Today’s post includes articles written by Chloe Bayfield on the subject of emotionally preparing for another birth after your CBAC and Heidi Thaden-Pierce, writing on the subject of birth plans for a cesarean birth, should you face another CBAC.
Emotionally Preparing for Birth after a CBAC by Chloe Bayfield
I think that one of the hardest parts of dealing with a CBAC is moving beyond it. Can we take on board the lessons we learnt, acknowledge the positives and move past the negatives? As women, we will probably never leave it completely behind us but add it to the load we carry, which is no bad thing as long as we can utilise it positively.
Are there things you want to do differently, things you want to avoid? Creating that safe place for you to bring your new baby into the world, whether that’s planning a caesarean or booking your homebirth.
At this point I believe that we are all well aware of the options and risks and need to make our decisions without external influence. Nobody else has been on the journey you have; nobody else knows what you need to do to arrange your birth.
Are there parts of your previous births that still haunt you? As a first step towards your next birth, you may want to take the time to go over your previous birth(s) with somebody new, somebody who understands the VBAC ethos and is supportive of what you have been through. This will help to take a fresh look at events and to work out exactly what happened and why.
Then you can go on to isolate exactly what may worry you about future births and work on overcoming those fears. Until you have done this, prepping for future births may cause you more stress and trauma instead of being a potentially healing process. Fear release techniques can be a very good way of achieving this. I think there are parts of the birthing experience that worry almost everyone, whether they bring past events to the birth or not. Embracing these fears and working past them can help us not only with future births but with our general emotional health.
When you then move on to prepare for your coming birth it becomes really important to be very clear with yourself as to exactly what you want from the experience. You will then be able to sort through what this means to you and then go on to surround yourself with the people you need to make it happen. Being very clear with these goals will help those around you as much as anything, when the labour hormones kick in you won’t want to have to go through your reasoning again. Writing it all down should also help to clarify things for you and serve as a quick point of reference for your supporters.
Some may find it helpful to have a back-up plan, to spell out exactly what you do or don’t accept in case things don’t go as outlined in your plan A. For me this would also help to prepare myself for the eventuality that there may be a plan B, but to still be in control. To know that nature may have other plans but that we are still calling the shots can help us to maintain our empowered birth experience. Writing your plan B can also help you to reinforce your plan A, by working through the “what we do if this happens,” you can try and implement steps to avoid it where possible.
By understanding as much as possible about our past birthing experiences and about our future needs, we can take control and hopefully that control will afford us the most peace of mind within our future births.
Creating a Cesarean Birth Plan by Heidi Thaden-Pierce
For those mothers who know they’ll be delivering by cesarean birth, or for those mothers who like to prepare for every possible outcome, here are some questions to consider for your birth plan. Many people believe that a c-section means you have few options as far as your care, but that’s not true! By learning what possibilities there are you can make your birth experience more personalized. Many of the questions asked on a vaginal birth plan are also important to discuss for your cesarean birth, but here are some that you may not have considered. Some of these may not be relevant to your situation, but hopefully they’ll get the discussion going with your partner and care team:
Who would you like to have with you for your baby’s arrival? Your partner, a family member, doula, a photographer?
May your support person remain with you while your epidural/spinal is placed?
What would you like photos of and who will take them? Is there anything that may not be photographed? Will the anesthesiologist lower the screen so you can have photos of the baby emerging?
What type of anesthesia is available, and what pain relief options will you have in recovery? May you speak with the anesthesiologist in advance (a call the night before?) to discuss these options?
Are there any other medications routinely given by IV and what are their risks and benefits? Are there any medications that may impact your ability to stay alert and nurse immediately after the birth (sedatives, etc) and would you like to decline those?
Would you like to request the catheter be placed after anesthesia has taken effect? (It should be placed after but sometimes it’s not, so check on that!)
Can your arms be left free to touch your baby?
Would you like your doctor to verbalize the steps of the procedure to you?
Would you like music playing? What speaker set up is available? (For the recent birth I attended we just plugged in the iPod!)
Would you like each person in the room to introduce themselves to you and explain their role?
Would you like silence when your baby is emerging so you and your partner can be first to greet your baby?
Do you want the gender announced by the doctor or your partner?
Would you like the screen lowered as your baby comes out? Is a mirror available for you to see?
Do you have any requests as far as double vs. single layer sutures? Do you prefer staples or sutures for your external closure?
Do you want your baby to be lifted up so you may see them right away?
Who will cut the cord and can it be left long so partner can do so?
Is skin-to-skin possible while in the OR? (Your partner or doula will assist in holding your baby to you and you’ll be covered up with a blanket.) Here is a video on the skin-to-skin option: A new way to have a cesarean birth.
If the baby cannot be skin-to-skin immediately, would you like the bed warmer to be kept in your line of sight so you can see baby at all times?
Will baby be suctioned, by bulb or deep suction?
If the baby needs to be taken to the nursery or NICU, who will go with the baby?
Do you want to keep the placenta?
Will you bank the cord blood?
Do you want footprints made for the baby book?
How long will you need to remain in recovery before moving to your postpartum room?
When will the epidural & catheter be removed?
Will your baby remain with you at all times? Can newborn exams be performed at your bedside in postpartum?
What newborn procedures would you like? Vitamin K, eye ointment, Hep B vaccine?
How soon after the birth can you eat and drink?
How long will you remain postpartum? If staples are used, when will they be removed?
Will the baby be bathed in the room or nursery, by staff or by your partner or another family member?
Will baby be offered a pacifier, formula, or will baby nurse exclusively? Would you like a lactation consultant to visit you?
Hopefully these questions will help you in formulating the best birth plan for you!