Cesarean Birth: What You Need to Know Before, During & After

Cesarean Birth: What You Need to Know Before, During & After


Giving birth by caesarean was the last thing I expected when I went into labour with my first baby. We were all set for a home birth, and I was confident that all would go to plan. We ended up transferring to the hospital when I was around six centimetres dilated, because of meconium in my amniotic fluid. It wasn’t an emergency.  Everything was fine. I was still on my way to having the vaginal birth I wanted.

Of course, that all changed.

I was nearing nine centimetres when my midwife checked me and discovered that my baby was breech. When I think back on that night, it all still feels surreal. Doctors and nurses rushed in. There was an ultrasound. Yellow forms detailing who-knows-what were signed in haste. And - whammo - I was being prepped for surgery.

It took a long time before I was able to make peace with my first birth experience (like, years). I felt as though I had been robbed. I had worked so hard and come so close. I felt dis-empowered. And while I know a C-section would have been difficult for me to accept under any circumstances, I’m certain it would have been beneficial if I had been more open to the possibility that it might happen.  

For some mamas, caesarean birth can be incredibly beautiful and empowering. I wish I had been more prepared for what my c-section would look and feel like, and how challenging the recovery would be. (It’s major abdominal surgery, after all.)

Whether your c-section is planned or not, being informed can help you through what is a very physically and emotionally overwhelming experience. Feeling as-ready-as-you-can-be will help you have a “belly birth” you’re at peace with. I adore this new way of describing a caesarean, because it keeps us connected to the fact that we are giving birth, and not just undergoing a medical procedure.

 

BEFORE

The fear can be real if you’re planning a c-section, or even just considering the possibility. It’s major surgery, and many of the images we’re exposed to are intimidating. You might also fear the stigma and shame that many c-section mamas still feel around notions that you weren’t strong enough, or didn’t really give birth to your baby. (Nonsense!)

Acknowledge whatever you’re feeling and allow yourself to sit with those emotions. Never doubt that you are amazing! You are growing and birthing a tiny human being! This is a remarkable accomplishment, however you give birth. It’s completely natural to experience feelings of fear. Trust your body and accept that some things may be out of your control. You got this!       

Ask for what you need. Depending on the circumstances of your belly birth, there are many things you can request in the operating room to make the occasion feel more personal and connected to your birth plan. Skin-to-skin immediately following caesarean birth IS possible! Ask and ask again to make sure this can happen if it’s something that’s important to you.

Consider any other birth plan wishes. Ask about playing music, taking pictures, keeping your placenta and whether or not the hospital offers gentle caesarean birth planning.

A gentle c-section aims to make the experience more like that of a vaginal birth and might include a clear drape placed lower down on your chest, so that you can witness your baby’s arrival into the world, as well as initiating breastfeeding immediately, rather than postponing until you’re in the recovery room.  

TIP: Make sure you talk to your healthcare provider about your wishes well in advance of your due date.

Postpartum planning becomes even more important when you give birth by caesarean. Caring for a newborn and recovering from abdominal surgery is a tough gig. (Plus, if you’ve had an unplanned c-section, you may also be recovering from a long labour, to boot.)

Plan to have someone home with you as much as possible in the first weeks after giving birth. As your due dates gets closer, stock your pantry with healthy snacks and your freezer with hearty meals. (This is essential, however you give birth!)

Think about how you will get to and from appointments and have a support person with you.

Make sure you have plenty of loose-fitting, high-waist underwear and clothes, as you won’t want anything rubbing against your incision.  

 

DURING

You will be separated from your partner. Depending where you are in labour, this can be a very unsettling part of caesarean birth. I’ll never forget the moments I spent sitting on the cold metal operating table, working through some of my most intense contractions alone, seemingly invisible to the nurses in the room. It was a time when I desperately needed support and had none. My midwife was prepping for the OR and my husband wasn’t allowed in the room until after my spinal anesthesia was in place.   

If you have a planned c-section or are still in early labour and not experiencing strong contractions, this short time of separation might not be so impactful. If you’re in the throes of transition, like I was, it can be very difficult.

