Even though approximately 30% of families will birth their babies by caesarean, we don’t talk about it! We don’t talk about what it feels like or sounds like. And as doulas, we often see some of the fear around caesarean birth is about the not knowing, rather than the birth itself. So in our second installment of Everything You Wanted To Know…But Were Too Afraid To Ask, we are talking about caesareans.
A quick note as we start off that we use caesarean and caesarean birth interchangeably and we do this for consistency. We respect each birthing person’s own experience and what language they use to describe their own birth. And whether you are having a scheduled caesarean or you are hoping to avoid one, a caesarean birth is still absolutely a birth.
Is It Like In The Movies?
Like lots of things in life, Hollywood gets it wrong a lot of the time. And while caesareans are not depicted as often on television or in the movies, we do have enough examples to add to the fear. Perhaps even more than Hollywood though, our peers influence our perception of caesarean birth.
Sharing birth stories is common once you get a group of parents together, especially when their children are tiny. Inevitably,, someone has a terrifying caesarean story. And while there are absolutely times where a caesarean birth needs to be performed immediately because it is an emergency, they are rare.
There are three types of caesareasns: scheduled, emergency, and stat/crash caesarean. Scheduled caesareans are often recommended when the baby is breech, if there are concerns about the placenta, medical conditions (either parent or baby), and in some cases of multiples. An emergency caesarean isn’t actually an emergency, but it means that someone needs a caesarean, and it cannot wait because they are in labour. A stat or crash caesarean means baby or parent need the birth to happen immediately and often the birthing person requires general anethesia.
It is important to know that, scheduled or emergency, most caesareans happen in a calm operating room, with the birthing person awake, their support person with them, and it is a happy and exciting time.
So What Actually Happens?
Although every hospital has it’s open routine and protocol, most are relatively similar.
For a scheduled caesarean, families are given a time to arrive by, typically two hours prior to the scheduled time of the caesarean. Once they are admitted, the birthing person is given a hospital gown and the nurse will usually do bloodwork. Anethesia usually comes by before they see you in the OR, to ask their questions and answer any of yours. Once it is time for the birth, the birthing person is taken to the OR where the anesthesiologist will administer a spinal block which will keep you completely numb for the entire surgery.
Those who labour before needing a caesarean will likely already be at the hospital and their bloodwork may already be done. If the birthing parent already has an epidural, different medications will be added to increase the strength of the pain block. If they do not have an epidural, a spinal block will be administered in the OR.
Once the birthing person is numb and the medical team is ready, the support person will be brought to the OR wearing some form of scrubs, mask, and hair covering. They will be seated on a stool near the head with a surgical drape hung between the head and the bump. This drape protects the sterile field, so remember not to touch it!
Once the birth begins, it is fairly quick until your baby is born. Usually between 10 and 15 minutes. It is often surprising to people that they are not completely numb to all sensation. While they are much number than with an epidural, you still feel tugging, pressure, and sometimes referred pain on the right side, caused by the uterus being moved as the baby is born. All of these sensations are normal, even if they are disconcerting for some people. However, the anesthesiologist is by your head the entire time and you should inform them immediately if you feel any sharp, cutting, or tearing sensations, if you are nauseous, or if you are feeling panicked. They have medications on hand to help with all of those things.
Once your baby is out, they will be taken to a warmer and quickly weighed, wiped off, checked over, and then swaddled and brought over to you. It takes between 20 and 45 minutes to finish the surgery once the baby has been born. After that you will be taken to post-operative recovery.
But I Won’t Be Able To Have The Important Moments
It surprises a lot of people to know that needing a caesarean doesn’t mean you can’t have all those special moments you have been hoping for. And they are worried that means they won’t feel connected to their birth. While not all requests can be accommodated, but here is a list of some things you can ask your medical team to do, to help you feel connected to your caesarean birth.
- the OR team introduce themselves so that you know who is in the room
- request that they do not talk about things other than your birth (not everyone wants to hear what they had for dinner)
- lower the drape so you see your baby be born (you won’t see anything graphic, it isn’t lowered all the way)
- give a “push” as the baby comes out
- newborn procedures such as vitamin K be done in recovery, after the first feed
- skin to skin in the OR
- if skin to skin with the birthing parent cannot be accommodated (or they don’t want to), it can be done with the support person
- music playing
- scents on a cotton ball in a ziplock baggie (hospitals are scent free zones so we recommend asking first)
- breastfeeding in the OR
- extra support person such as a doula or parent (this is the most likely to be turned down, but if no one asks, nothing ever changes)
Caesareans do not need to be a terrible experience. Even unexpected caesarean births can be full of fun and celebration. For tips on recovering from a caesarean, check out our past series, The Postpartum Experience.
To check out our first installment, read here.