/2004 16:29

Mears, is it reasonable to ask for the following for an elective c/s?

catheter to be placed in private (not in full view of all and sundry in theatre)

lower pelvis and breasts to be covered at all times

catheter to be removed just before the spinal wears off

baby to be removed at night so I can get some sleep

Also, why do some women object to the baby being given a bottle? If there's no boob milk, won't the baby get hungry and grumpy?

hmb · 14/02/2004 16:31

My top half was covered at all time when I had both my sections. I also had ds taken for one night because I was very hormonal and knackered

mears · 14/02/2004 16:52

Highlander - you can have the catheter put in in private. The reason it is usually put in in theatre is because it is done once the spinal anaesthetic has been put in and there is less sensation. Best to wait till effects of spinal have worn off before catheter is removed so that sensation of needing to pass urine has returned. A lot of fluids are given at C/S so the bladder can fill up pretty quickly. If it gets overfull, the womb cannot contract down and there is an increased risk of a haemorrhage. Removal of a catheter is pretty quick and can be done whilst mainly covered up.
Breasts can be covered up at all times. Lower pelvis needs to be uncovered until the skin has been painted with pre-operative antiseptic solution and then the whole area is covered with drapes.
Babies are not removed from mothers bedside at night for a number of reasons one of which is security. The other important reasons are that, believe it or not, mothers settle better when they know it is not their baby they hear crying. There is less risk of infection when babies are kept beside their own mums. Immediately post section there are staff available to help look after the baby and will settle him/her if need be.
It may be harmful for a breastfed baby to get a bottle when the plan is to breastfeed. There is colostrum in the breast for the first couple of days and although it is not a large volume it is packed with protein and antibodies. Colostrum encourages the lining of the baby's bowel to develop a protective lining against infective organisms. A single bottle of formula disrupts that process which increases risk of allergic response. Baby also needs to go to breast to stimulate milk production. In days gone by, babies were taken away from B/F mothers overnight and bottlefed. Result was many mothers did not produce enough milk and wondered why. Then babies were taken away and brought out just for feeds. This disrupted milk production because the mum did not have the stimulus of hearing the baby crying to trigger milk let down. The result again was lack of milk production.
The ideal scenario is a baby placed skin to skin with mum as soon as possible after delivery and for the first breastfeed to take place within the first hour. Skin to skin contact also encourages the mums skin commensals to pass to the baby which protects against infection. Babies also love it

fio2 · 16/02/2004 22:14

Do you know what was the most helpful thing after having my ds (2nd section) ? It was the fact that the midwife on duty, at night, let me have him in bed with me so I didnt have to keep struggling to get him in and out of the bedside cot. She made me put him on top of the bed and put the sides up and put his cot wwedged up against the bed so he couldnt fall out. This was not hospital policy btw but soooo helpful because it is horrendous getting in and out of bed after a section.

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