Why You Should Plan to Have a Cesarean
Except for in cases of medical complications, most pregnant women don’t head towards the birth of their first baby anticipating having a cesarean. A 2013 survey of US mothers about their childbirth experience found that just over 1% of mothers having a primary cesarean had requested the cesarean themselves with no medical reasons. Most women don’t hope to have a cesarean when they are making plans for their first birth. Understandably so. It is, after all, major abdominal surgery. As with any major surgery, the recovery and healing time is not something to be envied. Many couples, when thinking about their birth preferences during pregnancy, don’t give too much thought to the possibility of a cesarean. It’s as if we superstitiously believe that thinking about it will make it come to be and that if we don’t want it to happen, we don’t need to plan for it. However, I think this is a case where we should “hope for the best, but plan for the worst”. It’s fine to do everything in your power to have a vaginal birth, and fine to think positively and believe that it will happen, but I also think it’s wise to think through the possibility of a cesarean birth. The cesarean rates at the three hospitals most of our local parents birth at range between 25 and 30% for first time moms. Let that sink in… ¼ local first time moms will have a cesarean. Likely all 4 of them anticipated or hoped to have a vaginal birth, but one of them had a cesarean. Was that mom prepared for that possibility? Birth is absolutely and entirely unpredictable. A baby (with a brain of their own) and a mom’s body are working together to make this thing happen, and until you’re in the middle of it, there’s no way to predict how that dance will look. You don’t know if you will be the one or one of the three. Prepare yourself for both possible outcomes. Understanding what happens during a cesarean, knowing what our options are in the event that we need one, and having a birth and postpartum plan that includes some of those “what if” scenarios will help you to be prepared.
Here are some ways that you can ensure that you are prepared:
1. Get informed:
Take a good childbirth education class.
Ask your care provider about the cesarean rate in their practice.
Talk to your care provider about the circumstances that would necessitate a cesarean.
Find out about cesarean policies and procedures in the hospital you have chosen to birth at.
2. Make plans:
Do some research about available options during cesarean and talk to your provider about whether these options could be available to you in the event of a cesarean (eg.could you hold baby skin to skin in the OR?).
Make a postpartum plan – I think it’s important to plan for the postpartum period regardless of the type of birth you have, but when you have a cesarean you are recovering from major surgery during those early postpartum weeks. Plan for this – have people lined up to help with household tasks, have meals pre-made in your freezer, have help with childcare lined up if you have other children, etc.
3. Gift yourself with good support:
Find a supportive provider who you trust.
Hire a doula – having the support of a doula can become especially invaluable when your birth takes a turn for the unexpected and you need a cesarean. Having someone with you through that experience who can be a source of calm and can give you information and reassurance can be huge!
Ask friends and family for help. Often people WANT to help, but don’t know how. Tell them ways that they could help and support you… they’ll likely be glad you did, and so will you!