C-Sections: What to Know & Expect
There are many reasons why someone might end up having a Cesarean section. Often people don’t like to talk to pregnant people about the ways their birth plan might change, but we here at Wumblekin want to make sure that if you want to know more you can.
Around 30% of American babies are delivered by cesarean birth. Some people have a planned cesarean delivery due to the baby being breech (feet/butt down versus head down) or another medical indication. These types of cesareans are typically prescheduled. The pregnant patient is usually instructed to stop eating around midnight the night before the cesarean and comes to the hospital in the early hours of the morning. Others find themselves having an urgent or emergent cesarean section during their course of labor.
Either way, cesarean delivery can be an intimidating topic to discuss. Having had my first born by unplanned C-section before I became a nurse, I can admit plenty of things I wish I knew beforehand. The purpose of this post is to share information on cesareans for our readers who want to learn more.
The operating room can be noisy and overstimulating. There are people counting instruments, tools being opened, bright lights, monitors beeping, and lots of people moving around and talking. This can be very anxiety inducing. Try to remember that even though the movement and sounds look or feel chaotic to you, this is a well-rehearsed “dance” your provider team does all the time. We move quickly to keep both the parent and the baby safe, but we don’t move so quickly that we are using haste. Also, don’t panic when you hear them counting tools multiple times (I felt sure they had lost something in me – I really needed to cut down on how many medical dramas I watched). Counting multiple times is normal. This is all part of the protocol.
TIP: If the noise causes you stress try to only focus on one person...ignore the rest! It is also reasonable to ask for talking to be minimized to necessary communication.
Before any C-section the patient will be given medications to prevent vomiting while lying flat. This is to prevent the patient from choking. Antibiotics are also given to prevent infection in the wound or the uterus.
You should not feel sharp pain during a cesarean section. However, you will know people are manipulating your body and you may feel pressure but there should not be pain. If you are experiencing pain or anxiety the anesthesia team can give you intravenous (IV) medications. It’s always smart to talk with your team about what you are feeling and discuss what they can do to help you. I recommend asking if the medication will make you feel "loopy,” sleepy or forgetful.
Postpartum shakes are extremely common, and even more so during a C-section. These shakes are believed to be caused by the fluctuation in hormones. It’s important to remember these are normal.
TIP: Sticking out your tongue or gently biting the tip of your tongue can sometimes reduce the shaking.
Most hospitals will have cesarean section patients recover in the Post-Anesthesia Care Unit (PACU) or a recovery room, while others allow the patient to recover in their original labor room. Regardless of location, it is common that the hospital policy will require two hours of close monitoring. This involves checking the incision, feeling the uterus by doing a fundal massage (uterine massage), and closely monitoring the patient’s vital signs.
We wouldn’t be true to our mission of sharing evidence-based information and insight at Wumblekin if we didn’t talk about the hard stuff. That said, the truth is that MANY parents suffer from feelings of disappointment when their birth plans don’t go as they had hoped. If you are feeling this way, please know that you are not alone. In fact, this feeling is so common there are support groups run by the International Cesarean Awareness Network (ICAN) where parents can discuss their feelings about their birth. This is true for both the birthing person and their support person.
If you have enough time to request some cesarean preferences, consider using one of our clinicians' favorite ways to make a C-section feel extra special:
1. Ask about a clear drape. Many hospitals have a double drape feature where they can drop the opaque drape and give you a view of your baby coming out. Don’t worry, you won’t be able to see your “insides”! You can watch your baby take their first breaths through the clear drape, and many times delayed cord clamping for about 1-2 minutes is allowed to occur.
2. Request time and space to do skin-to-skin while they finish the operation. Many patients are able to get their baby onto their chest or at the very least nuzzled up to their cheek. One of my personal favorite things is when I get to hold a baby to their parent's cheek for that first kiss. They love to hear your voice and it calms them quickly.
3. Make sure the team knows your breastfeeding goals. If you want to try to breastfeed as soon as space allows, tell them. Depending on the staffing and space of your operating room this can be possible during the procedure or as soon as it finishes.
4. Ask for family photos. Many nurses will be happy to snap some photos of you and your new little family while the procedure finishes.
5. Other things to consider include requesting your own music, requesting the lights be lower if possible, requesting to see the placenta before it is removed from the room, requesting your partner to stay with the baby if baby needs any additional support.