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For a planned, or unplanned Caesarean.
This might be an unpopular opinion, but I believe it is a great idea to make a Caesarean birth plan, whether you are planning a Caesarean or not. Here’s the thing…. Caesarean rates are high at the moment….very high. Here at my local trust in Nottingham, it is sitting at almost 50%. Some of these are medically necessary, and some (many) of these are not. But we are not here to discuss the in’s and out’s of how to decrease your chances of a medically necessary caesarean (you’ll have to join my antenatal course for that!) What I really want to talk about is making a solid plan and knowing your rights and choices around a Caesarean birth.
Most people I talk to have no idea there are so many factors you can control and things you can ask for, that will make a huge difference to both you and your babies experiences of birth, even if your Caesarean is not planned. Also, if you have only ever thought about your ideal vaginal birth, and for whatever reason (mother nature, choice or the maternity system) your birth ends up becoming surgical, but you haven’t done any research around this, you have no idea what is involved or the things you can request, you may feel more lost and out of control, which could lead to a much less positive experience.
So here are some of the things you can request:
Environment – You can ask for lower lighting, your own music to be played and for voices to be kept low. Having it a bit darker and quieter will make you feel more relaxed and having your baby born to a song of your choice is a lovely way to personalise your experience.
If there is no medically urgent need for your baby to be born, you can request for baby to be born slowly and gently, to mimic a vaginal birth. This can help squeeze some of the fluid from babies lungs as well as give them a more gentle transition to the world .
You can request for the ECG dots to be on your back, rather than your front, so your chest is clear for skin to skin, and that your gown is on backwards with the opening at the front, for the same reason.
You can choose which hand your IV goes into, so it is less in the way .
You can ask for the screen to be lowered so you can see the baby emerging. Because of the bump and the angle, it is unlikely that you will be able to see the incision but it does help some people feel more connected to the experience. You can even ask to assist in guiding the baby out, some surgeons are comfortable with this, others are not. But if it is important to you, push for it! This is still your birth.
You can ask the surgeon to talk you through what they are doing at each point, some people find this comforting, others don’t! You do you.
You can ask someone to take some photos of your baby being born and those first few moments with you.
Skin to skin should be done as standard, but you can make it clear that it is important to you and ask for support to get the baby onto you as soon as they are born, and if for any reason you can’t do it, for your birth partner to do it in your stead.
Now…here is the biggy. To me it is one of the most important things… Cord clamping. So in a caesarean it is becoming more common to accept a request of delayed cord clamping (i.e waiting one minute before cutting the cord) but not all babies will have fully transferred the blood from the placenta in that time frame. We really want our babies to receive all of their blood, it is kind on a no brainer. If cords are immediately clamped and cut, the baby is missing out on up to 30% of their blood volume (imagine how unwell you’d feel if you suddenly lost 30% of your blood!) Babies who receive their full blood compliment have millions more stem cells, higher iron levels and higher birth weight. Not to mention that if the baby is having any difficulty in transitioning to breathing, if we cut the cord straight away we are detaching them from the source of oxygen that has been keeping them alive all this time.
Back to our Caesarean… Surgeons understandably don’t want to leave is an undetermined amount of time to wait for a white cord, while your abdominal wound is open on the operating table. So what you CAN request, is that the placenta is taking out WITH the baby, the cord is kept intact until you are ready to cut it. They can pop the placenta in a little kidney dish and pop it up near the baby while you are doing it skin to skin. There is then absolutely no rush and you can be getting stitched up, while your baby receives all the good stuff. Win win!
This is not standard practice and so may take a bit of persuasion but I have had clients who have successfully negotiated this… it absolutely can be done! If you want to read more about all the incredible benefits of letting your baby get all their blood (!) head to Amanda Burleigh’s website linked below, she is a midwife and an epic campaigner for change in the cord clamping world.
You can use your own cord tie, rather than the plastic cord clamp. You all know I love a cord tie, but more than that it is another little thing you can bring to the experience that could make it feel more personal.
Don’t forget to have a think about what is important to you and your family. There will be loads of other things that I haven’t listed, that are personal to you that you can chat to your health care providers about. We dive deep into the world of birth planning on my Hypnobirthing Antenatal course, so do check that out and get yourself book in if you are local to Nottingham to Derby! If you are looking to level up you birth team, have a look over my doula page. I support all kinds of births, including caesarean. You’ll have to be quick if you want to hire me for 2024 as I only have a tiny bit of availability, but have plenty in 2025.
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