Birth plans all changed - advice for c section please?

[AisieSusie]

Its my due date today and I went to the hospital for a check up & sweep, and everything was fine until the sweep where they felt a foot not the head, so big panic over breech birth, already 3/5ths engaged in wrong position, so won't change position now.

In a matter of minutes gone from my dream birth plan of birth centre, water bath with doula, hypnobirthing music and lots of instant skin to skin, to a c-section booked for friday.

I know i should be really glad its not a real emergency, or huge risk to the baby, and i am, but also, i am so upset. feel like i;ve failed somehow, and sort of mourning the fact i'll not have contractions, and feel like a fool wasting all that time preparing and visualising for a natural birth.

I know you can't ever plan on things, but having got this far, and really pressed for a natural birth all the way through, i am so sad right now.

I am so scared of a c-section, am really worried about bonding with the baby if i am not the first [ish] to hold him, how will he know its me? what about breast feeding, and staying in hospital so long and not being as mobile... and practically, what about my hospital bag, anything different to pack...

i know am making a fuss about nothing, and will pull self together shortly, but any tips or hints would be really welcome to help me get my head around it...

first of all relax

Who's to say that had your baby been head down that you would have gone into labour (i didnt), or that your contractions would be strong enough, or that you would have been able to deliver your baby.
We all have a romantic view of 'how birth is meant to be' but I can promise you that most of the time its not like that and we dont get what we want.

An ELCS will be lovely, you should be able to have a spinal or an epidural and therefore you will be awake so will be able to hold your baby straight away, and also your partner will be able to be there too. Just think that if you couldnt give birth and had to have an EMCS you might have had a GA so no holding baby and no partner (just trying to make you feel better).

I was in a lot of pain after my section, make sure you take all the painkillers they offer you and DONT DO ANYTHING when you go home, get lots of help and just rest and enjoy your new baby.

Congrats, good luck, you will be fine

Hi Alsie.

You sound a bit shocked, and that is completely natural. Try to be kind to yourself and allow yourself to feel all the emotions that are bubbling up. It might help to have a good blub and/or to let ut all out to your DH or mum or whoever you feel closest to.

On a practical tip, all the birth prep you did is not wasted. Breath control, relaxation techniques and hypnobirthing techniques are all really useful for a c-section and can help with nerves.

I have had two c-sections. My first section was an emergency after a long failed induction. I was exhausted from days in hospital trying to get the baby out naturally and it all went in a bit of a daze. I barely remember it to be honest.

However, my second was an elective and was lovely. It is very surreal and I was shaking with fear when I got into the theatre - it all seems so imposing and clinical. But the staff were lovely, it was very quick and I felt absolutely no pain at any time.

My surgeon had the curtain lowered so that I could see her being lifted out (very bizarre!) and you certainly can be the first person to hold the baby after the surgeon has removed him/her. My DH cut the cord (both times actually) and my baby was handed straight to me. She was then taken away very briefly - but always in my line of vision - to be checked and weighed, then handed back to me wrapped up in a towel. The midwife pullled my gown off my shoulder so my DD could lie against my skin for a while. DH held her for the rest of the time while they stitched me up. I breastfed my baby as soon as we were in recovery.

I would suggest that you write your 'birth plan' in your maternity notes and get the consultant to physically sign off your wishes before you go into theatre. Make a point of asking that all relevant theatre staff see the notes.

I know it is a daunting and frightening proposition when you have imagined a natural birth, but an elective is honestly not a terrible experience for most women and can be incredibly positive.

A few more words of advice:

If you do still feel feelings of guilt or failure after the birth, don't bottle them up. Tell someone, anyone. It is very normal for c-section mums to feel they have somehow failed. Best to get those feelings out there and deal with them.

And make sure you line up some extra support for the weeks after your baby is born. bending, lifting etc is going to be out for a while and you will need some rest and TLC for a little while.

Good luck x

Gosh, that was long!

I echo moss, btw. Take the painkillers they give you (keep taking them when you get home, too). They work!

A quick reply...my first (breech also - my plans for my natural, hypno birthing out the window too!) and third were both sections and i never had any trouble bonding or breastfeeding them so don't panic!!! DS also ended up in SCBU (cos he was earyl not cos of the c-section) so took a while for us to get proper cuddles and feeding established too.

I'm due my third section at the end of the month so they're not all bad . The recovery is a bit painful but nothing too bad compared to the 16plus weeks of SPD i've had!! At least you can take lots of pain killers! Just take it easy - keep mobile but don't over do it and you should be fine.

