Over thirty percent of women in the United States will end up with a C-section when they give birth. That rate is high, and though C-sections can save lives, they are also sometimes used when not necessary. Plus, many women report their surgical birth being less than what they'd hoped, even for a C-section.
Many procedures that take place before, during, and even after C-sections are based on thinking that hasn't been analyzed in many years. Doctors do what they've always done and don't think much about how to change C-sections to make them less common or more satisfying for moms. That is, until recently.
With a push from organizations who are concerned about the climbing C-section rate and from moms who want a gentler, more family-centered experience in the operating room, doctors and researchers are rethinking trends in the C-section community.
New research and outspoken moms are hoping to make C-sections less common. However, when they have to be performed, moms are demanding certain guidelines on their birth plans still be met. Since doctors are finding there's no reason not to let mom choose how she wants certain aspects of the procedure to go, doctors are listening.
Moms are being rewarded with birth experiences that, while still being surgical, are also more fulfilling and nurturing. Some of the items on this list might not be for everyone, but many women will be glad to see how the tide is turning when it comes to thinking about surgical births.
15 Once A C-section, Always A C-section
Most of us grew up hearing that once a woman had a C-section, she always had to have one. That means if mom needs a C-section with baby number one and she wants four kids, she has to have a C-section every time, increasing her risks of surgery-related injuries and infections.
However, this isn't the case, and it really never has been. While some doctors are more comfortable with forcing moms into repeat C-sections, studies show that around 90% of women who have already received a surgical birth are good candidates for a vaginal birth after Cesarean(VBAC). In fact, anywhere between 60-80% of these moms will successfully deliver their child vaginally, even though they had a C-section previously.
VBACs help moms avoid the increased risks of C-sections, and this is important because every C-section a mom has increases her risk of complications. Doctors and researchers now understand that VBACs are viable, safe options for most women, and this could help bring the C-section rate down and allow women another chance to birth vaginally.
14 After A C-Section Mom And Baby Must Be Separated
Besides the obvious concerns about surgery and dealing with an extended recovery, many moms report that the scariest part of their C-section is being separated from their child. It's true that the cold, sterile operating room isn't a place that doctors like to keep newborns who have problems regulating their body temperature.
However, the immediate bonding that can take place right after birth is precious to both mom and baby.
That's why many doctors are opting to let the baby stay in the operating room. It requires constant vigilance to make sure the baby is weathering the cold temperature, but with appropriate precautions, the baby can be placed in mom's arms immediately.
Many hospitals will ask that the nursery nurse be available in the operating room in case the baby has any special needs after birth. However, if the doctor is comfortable with this approach, it's possible for mom to never lose contact with her child, and she can hold him in her arms as she's wheeled to recovery.
13 Mom Shouldn't Labor Before A C-section
The old school train of thought said if mom was probably going to end up with a C-section anyway, plan it and don't let mom labor first. However, the new thought says that even if mom is going to need a C-section, let her labor. The benefits of laboring first outweigh the old concerns doctors and researchers used to have.
Some of those benefits include easier breathing for the baby and an easier time for mom in the milk department. Because contractions squeeze the baby, fluid trapped in the airways is often forced out during labor. Labor also releases a massive amount of hormones, and some of those help mom's milk come in faster, something she will desperately need when the baby arrives.
Oxytocin, the love hormone, is also released during labor, and it is responsible for helping mom and baby bond. If mom doesn't labor before her C-section, she and baby will not be exposed to this hormone during the birthing process.
12 Schedule The C-section Early
When there was a situation doctors thought called for a C-section, they would often talk their patients into scheduling C-sections early, often before 39 weeks. The thought was that if it was going to have to happen anyway, why wait? It turns out, there are plenty of reasons why.
First of all, a baby needs time for their lungs to develop, and those last few weeks in the womb are not there for nothing. The risk of blood sugar issues and infections increase when a baby is taken before 39 weeks. Taking a baby too early can cause a plethora of problems, and scheduling a C-section before mom's body is showing signs of evicting the baby can mean there's a reason the baby should still be in.
