Elective c-section birth plan: ideas, experiences?

[Fingerbobs]

I'm having an elective caesarean next week (placenta previa) and am trying to think what to put in a birth plan. So far all I can come up with is:

• screen down when baby's being delivered
• partner to identify sex
• skin to skin if poss (friends have said the operating table's too narrow really and also that you can get a bit sick/dizzy whilst they're stitching you back together).

Is there anything else I should consider? anything you did that was good, or that was particularly awful and should be avoided if poss? I'll be bringing my own music as the consultant hinted the selection wasn't great. I'm assuming that you can't really have lights dimmed in an operating theatre, is that right? Thanks in advance for any hints and tips

My DH had the skin-to-skin whilst I was being stiched up. They just popped DD down his theatre top with her little head poking out - she was wearing nothing but a hat.

Make sure they put your catheter in after you have your spinal.

I'll hunt out my birth plan and add some more notes later.

the other things I have on my (just in case plan, hoping for VBAC) C/S plan are

My preference is to have a spinal/epidural anaesthesia as I wish to remain awake for the entry into the world of my baby.

I request that the theatre team are very quiet and respectful at the moment of birth, so that the first voice my baby hears is mine.

I wish to have skin to skin contact with my baby as soon as possible, please leave one arm accessible/unrestricted.Please do not have the screen so high that I can not have my baby lying across my chest. (DH can help you have a bit of skin to skin, it is difficult on the op table, but not impossible)

I want a continuous dissolving suture of my incision, not staples. (What I had last time, some friends have had staples & these are horrid as they have to be taken out - worth asking what the choices are at your hospital)

I want the catheter & IV to be removed as soon as possible.

Fingerbobs,your "partner to identify sex" made me laugh.When Ds3 was born the anaesthetist shouted "Ooooh! He's weeing!"

Betsy,catheters are removed when you are able to walk safely to the loo,and IVs are removed when you are drinking enough,unless there are serious complications and they need to monitor fluid balance closely,so thats a given really.

sugarfree - that may be the theory - but from experience I had to hassle them to take my IV out last time(I'd already been up to the loo & eaten breakfast at that point) as it was driving me mad, it was so uncomfortable. I also asked to get up & use the loo (ie get rid of catheter) rather than wait for them to get round to seeing if I was ready - so I don't see any harm in including in you birth preferences that you are keen to get back to "normal" ASAP

Both times I requested that staff respect my privacy - they see so many fannies I think they can forget patient dignity!

Don't worry too much about getting skin to skin on the table. If everything goes smoothly you'll have a prolonged snuggle in the recovery area

Lights on I'm afraid.

If you're BFing, note in your plan that your baby is not to be given formula.

You've probably heard the scare stories that CS babies gag a lot of mucous - not true if you're BFing. Both my DSs possetted twice in the first 24 hours, whereas the formula babies were being sick all the time, regardless of birth type.

Make sure the anesthetist gives you a Volterol (Diclofenac) up the bum before you leave theatre.

KEEP ON TOP OF YOUR PAIN/INFLAMMATION!!!!! Take Volterol regularly for the first 48 hours - don't wait to be in pain. Find out when the pain relief is due and buzz 15 mins beforehand. Ask for Codeine in the first 24 hours if you're struggling.

GOOD LUCK!

Definitely make sure that if you wish to breastfeed not only is it in your notes, but DH knows, with my el-cs nurses tried to feed DS a bottle, and also told me he needed one as he was hungry, sorry but that's rubbish, babies can go at least a day after birth without feeding, so they can certainly wait for you to be stitched up!

i went for GA as I just can't be awake for surgery. childbirth for whimps for me. I am just thankful its over.

Im frightened to death of GA and demanded local - was most bizarre feeling.

I was soo glad i was awake when dd1 and dd2 (both electives) where born. Dh was present and we both had really positive experiences of it all.

Skin to skin deffo!

Other than that, itll be over before you know it.

Probobly feel sick and dizzy due to blood pressure changes rather than skinny table - i didnt even know if i was still on a table - i couldnt feel one!

I planned to have a csection this monday but baby had other ideas and I had to have my csection last Friday, I came home on Monday and the birth was a beautiful experience they lowered the screen for me so I could see baby coming out,then they lay him straight on me, left a long section of cord on, so when they were cleaning him my husband could cut the cord. They dimmed the lights and there was silence so the baby heard our voices. COmpletely different to my emergency c section with our first born. I adapted one I found on line:
As I have not yet had a natural birth, and plan to have no more children due to the severity of my condition I would like to make this c-section as natural as possible. If possible might I be able to have the following:

1. To have the screen lowered or use a mirror to watch my baby being born.
2. If possible we would like to take photos of the baby being delivered.
3. As I was not the first to see my baby last time, I wondered if it is possible to ask for the lights to be dimmed for a couple of minutes at the moment of birth, and for there to be silence so baby sees me and hears me first.
4. I would like baby to be wrapped in a blanket and laid across my shoulder so husband and I can be with baby whilst I am being stitched, as last time my mum was the first to hold my baby and open his eyes to.
5. If all is well with baby, I do not wish to be separated from him.
6. If for any reason I cannot be the first to see my baby or am unwell I wish my husband to be the first to hold and tend to the baby.

