It's the comment I get most often: "I'm having a c-section, I don't need a doula"
To those people, I want to give a peak into what we do as doulas' at your c-section whether it's planned or unplanned. First thing, being a doula focused on working through birth and pregnancy trauma, in our prenatal meetings we can address fears, concerns, and strategies to have the best birth possible! I can help you find the hospital and provider that will work with you to carry out your wishes whether it be a gentle cesarean or a surgery where you are completely put under, we can work together to talk over what your options really are, and what is best for your specific situation. I'm going to quickly list some of the many options we will help you with:
- Immediate skin to skin in OR
- Initiating immediate breastfeeding
- Pain medications and its delivery
- Skin to Skin with partner in OR/Recovery
- Options if there is an emergency
- IV placement
- Vaginal Seeding
- Gentle cesarean delivery (baby is slowly born from the mother's womb)
- Newborn tests and procedures
- postpartum support
What is a Gentle Cesarean?
This is probably a term you've seen tossed around in Facebook groups and Baby Center chat rooms, but what is it really, how do you achieve one, and lastly WHY? Here are a few changes some hospitals have made to make the most common surgery in the United States more family centered.
- IV's are placed in the non-dominant hand
- The Mother's arms aren't strapped down
- Baby is immediately placed on the mother's chest
- Clear drapes so the mother can see her baby being born
- Vaginal seeding (swabbing vaginal bacteria from the mother onto the newborn)
- Mother's are alert and have epidurals or spinal blocks instead of general anesthesia
- EKG monitors are placed elsewhere, not on the chest.
- Delayed cord clamping
- Dr's and staff are asked to refrain from "shop talk" during the procedure
- Gentle music played
- Doula or other birth partners allowed in to photograph procedure.
So how do you achieve a gentle cesarean?
Firstly, finding a practitioner that is on board with a natural c-section is key, and then reviewing hospital policies regarding all of the items above, you will find a lot of the decisions are up to your anesthesiologist rather than your OB, so having an OB who will advocate for you is ideal. That sounds like a lot of work, right? Having a doula is the best way to help navigate those choices. Often times doulas are familiar with OB's and practices that are more natural minded, and which hospitals offer what services from the best food to NICU/Special Care Nurseries.
Why have a gentle cesarean?
A healthy baby is what's most important right? It's what we hear time and again "at least my baby is healthy". The guilt and shame that can surround mom's who have had to have a c-section is tough, and can lead to postpartum depression. Creating a birth environment that is family centered, emotionally supportive, and as close to the experience of a vaginal birth as possible all help with getting the best start for mom, baby and family. Doula's can help you wade through the deep emotions of having to choose a c-section whether you know leading up to birth or it's an emergency c-section we are there to help you process emotions and give evidence based support so you can choose what's best for your family.
Doula's also help families prepare for the postpartum time, when caring for yourself and a new baby is incredibly difficult. Major abdominal surgery leaves new moms with lots of restrictions on movement, lifting, traveling ect and having a doula who can assist in the postpartum period is a huge help. We're also on the front line of getting new moms connected with the community, mom's groups, support groups, therapy if its needed, and many other services.
My Personal Story
When I learned I was pregnant, I knew I wanted a midwife assisted home birth. Unfortunately, as my pregnancy progressed we learned due to a short cervix it was best to be in the care of an OB and deliver at a hospital with a NICU. I immediately knew I wanted a doula to attend my birth with me. During my labor, I failed to progress and the doctor recommended a c-section. When I asked about skin to skin in the OR I got a lot of negative talk from the Doctor and nurses, but I wasn't to be turned away. Per what my doula had discussed with me previous to labor I simply said "If Catholic Medical Center can do gentle cesareans, why can't you?" Advocating for myself was what turned a corner with the staff, and I was able to hold my baby immediately upon birth in the OR. My doula had prepared me for this outcome, helped me process my feelings of self doubt and was integral to me getting the help I needed postpartum.
All photos provided by Mindful Mama Birth