Birth plan for c-section?

[MsHedgehog]

I have a c-section booked in for a couple of weeks time. I had the final midwife appointment today before my c-section.

My next appointments are the pre-assessment the day before the op, and then the op. This will be my first child.

I have always been told that the birth plan will be discussed at the 36 week appointment, and even with a c-section, you still discuss and put together a birth plan for what you would like for the op. However, the midwife I had today appeared completely clueless. She couldn't answer any questions I had, and options that I had been given previously for the birth (immediate skin to skin, pumping blood up the cord because you can't do delayed cord clamping, choice of music, etc) she said are not actually available.

I don't if it's a case of the previous midwives not knowing about birth plans, or if it was today's midwife, but it's left me feeling really deflated. I went in with a list of questions so I can be mentally prepared and halfway through I gave up because she couldn't answer them or told me something different to what I had been told before, so I figured no point in carrying on the conversation.

Does anyone know if there is such a thing about birth plans for c-sections? I was definitely previously told there are, as the previous midwife I saw went on about how just because it's a clinical birth, it doesn't need to be a clinical experience, but today's midwife was very much of the view it's a clinical process. If that is the case, then fine, but it's not what I had been told until today!

I'm wondering if it's worth calling them back and asking if I can have another appointment with a different midwife because I didn't feel reassured by her at all.

There were other issues with the appointment too (she said I have protein in my urine but because my blood pressure was fine, it's not an issue - my blood pressure was the same as it's always been during the last couple of months, which is very slightly on the high side so I have been told to monitor it. I have also had a bad rash on my leg for the past few days which has been really itchy but she didn't even look at it and just said it's probably the clothes I'm wearing - if that's the case then fine, but I thought you need to raise itching with them!)

I just didn't feel completely reassured by her and it's left me anxious and uncomfortable.

I’m sorry she has made you feel anxious and uncomfortable.

As far as what you are asking for in your birth plan, it will depend upon both the hospital/trust and individual surgeon/team on the day.

Skin to skin should always be available and you will always be asked about vitamin k.

That sound rubbish op.

From my experience I didn’t have any say in any of the proceedings.
To be honest the whole thing was over so quickly I don’t see what plans I could have made. The next couple were waiting to go in after me and a couple after that, it’s fast & in & out.

It’s major abdominal surgery, it’s in the hands of the surgery team really isn’t it.
I did however have skin to skin straight away. The radio was on in the corner during the surgery,
It was a brilliant experience.

It depends on the hospital. Mine let me bring a CD or they could provide music. I requested skin to skin as soon as possible and as delayed cord clamping. They told me what their standard was and I was happy with that.

I never had a "birth plan" for my elcs. Just go in getvit all done and get my babies out safe, I didn't care about anything else.
Wasn't bothered about immediate skin to skin before cord cutting, 1st 2 vb's I didn't get that because they both needed respite assistance (cord round neck & meconium in waters). Those few minutes wait are worth it.

You still have choices OP. I had a section last year and had options like skin to skin in theatre (or your partner can do that if you prefer as it's difficult when you're all wired up but still possible), whether to give Vit K or not, whether you want the screen down when they bring baby out. The midwife who was on the team for my section asked me everything to confirm my choices but I went through it all with my midwife at my 36 week appointment too.

Sounds like your midwife isn't very keen on a C-section...

**Respiritory fat finger syndrome

I will be having my fourth c section later this year and at my booking appointment with the midwife (I will see the same midwife throughout), she told me to have a think about the type of section I would like.

She advised I think about a calm c section - dimmer lighting, my choice of music, delayed cord clamping and immediate skin to skin.

Tbh I had most of that with my previous section anyway.

But basically yes, she said I would still be asked to write up a birth plan for the c section, and only in the event if it becoming an emergency might they not be able to follow what I want.

If you were originally given a different impression then I absolutely don’t see anything wrong with phoning and speaking to someone else who might be able to clarify either way.

Good luck x

Remember that you will be awake and totally with it, so there is much less need to plan ahead with a planned section. Anything where you need to make a decision will be discussed beforehand/during the procedure (e.g. skin to skin, does the birthing partner want to cut the cord, etc).

Sorry for sounding dumb but what is the purpose of a delayed cord clamp? I had an emergency section with my first so had no options at all. I will be having an elective section this time so interested to find out more.

OP I had a plan for my second DS which was a ELCS after a previous EMCS. I had written it myself - not sure if the midwife looked at it, I can't remember specifically. They did look at it when I arrived at hospital though. I got my skin to skin, baby got his vitamin k shot, my husband got to trim (not cut) the cord and carried the baby over to me.

Go ahead and write down your plans. Be aware you might not get every option you think of, but they will take note and do what they can.