Good luck for friday x

thanks for the nice messages and for not just telling me to get a grip, as will do that in a while - at least they didn't have room to do the c section today, or i would be a gibbering wreck and actually doing it.

I know things don't go to plan, [and i know am ebing such a wuss about this], for some reason was fine with the idea that would go to birth centre and then it would all change there, but totally caught me on the hop that things would change before even gone into labour - I think you are right annasceptic, am a bit shocked, and moss chops, of course you right that a planned csection is so much better than an emergency one, i will focus on that.

do you think i should write another birth plan for the csection then? i don't know what's realistic to put in it, or what i might need to specify?

when i asked this morning, the doctor said that they'd show me the baby as soon as it came out, then take it to get it breathing & rub it before i could hold it... does this sound right or can i somehow ask them for me to hold him first or something?

and here's a really dumb question... when you go up to the ward, how can you pick up the baby if your legs are still numb/ wobbly? can you kind of lean over and scoop them up, or is it really difficult to get them out of the little plastic crib thing? i have quite bad spd, and the idea of sprottling around with a drip in arm, bandages on stomach, catheter and legs that i can't swing around feels very daunting!

What's important to you?

You could specify things like:

Would like screen lowered at point of birth

Do not want to be told sex - want to see for myself

Want to hold my baby asap in theatre (for my first section they did as your doc decribed, second section they let me hold my DD for a minute before they took her to be checked. To be honestm it is slightly awkward to hold your baby when you are lying flat with a drip in your arm!, but it was still nice to hold her and smell her).

Want skin to skin in theatre

Want help to establish breastfeeding in recovery

re: picking up afterwards. I found it very hard both times, although I could do it. I had to move very slowly. It helped that they had those remote control beds that lower and higher etc. I also had a buzzer which I could press for assistance. First birth the hospital staff pretty much ignored me. Second birth they were great and came whenever I called and lifted my baby up to me.

All being well, you'll be up and walking with no catheter in 24-36 hours anyway.
You may also find your SPD vanishes (it might not, but mine did after my first birth).Fingers crossed!

absolutely write another birth plan, state hat you want your birth partner there, and discuss with the consultant about wanting the baby passed straight to you.
TBH ds2 went straight to be checked and then passed to me, it was a matter of seconds and I could see him the whole time

When you go to recovery and the ward make sure someone always picks up baby for you, believe me that even when your spinal wears off you will still not be able to pick up baby because of the pain, the nursery assiatnts or midwives will pass baby to you.

about the post op pain, i had terrible spd and hyperemesis, and both were gone after the CSection so i actually felt pretty fantastic and had no post op pain.

thats not to say i felt up to running around or anything, but i wasnt in pain.

hth

I too was completely freaked out by having a CS and was convinced I would still feel them cutting me etc but I have to say it was the best thing that happened. I didn't feel a thing, they showed me DD1 and I didn't rewalise they had even started! We do not always get to choose how our babies arrive but just be thankful that it arrives safely.
The one thing I would have done differently is to get my husband to have skin to skin once the baby was born. I was still in theatre being stitched up for 40 mins while he was back in the delivery suite with DD1 and had I thought about it I would have liked him to do that but neither of us thought about it at the time.

I've had an em cs, planned cs, and a hysterectomy so I've had more than my fair share of abdominal ops, not much to add to what everyone else has put but I can't see these mentioned before...

• When the hospital give you your painkillers to take home get them to write on the boxes what time you need to take them as I got in an awful pickle after my em cs and wasn't sure what to take when. IIRC after both cs's I was prescribed voltarol and paracetamol, they need to be taken at different intervals to get the maxmim benefit so try and make sure you know to take them the same time you would as if you were still in hospital.

-they will probably give you a morphine suppository after the op. Obviously you won't feel it as you'll be numb from the rib cage down. I found that not pigging out helped prevent constipation and I found Movicol (stool softener) better than Lactulose, but I have IBS so laxatives are not a good idea! I took herbal tea's to hospital which tasted 'nice' but stopped me eating too much while my stomach and bowels were still getting back to normal.

• big pants, they will probably put some huge mesh pants on after the op but may well not let you have any to take home. You can get the mesh hospital pants in some shops and on line but otherwise the big cheapy tummy control pants in somewhere like Primark are fine. Basically you need something that comes up to your belly button and doesn't rub the scar. Sarongs are handy too, pity it's not sarong weather!

• Try and get a private room afterwards, I had a lovely time in mine after my planned cs. DD breast fed like a dream and I was happily reading the weekend papers between feeds.