Doctors are now rethinking scheduling C-sections too early and are now leaning towards letting mom's body take the lead. Unless there is a reason to hurry due to risks to the baby or mom, some doctors will let mom go into labor before talking about taking her to the operating room.
11 Twins Must Be Delivered Via C-section
It's true that pregnancies with twins are more risky, and birth can be as well. Many doctors in the past found it not worth risking a natural delivery and signed mom up for a C-section whenever she became pregnant with twins.
Today, twin pregnancies are increasing, and doctors who demand every woman who is pregnant with twins have a C-section are driving up the C-section rate. That's why many doctors are now saying if women meet certain criteria, they can give a natural delivery a go.
For fraternal twins, the risk of a vaginal delivery is less. Fraternal twins don't share a placenta, so the possible complications during birth are less. Identical twins who share a placenta will have to be monitored closely for conditions like Twin-to-Twin Transfusion and Twin Anemia Polycythemia Sequence. Those present specific dangers during labor.
However, if the babies are safe and the one presenting first is not breech, many doctors will let mom try a vaginal delivery.
10 A Breech Presentation Means A C-section
Make no mistake, there are plenty of doctors who feel that a baby presenting in a breech position needs to be born via C-section. However, there are others who see a breech presentation as an opportunity to look deeper at the situation and make some choices.
Babies may be complete breech, incomplete breech, or frank breech, and this will tell the doctor quite a bit about if he wants to move forth with a natural delivery. More doctors are considering the delivery of breech babies because the risks are still relatively low to both mom and baby, and because trying to deliver breech babies naturally can go a long way in giving mom the chance to have future vaginal deliveries.
While it's possible to VBAC, avoiding the first C-section is still the best option if possible, and working with women carrying breech babies to see if they can have a non-surgical birth is one way to do that.
9 The Baby Needs To Be Taken From The Womb Quickly
C-sections may feel like they take forever, but once the doctors actually place their hands on the baby, they move quickly to pull him out. For years, no one thought of doing this any other way. They removed the baby and then moved quickly to sewing mom up and getting her to a recovery room.
However, there are benefits to the doctor taking his time to pull the baby out of mom's womb. By moving slowly and letting the baby be squeezed, the baby's airways can be cleared. This can help the child avoid respiratory problems that lead to stays in the neonatal intensive care unit(NICU).
This approach takes a bit more time, but the benefits outweigh the extra time spent in the operating room. All mom needs to do is ask her doctor for this approach and make sure he is okay with it and familiar with how to perform it.
8 It's Okay For Breastfeeding To Be Delayed
Studies show that the sooner a mom breastfeeds, the longer she breastfeeds. The first hour after birth is essential for introducing the breast and helping baby learn to latch. The baby is the most aware the first hour after birth, but if mom has a C-section, it's likely she will lose that first hour and not even be near her baby until she lands in the recovery room.
Now more doctors are willing to let mom breastfeed immediately after a C-section. It's not easy, and many moms feel groggy from the drugs they're given for the surgery. However, when the doctor gives mom the go ahead, a nurse or partner can help her nurse. If mom knows she wants to nurse after birth, some doctors will even let her have the C-section sitting up partially to help.
They will also put the IV in her non-dominant hand so she doesn't have problems holding the baby while breastfeeding.
7 Optional C-sections Are Fine
The term "too posh to push" came into the world decades ago, and some women still believe it. Celebrities and regular women often ask for a C-section to avoid labor, and doctors in the past have often had no problems with letting them schedule a C-section for no medical reason.
The rising C-section rate and all the risks that come with C-sections have brought this practice under scrutiny. Unless there is a medical reason that can be proven, many doctors will not allow mom to simply request a C-section.
A C-section is a major surgery that can result in blood clots, excessive bleeding, and problems for the baby. Performing one for a medical necessity is wise, performing one for preference so mom doesn't have to work through labor is a huge risk. Though there are still some doctors who will allow this, most will not.
6 Closed Curtains During Surgery Are Best
One reason moms feel disconnected from their birthing experience when having a C-section is because they can't see what is going on. During a natural delivery, mom can place her hands on her child's head as he emerges, and she can see her body at all times. During a C-section, a curtain keeps mom from seeing her child come from her body.
