A Positive Caesarean.

Not all women can have a vaginal birth, for their own specific reasons. So, although Birthrites' considers a VBAC to be the best option for both Mother and Baby, where possible, we realise that it may not always be a viable option when each pregnancy/birth is considered independently.

We have, therefore, produced this page in the hope of your caesarean being a "better" experience than it may have been last time. We hope you will remind your Obstetrician that Birth is a sacred event, and you would appreciate it being treated as such. This is the birth of your child, a completely different surgical experience than any other, an experience to be treated as similarly to a vaginal birth experience as is humanly possible.

Below are some suggestions to help make your caesarean a positive experience.   These suggestions have all been sent in by mothers who have had empowered caesareans.   If you have any further ideas, please send them to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

The following birth plan may be used to help you achieve an empowered caesarean birth.   You and your partner can use it to decide what is important to you.   You can then discuss the various points with your care provider.  Some of the items may need to be arranged in advance of the birth.

It is written in such a way that it can be used as a hospital document.   Birthrites gratefully acknowledges the work of Sara Bayes in the development of this birth plan.

Positive Caesarean Birth Plan.  

• Acknowledge your feelings.   Where possible, take the time to examine your own feelings, fears and expectations of caesarean birth.
• Educate yourself on all aspects of caesarean birth, both benefits and risks.
• Maintain a healthy pregnancy.  Keeping yourself and your baby in good health will help you both recover more quickly.
• If you do need a caesarean, then it would be better for you to receive a spinal/epidural anaesthetic and remain conscious during the operation, participating in the birth of your child.
  
   
• If an emergency caesarean is necessary, under general anaesthetic, then be sure your baby is given to your partner as soon as possible after birth and held by him (hopefully next to his naked chest - skin to skin contact) until you are awake and can be told of the baby's sex and well-being (by your partner).
  
   
• If an elective caesarean is necessary, then you can request that you be able to begin labour naturally before the caesarean is done. That is, you do not want a date and time preset, you wish for your baby to decide the day on which it is ready to be born to avoid any problems with prematurity and for both of you to reap the benefits of your hormones.  
  
   
• If you know that a scheduled caesarean must be performed, then you should request preoperative blood work and tests to be done on an out-patient basis, and hospital admission on the day of the birth (not the night before).
• Where possible, you may be able to walk into theatre and not be wheeled in on a bed.   This will allow you to see the reality of the room and not a distorted view from laying down looking up at the room and lights. 
  
   
• As far as possible, your baby should remain with you at all times.  If you are both well, your baby should not be sent to the nursery without you.  Care providers are becomingly increasingly aware of the benefits to the baby of remaining with the mother, particularly with skin-to-skin contact.   If your baby must go to the nursery, then DO send your partner and encourage the "skin-to-skin" contact mentioned before. Your baby will really be craving this beautiful contact, and should recognise your partner's voice.
  
   
• Would you, and your partner, like to view the actual birth? Then make sure your Ob. realises this... Tell him you (both?) would like the option of viewing the birth, either by lowering the screen or by positioning a mirror. Maybe your previous caesarean is still a bit unreal, as you never have actually seen a baby leave your body - they tend to just appear from behind the green screen and be held up for a quick look before they disappear to be wrapped up and tested.
  
   
• Make sure theatre staff realise that you would appreciate a verbal description of the birth as it occurs. You may have previously felt left out of your past caesarean(s) as your body and labour might have been discussed as though you weren't there.
  
   
• How about asking the surgeon to leave the umbilical cord long and allow the father or mother the chance to cut it.  That way the parents do not miss out on the sensation or their own right to tell their story of 'cutting a cord.
  
   
• Would you love to meet your new baby in his/her unclothed, naked newborn state - a wet, slippery baby? Then request that the baby please be placed on your chest with a warm blanket over you both. It would do a lot to make this surgical delivery a bit more natural for mother, father and baby. And it may even resolve a few inner conflicts that are faced after the birth.  There are sound medical reasons for this too.  A baby's body temperature is better regulated when they are in contact with their mother. 
  
   
• How about breastfeeding your baby straight away, rather than hours later? Let them know that you would like to feed your baby while you are being sutured, if you feel up to it, and you would like your baby to stay with you throughout the surgery and even during the recovery. Or you could arrange for the lactation consultant of the hospital (or your own privte one) to be present at the ceasarean birth and bring the baby to you in recovery, to breastfeed within that first hour of birth.
  
   
• Let them know that your partner would be delighted to hold his/her child within your view if you are unable to hold the child yourself.  This enables you to view the bonding taking place between your baby and their father.
   
• You may also be able to organise with your doctor to allow a quiet relaxation CD to be played throughout the birth.  Chosen by the parents of course. They may find the music so enjoyable, that they may make it a regular part of caesarean births. Don't let it intrude on the birth, though, just gently enhance the experience.
• Maternal Assisted Caesarean.  The head and shoulders of the baby are delivered by the obstetrician.  The mother then reaches down and pulls her baby from her abdomen.  This gives some women a greater sense of being involved in the birth process.  This is an innovative procedure that may not be available at all sites.  Speak to your doctor for more information.
  
   
• And lastly, what about that placenta? Most women who birth vaginally get to see it, at least, and maybe you would like to to. Make sure theatre staff know you want to view the placenta. Make sure they realise the importance of this and let them know not to just discard a part of you that you have carried for nine months as insignificant. You may like to take the placenta home, to plant under a tree, or even to eat so please tell them to be sure to make suitable arrangements with you to see that this happens.
  
   
• Make a birth plan! Have several copies with you and give it to everyone invovled in you caesarean!!! They won't know what is important to you unless you let them know. Below is a sample birth plan you can modify to suit your own needs.

Below are some comments that Birthrites was sent by email.   We value all comments and input so please send them in. 

• 
  Hello, I was reading with interest your article on Positive Caesarean Experience and I wanted to add a few more things (based on my own experience) that might be useful to others: -
• Write to the head of the birthing suite and operating theatre in the hospital about your birth plan. That way they have plenty of time to fully understand what you want, as well as give them the opportunity to raise with you any concerns they may have. Once you have both reached an agreement about your c/s then get that agreement in writing and take it with you to the hospital so staff do not have to run around and "get approval" from the "appropriate person".
  
  
• Get the hospital to take you through every step of a c/s procedure. Make sure they explain to you every light and every sound. Much of the anxiety happens when you can see flashing lights and disturbing noises and you don't know what it means (and the staff seem too busy or intent on doing other things.) If they don't know how to take you through the c/s procedure, then get your hospital to contact The Calvary Ante-Natal Clinic in Canberra. They have written an excellent course on c/s procedure (which anyone can attend - prior or after the birth).
  
  
• Make sure that there is someone to take digital photos of the birth and the bub (in case you are having a GA). Then if the bub has to be taken away to Special Care Nursery (SCN), you can see pics of the bub as soon as you wake from the procedure and while you are being wheeled into SCN.
  
  
• After being wheeled into the recovery room, ask that they dim the lights for you and bub. (Note this might not be possible - especially if you have a few other patients in the recovery ward and checks requiring observations are being done all the time).
  
  
• You might want a special blanket to wrap bub in while waiting with you at recovery. Note that if bub is with you at recovery, most hospitals will require a midwife to be in attendance. This is why its a good idea to get the head of maternity and operating theatre involved very early - to assist with staffing requirements.
  
• I didn't end up having a caesarean but a VBAC for my second child, but I did have a birth plan in the event of another emergency c/s. Still I found that doing/planning for the above very empowering.