• rest in hospital, get the midwifes & health care assistants to change nappies as mmuch as you can and you just concentrate on feeding and recovering. When you get home don't lift a finger, just wander to the loo every so often or to the kitchen for more choc bics . I was able to change my DD's nappy after my planned cs as we had a cot top changer so I didn't have to get on the floor, but apart from that I did nothing and everyone else helped look after her big brother. The more you can rest in the first few days the better you will heal. I had my first trip out of the house after a week, but didn't push the buggy that time.

All the best for friday. We are all here if you need any more info .

I had an emergency section 5 weeks ago as my DD was breech, found out during a scan as she was measuring small for dates and then went into labour that evening!

I had to have a GA as they couldn't get the spinal in.

I was out for about 40 minutes but after she had been delivered they called my DH back down to hold her until I came round. I've had no problems breastfeeding etc. despite not having skin to skin for a couple of hours after the birth (I was very sleepy after GA and on a morphine PCA).

I couldn't move around because of catheter (and I was worried about pain) so the midwives passed her to me when I wanted her and during the day DH was there to do it for me.

The pain was no where near as bad as I expected it to be, the PCA was taken down the morning after the section, and I stopped taking dihydrocodeine the next day. On discharge (delivered just before midnight on monday and was discharged on the thursday) I was taking just paracetamol and ibuprofen but they would have given me diclofenac if I needed it. My SPD also disappeared after the birth.

For your hospital bag- you'll be in hospital for a few days so take some nice snacks and drinks to see you through (I had little cartons of apple juice and hula hoops, they came in useful for DH too). Also, I had those paper knicker things, but they seemed to sit low over my wound so take some big granny pants!

I can understand why your upset, I cried and cried when we came home from the scan. It's frightening when you don't know what to expect and you've spent so long preparing for birth. At least you know that on friday you'll have your beautiful baby!

Good luck
xx

you've had fab advice on c-sections already, and mosschops is spot on.... you never know how it'll turn out.

i just wanted to throw into the mix though, that you CAN have a vaginal breech birth if you want!! google mary cronk!

Hi, I had a virtually identical experience in November with late identification of breech and a quick switch from planned natural delivery to ELCS.

You've had loads of good advice above (lots of which I got here too and it made a big difference). In particular peppermint oil, lactulose and being a complete diva when you get home were three things that made a big difference for me.

Looking back I can honestly say that it was fine, my worries were unfounded.

Re: your concerns about not being the first to hold baby, the hospital did the absolute necessary and then brought DD to us and DH had skin to skin virtually straight away, in fact we had much more early contact than with my prior natural delivery.

My hospital were fantastic at helping establish breastfeeding, they paid special attention to how I was positioned on the trolley post op to support skin-to-skin and bf, I was propped on my side and the gown loosened. As a result I have established bf with DD2 much better than I ever did with DS1 with whom I had a vaginal delivery.

Also, I was home the next day so don't assume a long hospital stay is a given.

The more limited mobility is a pain but the staff did not seem to question how often I buzzed for someone to help.

I felt the way you describe (mourning my other labour, fear etc) every day until the day of the procedure, on that morning I woke and the best comparison I can give is it felt like Christmas day when you were little, so exciting, knowing by the end of the day you'll have your baby - from that morning it was plain sailing. Best wishes for Friday x

Aisie - about picking up your baby afterwards, you can either:

• do it yourself though it is very painful
• press the red button and ask a nurse to do it for you (lots of women do that)
• or (like I did), make a nest with a few pillows in your hospital bed and that way your baby is always on hand - easy for breatsfeeding, cuddling and for gazing at him/her forever!

Good luck!

with all everyone else has said there is only one other tip i can give.
i was most worried about having the staples removed afterwards so i made sure i used loads of aqueous cream over the scar and it made the skin so soft and supple i didnt feel a thing.
had emergancy sec 1st time and have just 95% confirmed my wishes for elective in couple of months. i was initially terrified of a 'natural birth' when it resulted in sec i was a little dissapointed but honestly now i believe it is no failure, you still carry babe for 9mnths and mentally/physically go through everything that defines birth even if its a fella in a mask and gown actually pulling him out. he wasn't gonna get all the credit for 20mins work!!!

Wow - great advice QT. I'm currently 36 weeks with a stubbornly breech baby (he's been in the same position since 22 weeks). They're trying an ECV next week, but don't seem too hopeful of it working. So, it's great to know that a c-section doesn't have to be all doom and gloom, even though it's not at all what I was hoping for.