Obviously the above points will be dependant upon the health and welfare of baby at the time.

Sounds as if you've got it all worked out, Fingerbobs. Nothing I can add to your birthplan except to say it looks as if you have thought it all through.

When I had my last c-section we asked the anaesthetist how many people request the screen to be taken down. He said, in the last 2 years at that hospital, only one person! So it's actually quite an unusual request (most people, including me, would rather not see the blood and guts) but if that's your sort of thing, why not?

Having your own choice of music is really important I think as it can create a lovely atmosphere.

Thank you all very much - and congratulations, loopyredangel - it's most reassuring to see you back on MN so soon after the birth!

Oh yes, i forgot. Dp took in a camera we had several shots taken, anaesthetist even took some of the three of us.

I had a electice Cs with DS and they did not drop the screen due t DH queasiness but we discovered together his sex, and Dh then had him skin to skin for 2 hours before I was well enough to hold him( various complications I have with bleeding and reason for elective cs in the first plce) I believe that this is why BF was so sucessful despite my severe anaemia

Good luck with th birth plan, and the arrival of new baby

This is very interesting, I had no birth plan and nothing was discussed with me, when I had my elective c-scetion with ds.
I am taking notes.

I had a planned section last November dut to Placenta Previa. I had some great advice from Marslady on here

Some of the things I put down were:

A blanket that I had slept with previously to be used to wrap baby in.

Dh to be with baby at all times. Because of this the midvives in theatre let him clean ds1, dress him, weigh him and everything! It was fantastic (They were close by of course!)

Skin to skin as soon as possible. (Ds1 was put with me as soon as dh had got him sorted) We then had a long time skin to skin in recovery.

No formula at all! With previous baby they had tried to give formula as she was a preemie, luckily dh insisted a nurse come to me in recovery and get my colostrum

Definately Voltarol pessary up the bum! They are great

I had a drain in the c section wound and if I ever had another section I would try to avoid this as it was agony coming out

Good luck xxx

Oh and dh took photo's of the section being done and ds1 being born. Theatre staff were great.

If you have the capability on your camera to do so, take the pics of the birth in black and white so you don't see the blod and gore everywhere (eg splattered on clothing of surgeons etc). We have some lovely b&w pics of dd being pulled out of my tummy which might have been a little too much had they been taken in full colour!

OK it's all good suggestions ut don't make assumptions. Staff in the theatre refused point blank to lower the screen at birth, even to show me the baby above the screen. Also, they take the baby away to another room to clean dress him and I could hear him cry, but he was at the other end of the hall (DH was with him and took lots of photos). They couldn't find a scale (!!!!&$I$*((ED^) and it took ages before they brought him back. I was Livid. Still am.

I had heard all those stories that you could ask for the screen to be down, see your baby immediatly after birth, but the staff on the day was adament that they wouldn't do it.

Remember to take CD of your own music in - they should be happy to put it on. I had it both times (for same reason as you). We took same CD of swing songs for both. For dd1 'her song' was 'let there be Love' Nat king cole and dd2 was 'Move over Darling'!! A message to dd1 I think....

Don't look up at the light as you'll see the op in the reflection. I found concentrating on the music really good as I was nervous. Give dh a list of things to check for you as he can go off with baby for initial exam when he/she is born.

REcovery time was really nice I remember, with just you and dh and only 1 or 2 theatre staff. You're off you tits on morphine and it's just you and dh getting to know the baby and it's FAB.

mmmmm Morphine........ Two of my happiest afternoons, post c-sections, morphined up to hilt, with gorgeous new babe to stare at and love.. Bliss

Thanks Fingerbobs, recovering better thistime around, I think it helps if you feel a little more in control of the situation. Good Luck by the way!

I had emergency c section 1st time and elective 2nd time. Make sure your DH holds the baby so that they are not upside down to you, the table is so tiny and the curtain is at breast level so some midwives/partners tend to hold the baby so that you can see their face but their body is up by your head and no room to tuck them down by your side.

We took photos of both our boys half way out of my tummy (you can't see inside me -you just see green gowns)

The atmosphere with an elective is really relaxed (unlike whipping a baby out who is in distress and an exhausted 25 hour laboured mother) you are really alert and both times they popped the baby over the curtain and although we knew the sex from the scans my DH definitely said they were boys to me before anyone else.

We didn't really have any specific plans for the elective section, we just went with it. I didn't want any plans set in stone in case it didn't happen and then I would be disappointed.

I went really sick with the elective and had a lovely cool facial from my midwife whilst DH held our son. Absoultely great staff, couldn't fault them.

Good luck.

I am having a section in 8 weeks. I am expecting twins and we don't know the sex. Would it be possible to hold both babies at all or should I leave that to OH and sister. I am told that I will be having a spinal block rather than an epidural. Is there much difference? I was not really that aware that you could request much by way of a birth plan if having a c-sect.

I asked them to give me the pain medicine as a top up in the IV rather than sticking it up my bum. Just don't fancy anyone sticking thing up my bum.

you won't feel the tab going up your bum, The rectal wall is one of the fast-absorbing areas of your body when it comes to taking pain relief. If they gave it to you IV, then all of the drug would be delivered at once - you need it slowly released over time.