Many moms now are asking to be put in an inclined position so they can watch their child emerge from their body. They are requesting a special curtain be used that is either see through or has a space cut out so mom can see what is going on.
This is not always a good idea for moms who have weak stomachs. C-sections are notoriously bloody, and mom may see things she can't forget happening to her own body. However, for the mom who thinks the risk of seeing some blood is not as bad as the risk of missing seeing her child enter the world, doctors believe clear screens are an option.
5 The Less People In The Operating Room, The Better
There's always a slight risk a child will have to be taken to the neonatal area of the hospital or that they will need to be assessed by neonatal nurses. Either of these situations can cause a mom who had plans to keep her baby with her at all times during and after the C-section to lose contact with them in a flash.
That's why doctors are asking neonatal staff to be on hand for births where the possible need for neonatal care is increased. It's true that there may still be situations where the baby has to be removed because he absolutely has to have care in the NICU, but there are other times when a NICU nurse can assess the baby, deal with any possible issues, and then leave him with mom.
This kind of flexibility helps mom have the birth she desires and keeps her baby within arm's reach.
4 Mom's Hands Should Be Strapped Down
Many moms who have had C-sections before can attest to being placed in the Crucifixion position and tied down during surgery. The logic behind this move was that women who were given heavy doses of anesthesia might act erratically and try to reach around the curtain, compromising the sterile environment.
Tying down mom's arms keeps her from being able to touch or hold her baby, and it adds to the disconnected feeling moms often have when going through a surgical birth. Because of this, doctors are now willing to let mom's hands be free.
Oftentimes mom can also ask about being given an epidural instead of a spinal because the medication goes in slower. It still works and mom won't feel anything during the surgery, but it allows her to feel less disconnected, which means she's not likely to do crazy things with her arms.
3 No Skin-To-Skin Contact
One of the most important post-birth activities for mom and baby is skin-to-skin time. The benefits for both mom and baby cannot be overstated. Babies who have uninterrupted skin-to-skin time with their moms after birth show less signs of respiratory problems, glucose and temperature issues, and less signs of stress. They don't cry as much because mom is near.
Moms feel more maternal and confident in caring for their child when they have uninterrupted skin-to-skin contact. However, this issue has been widely overlooked when mom has a C-section. Despite the benefits, moms who had C-sections were not encouraged or offered the opportunity to have skin-to-skin contact with their child in the sterile operating room. That's changing.
Now doctors are willing to let mom sit slightly inclined with her arms free so she can immediately take her baby in her arms. This not only helps in all the ways already mentioned, but it makes mom feel so much more a part of the birth story. Having a child be born from our bodies and then immediately taken away from us does not.
2 Heart Monitors Must Go On The Chest
Because a C-section is a surgery, mom will have to be monitored, and the heart monitors are often placed on the chest. The problem with this is that skin-to-skin contact with the baby is impossible if there are monitors in the way.
That's why many doctors are willing to let mom have the monitors placed on her sides or back. They accomplish the same task, but don't impede mother/child connection as soon as the baby is out.
Along these lines, many nurses now place the IV in mom's non-dominant arm, and many will shoot for a vein on the underside of the arm so the IV tube causes no problems for mom when she is holding her child. Since that IV will be in way beyond surgery, it's important that it's not placed anywhere that will make it hard for mom to hold the baby while breastfeeding.
These small changes can make major positive differences for moms going through C-sections.
1 Moms Need To Be Drugged Excessively After C-sections
There's no doubt that recovering from a C-section is hard and the pain afterwards is intense. That's why many doctors will keep mom on heavy doses of painkillers for her stay in the hospital and then send her home with a prescription for more pills.
While it may be necessary for mom to stay on pain medication so she can breastfeed without experiencing terrible cramping and start walking hours after giving birth, many doctors are now giving moms the option of being on less drugs after birth.
Because women report feeling groggy and disconnected, feelings that leave them struggling to connect with their newborns, doctors are willing to lowers the dose of painkillers. Of course, if mom can't take the very real pain, she can always ask for more.
This change gives women more control to say what works for them since we all tolerate pain differently.