TIP: If your c-section is planned, or it feels ok for you in labour, it can be empowering to walk yourself into the operating room, rather than being pushed in a wheelchair or hospital bed.

Ask for what you need, again. Even if you’ve discussed your wishes with your doctor in advance, it doesn’t hurt to remind them of the things that are important to you. You are your own best advocate. For me, it was important to have my placenta, as I planned to have it encapsulated. I must have reminded my husband and midwife a dozen times!    

The OR experience can be unwelcoming, to say the least. The room is uncomfortably cold, the lights unnaturally bright and the medication you’ll receive often causes uncontrollable shakes. (I was trembling the entire time; teeth frantically chattering.) In some cases, your arms might be strapped down to the table. While all of this sounds icky, and it is, it’s also normal.

TIP: Ask for extra blankets to help keep warm.   

It’s common to feel a lot of pressure and tugging throughout the surgery. I felt a shock of pain when the doctor started the incision and had to top-up on meds. Even with a higher dose, I still felt an unexpected amount of uncomfortable sensation – movement, tugging and pressure. It’s not uncommon to feel nauseated and very possible that you’ll cry. I bawled.  

TIP: Make sure your partner has tissues to gently wipe away tears. They can also keep a cotton ball with a few drops of peppermint oil on it in a resealable bag. Inhaling a few deep breaths can help to ease feelings of nausea.   

 

AFTER

Postpartum discomforts are a common, to-be-expected part of giving birth by caesarean, just as they are when you give birth vaginally. Some side effects of the medication you receive during surgery can include painful gas, night sweats, migraines and swelling in your legs and feet. Your milk might also come in late. Pumping can help, and it’s always good to connect with a lactation consultant.

TIP: Keep feet elevated as much as possible during your recovery. It can take up to two weeks before the swelling goes down. If you experience migraines, keep the lights low. Drink plenty of water.  

Day three to five after surgery is often the most uncomfortable time. You’ll be extremely tender. Wear loose and comfy clothes that come up high on your waist and keep a close eye on your incision for any sign of infection – redness, swelling, oozing, etc. If you feel something is not right, contact your healthcare provider right away. Keep the incision dry as much as possible, until you have the all-clear for soaking in the bath. Try to lie down or recline, rather than sitting upright. 

Don’t try to be a hero. Trust me. There are very good reasons why it is recommended that you rest, rest, rest and not lift anything more than your baby for the first six weeks postpartum. Take your pain meds, even if you feel like you don’t need them. (You might change your mind after a few hours without!)      

Do get up and move around. By that, I mean take a stroll around the house, not around the ‘hood. Keeping mobile helps to encourage healing, but don’t overdo it.

TIP: Laughter is not always the best medicine! Place a pillow against your tummy with gentle resistance whenever you laugh, cough, or sneeze to help brace yourself and lessen the pain at your incision.   

A postpartum doula is an incredible gift to give yourself, if it is within your means. Having someone around to help with cooking, tidying, newborn care and your own self-care makes it easier for you to rest. If a doula isn’t in your plan, be sure to have support people you can call on to help with household duties, preparing food and caring for other children in the family.   

TIP: Once you have the OK from your healthcare provider, you can begin to massage around your incision to help loosen the scar tissue. It’s also good to book an appointment with a pelvic floor physiotherapist.

Be gentle with yourself – especially if you’ve had an unplanned belly birth. Being a new mom is super emotional and exhausting, and a c-section can be difficult to process. Allow yourself the time and space you need to grieve the birth you didn’t get to experience. Every day will get a little bit better.

TIP: Talk with other moms who can relate to your experience, in a safe and judgement-free space.

 

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Picture of Lindsay Forsey

Author: Lindsay Forsey

Lindsay Forsey is the founder of Tenth Moon Mother Care and The Wellmama Project. She’s a postpartum wellness activist, a mom of two, and a former doula. When she’s not busy bundling up Tenth Moon postpartum care packages for new moms across Canada, you might spot her on TV talking about the fourth trimester, blogging about maternal health or perfecting her "padsicle" recipe.

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