I had an emcs with my first so didn't have any skin to skin or a choice of anything really.

My 2nd was meant to be planned section, ended up waters breaking early but anyway the birth plan was never mentioned at any appointments.

I knew that u cld request certain things though or even a "gentle" c section (Google it). I wasn't too fussed so didn't request anything but I did assume they'd give me baby for skin to skin but they didn't. I would mention anything that's important to you or even write it down in advance.

Mine was a non emergency emergency cs if that makes any sense. I remember thinking we really needed a birth plan and making my husband scrabble around to find some paper and write one down. The surgeon very kindly told me I was her 5th that morning so not to worry! It was all very routine but not much choice on how it happened....
I'm also reminded a bit of the section in Adam Kay's book where he talks about gentle c-sections... the nurse telling the mum that if she was the one being operated on she'd want the lights up as far as they go ...

@Moominmiss

I will be having my fourth c section later this year and at my booking appointment with the midwife (I will see the same midwife throughout), she told me to have a think about the type of section I would like.

She advised I think about a calm c section - dimmer lighting, my choice of music, delayed cord clamping and immediate skin to skin.

Tbh I had most of that with my previous section anyway.

But basically yes, she said I would still be asked to write up a birth plan for the c section, and only in the event if it becoming an emergency might they not be able to follow what I want.

If you were originally given a different impression then I absolutely don’t see anything wrong with phoning and speaking to someone else who might be able to clarify either way.

Good luck x

That’s odd you were still required to write up a birth plan. I didn’t for my fourth c section at all although I knew I wanted skin to skin and vit k injection afterwards, but I didn’t verbally say anything until it was after birth or write any of it down.

I've never heard of doing a birth plan for a c section.....I've had 2.....at the end of the day it's not giving "birth" in the truest sense of the word - there is little input you can have as it's a surgical procedure ? Other than maybe do you want skin on skin, do you plan to breastfeed etc?

This is the first time with all my 3 sections that I’ve been asked to write a plan and think about my wishes, but there are certainly choices you have.

Look up gentle/calm sections.

These types of c section aren’t always done as standard. Although some trusts do and will try to encourage it. Which is the case in my trust

I'm a scrub practitioner in obstetrics and have assisted with hundreds of Caesarean sections.

It's lovely when the patients produce a birth plan, but for safety reasons a lot of what is requested is simply not safe, such as dimmed lights and no talking in theatre. We have to see what we're doing at the table and communicate with each other.

We do in our trust try to accommodate where possible with delayed cord clamping, but again this depends on the condition of the baby at delivery, as with vaginal deliveries, the babes can be a little shocked, especially if they were asleep!

We always play parents choice of music which can try to personalise the birth and we've had some cracking soundtracks in the past! Heavy metal was one which stands out, we were rocking at the table and singing along with the parents!

Dropping the drapes at delivery is something we can facilitate in our trust so the parents can see the baby being delivered, but due to obviously preserving sterility of the operative field they are quickly put back up.

It's the magical birth of your baby but it's also major abdominal surgery with all of the requirements which must be adhered to for the safe care of mother and baby.

It's a privilege to do my job and be part of bringing a new human into the world, I love it with a passion and each baby is so special.

Good luck to all mums having elective C/s's and same to emergency C/s mums.

You are amazing.. ❤️❤️❤️

Can you call the labour ward or speak to someone at the hospital to find out your options and their policies?

I had a planned section and had an hour long call with a midwife specifically to discuss what options were available, the plan, what to take and useful hints/tips.

I made notes at the time and intended to write up in to a c section birth plan - which I never got around to 😂. In the end my waters broke early the section was brought forward and I went with the flow on the day.

Everything was fine. I explained I wasn't good with needles and fearful of moving/panicking. I also would probably need to cry and release some emotion/tension so apologised in advance.
Everyone was brilliant and although I cried much of the way through, the experience was fab and a lot of it I had just worked myself up over.

Communication on the day is key.

They explained each step and what would happen. With a planned section there are plenty of opportunities to discuss each stage before commencing. Plan for the day and consent with consultant, Gowning up/what will happen etc with midwife, medical history with Anesthesiologist.

Discussed vitamin k and if we wanted music. Anesthesiologist put some music on in the background, everyone was happy and chatty- which I wanted as a distraction. They lifted baby as he was delivered, I could see him being checked over. Partner was asked if he wanted to take pics and cut cord. Partner was given baby and was able to hold him nice and close to my head. In recovery we were both given time for skin to skin although my temp was v.low in surgery and a while after so this was delayed a little.

