What I wish a knew beforehand about an emergency C-section / Cesarean
I recently went to a screening of the Australian documentary “Birthtime”. As a woman who has had one emergency c section and one planned c section, I wanted to share my experience of these two births to shed some light on what was traumatic from each and what we can take from it all. I hope this is useful read for those who are preparing for their own birth or supporting someone that is. If we can reduce some of the unknowns and shock factor, it will help to reduce the birth trauma experienced for some. I hope that this helps you mentally prepare in some small way.
Pre-warning – I dropped science in year 8, so this is a VERY non-medical and non-science based recount!!
While I was watching the Birthtime documentary I was alarmed at just how many women experienced trauma after an emergency c-section.
No one thinks or plans for an emergency c section. You have your birth plan ready to deliver vaginally, and then everything can change in an instance, and I believe that this often leaves women quite mentally scarred by the experience.
A planned c-section is a different story. With the support of an open-minded medical team you actually CAN prepare, plan, visualise and bring your birth partner along the preparation journey with you.
I recall in my first hospital prenatal classes, one of the lovely ladies in the group was too queasy watching the c-section video, so we didn’t even get to see the process! As I had a very healthy pregnancy, it didn’t occur to me to do my own research into a c-section – as it was not on my typed up birth plan. I was armed with my heat pack, mantras, music and yoga ball.
My first bub (Toby), was over a week late, and the evening before I was due to go in and have an induction, at about 11pm, my labour kicked off. I was so calm at home and let my husband sleep for a few hours while I had a bath. After a few hours I woke my husband and we called the birthing unit at the hospital and let them know. We stayed home for a few more hours watching Law & Order SVU (of all things), and then at about 5am headed to the hospital.
Everything progressed really normally and well and we were enjoying the process together. Then (after about 13 hours of labour), things changed. All of a sudden I had no gaps between contractions – just a long stretch one after another. Baby’s heart rate started dropping. The midwives broke my waters to see if this would help to move things along and get this baby born. My Obstetrician was monitoring closely and assisted the nurses in assessing the situation, and then all of a sudden the baby's heart rate plummeted. A call was made very quickly that this baby had to be born right away and a c-section would be performed.
At this point I wish that I had greater insight into what the next steps would be after the c-section call was made. It all happened so fast and it was really hard to stay present.
My obstetrician advised that a c-section was required (they are the ones that will perform the c-section), and things happened really quickly from there. Whilst our OB explained the need to my husband and I, and technically it is our decision, however you realise that there really is no time to ask too many questions, when you are in an emergency situation.
Efficiency and tempo increases, more people and faces come into the room. You are given a form to sign (which to this date I have no idea what this form said – surely that this would not stand up in court of being of sound mind!) This lack of control could be one contributing factor to trauma in some women. I mean surely the birth partner can sign for you and make a better decision?
The process of an emergency c-section:
Obstetrician makes the recommendation/call, consent form signed, clothing on your lower half removed if not already, compression stockings put on you, a nurse will shave your pubic area even if you have had a recent wax, (this can be quite unexpected/confronting for some) as they need to have this area clean for stitches, husband taken away to put scrubs on, and you are wheeled down in the bed to the operating theatre. On the way, nurses put extra blankets on you as you enter the freezing operating theatre and they try to talk you through what is happening. Your nurse or midwife that was with you in the birthing suit goes with you, so that you have a familiar face on the journey. It is strange going through the halls and seeing lots of faces and bright lights whizzing past. In this moment you are handing over trust to others. For me I could think quite logically that these men and women were experts. This was routine and the safest way for me to bring a healthy baby into this world.
In the operating theatre, you are moved across to the operating bed, sat up and asked to curve forward over your tummy (not easy!!!). I held my Obstetrician’s hands (as my husband was still outside getting dressed in scrubs), and stared into her unwavering and strong eyes – her calm and focus brought me great comfort and stillness in this whirlwind experience. I hadn’t even seen the face of the anesthetists, yet was having a complete stranger insert quite a large needle into my spine (spinal block). You are then laid down and the spinal block takes effect very quickly. A urinary catheter is inserted and once they have checked that you cannot feel anything in your lower half, the Obstetrician makes the incision to open the layers of abdominal tissue to bring your baby out. All of this can happen in under 10 minutes! Quite incredible.
The Obstetrician then passes your baby to the midwife, who takes bub over to the warm resuscitation station for checking and any intervention that the baby needs. You do miss the immediate skin to skin of a vaginal birth, however, they need to check the baby and make sure it is healthy. This was the longest 45 seconds of my life, waiting for my baby to take his first breath. Finally those little lungs let out a breath and a scream and a sense of relief washed over my body.
The midwife brings over the baby as soon as possible when they have the all clear – for skin to skin and on your chest as soon as possible. Over this time, staring into baby’s eyes and loving this little piece of you that is now earth side – your obstetrician will be stitching you up – and you are quite oblivious to this process and you are obsessed with your new little person. The stitching up actually takes far longer than the process of the surgery itself.
There are a LOT of people in the room for an emergency c-section – all masked so you only see a lot of eyes! But you know what, in the moment, you don’t really notice the teams of people ready for whatever your emergency requires – for mum and/or bub.
Then to the recovery area – where you will be laying next to the midwives and your partner weighing and measuring your baby and you will get to enjoy lots of skin to skin contact. Make sure you do use your inner mumma bear voice (or empower your partner to speak up for you) and make sure that baby stays with you for this whole part – as I believe that at some hospitals they can request to do the measuring and weighing while you are being stitched up in the operating room.
Back in your room you will be confined to bed for a little while – you will need a support person or nurse to hand you the baby for feeds and cuddles initially and will need more pain relief and wound recovery awareness as you start your healing process/journey, and may miss the first nappy change (a massive plus in my books!!).
I also had a fantastic Obstetrician that came to my room later that evening to go through what had happened, and to answer any questions that we had. This was so important and a huge contributor I believe in having no trauma or lingering doubts about Toby’s birth. The last thing you want is lingering questions that you didn’t have a chance to ask prior to or being left with unknowns or what-ifs. Ask every question, big and small to make sure you feel at peace with all aspects of the birth and c-section requirement and process.
I feel very fortunate that I experienced absolutely no trauma in my birth via emergency c-section. I have subsequently had a second (planned) cesarean. They are some of the most special moments of my life to date. Whilst I am a planner by nature, I am good at going with the flow and adapting to change (something that I work on constantly with a coach) and accepting that the universe has a plan. The universe’s plan for me was the birth of a healthy baby and this was via C-section.
I hope that this helps even one beautiful New Mama in the processing and recovering from an emergency cesarean.
All my love,
New Mama Kit