I was extremely fearful and my planned section was fantastic. I hope you have the same great experience. X

The midwives I saw last year during my second pregnancy were so bad I was the one who kept prompting questions. It was shocking and if it hadn't been my second I would have been in bits. It's
infuriating when you get told as standard e.g. 'discuss birth plan at 36 weeks' but the community midwife just doesn't know how the labour ward run c sections. (Sorry, I know most are amazing and it's a tough environment especially now but I was put under the care of two job share trainees who just weren't).

I've had two ELCS and would defer to @Meezer2 's expert knowledge above! There are a few things you can request such as skin to skin but it is more limited.

To give you peace of mind though, what I would add is that the staff on the day will explain everything to you and answer any questions. They are the ones who will be in theatre with you and they know the drill where your midwife doesn't. As another pp said, it's not like going into labour where you might not be completely 'with it' so just take some notes of what's important and ask away on the day.

But don't get too hung up on the baby being born to a particular song or anything like that - the radio was on for both of mine but the surgeon selected the station. Looking back, I couldn't actually tell you what was playing anyway!

We were told we could bring in music - our hospital only had a CD player so we went to the charity shops to find some relaxing Spa music. The operating team loved it so we let them keep the CD for people who didn't bring anything.

I had done research about options for an ELCS and I spoke with the team about it on the day. I was allowed to have the sticky heart monitors on my upper back instead of my chest to allow skin to skin. I asked for dealyed cord clamping and they said they would - whether this was actually done or not I've got no idea, as she had a short cord. I can't even remember if she came straight to me or went away to get cleaned up first but I think I requested she came to me as soon as possible and I don't remember waiting!

My husband got to tell me the sex of the baby and I was asked if I wanted the drape to be lowered to watch her being born.
I had read about gentle c-sections and how you can request the lights be dimmed. I did ask this but they politely (humourously) said they would rather be able to see what they were doing with the lights on full lol!

My consultant insisted on a birth plan for what was meant to be an elective with dc2 (ended up with an emcs). She essentially wrote it herself as she was planning on doing the surgery but it was followed by the dr who delivered dd.

Dh held me for the spinal
They positioned the drape as low down my body as possible to ensure loads of room for skin to skin
Drape was dropped for dc2 emerging
Everyone stopped talking until I'd told dc2 how gorgeous she was
Delayed cord clamping
Skin to skin within 3 to 4 mins, just a quick rub from the midwife as she was passed to me
All measurements/vit k done in recovery about 3 hours later
Oh and they tried to give me the placenta in an icecream tub

It was amazing and totally different to my first exceedingly traumatic emcs.

Hi OP! Sorry your midwife was a bit rubbish! I had an Elective CSection last year with my 1st baby but I never got to discuss my birth plan with midwife either. I did write one regardless anyway and on the morning of my CSection, I discussed it with the midwife assigned to me and also with my surgical team and they said as long as everything goes as planned and the procedure is complication free, they are happy to accommodate anything. It was absolutely brilliant!!

I had options whether I wanted a see through screen or black out ones
I had my own music
I had delayed cord clamping, baby and placenta were taken out together, still attached.
I had immediate skin to skin
No bathing baby
DH got to towel dry him, and took over skin to skin until I was stitched up.
Breast feeding straight after.
Pictures throughout the birth

Also, check out some gentle c-section birth plans for more ideas if you haven't already. You are GIVING BIRTH, you have options!! Good luck and I'm happy to answer any questions

Thank you everyone. Good to know that I wasn’t imagining the concept of a birth plan for a c-section. As someone said, she was a community midwife who probably doesn’t know much about c-sections.

The thing is I had initially believed that a c-section was very clinical and impersonal and I accepted that. I have always known, even since before I was pregnant, I would need a c-section and believed it was very much a medical procedure. But the midwives I’ve seen along the way, and especially the one before the most recent one, stressed the importance of a birth plan to run through what you want in a c-section and the options available. I know that if something goes wrong the plan is out of the window.

The only two things I care about is immediate skin to skin as soon as baby comes out, and then the c-section version of delay cord clamping. Can’t remember what it’s called but it sounded similar to squeezing a toothpaste tube! So when the midwife told me I can’t have either, it took me by surprise!

Sounds like I’ll need to discuss with the midwife on the day, which is completely fine, but if that’s the case they shouldn’t have talked about c-section birth plans!

Just in case anyone is interested....

The rash on my leg that the midwife didn’t even look out turned out to be a blood clot! I called the midwife helpline about it after it didn’t go away and I noticed my calf and foot was more swollen than the other so they asked me to come in. Now I’m having to use daily injections for the next couple of months!

I’m not annoyed at the midwife, as catching it sooner would have simply meant starting treatment sooner - but just another sign that she was completely clueless! Which reassures me more that she doesn’t didn’t know how a c-section works!