Natural Caesarean Section

The new "natural" Caesarean - TIMES Online

This has been a long time coming and I am so happy to see this article. My second and third cesarean sections were much like this. I hope American women will read this and show this to their OBs so more and more of us can push for better cesarean births for us and our babies.

Great video of a Cesarean Section Birth

What should I pack to the hospital if I am having a cesarean section?

One of the most frequent questions I am asked about cesarean sections is what one should pack in their hospital bag. I am one of those people who totally obsess over what to pack and pack way too much because I do not want to be without anything but here is a list of things I recommend you take to the hospital for you and your baby. Remember to take what is useful for you and leave the rest. I tend to go overboard.

• Be sure to pack your cesarean section birth plan, and be sure to have an extra copy. If you have any specific instructions for the nursery staff bring that as well in case you are unable to express your wishes and need someone else to advocate for you or your baby.
• Don't forget your insurance information or any other important paperwork.
• Bring your own pillow. Maybe even two. I also bring a Boppy or nursing pillow to assist with breastfeeding and holding against my abdomen for coughing.
• Bring your own toiletries and don't forget your toothbrush. After two of my csections that is one of the first things I did after leaving recovery. Also, bring the lip balm.
  
• Camera and Video Camera. Have extra batteries for your digital cameras and bring extra film.
  
• Pack two nursing bras, I prefer a flexible one with some give to it like a sports bra because the girls are going to get big and you may need extra room. I also pack several pairs of socks, some granny panties, and a nursing gown. I tend to wear my own clothes after I get my cath out and my pain pump removed. If you are going to feel more comfortable in your own clothes take clothes you are going to be comfortable in that have some give to them. You will want something easy to move around in.
• Slippers or slip on shoes. Heck even some flip flops will do.
  
• Medication. If you are on any medication bring it with you, especially if you are going to be taking something for postpartum depression.
• You will need some snack foods. Hospital food sucks and when you are ready to eat flavorless chicken and jello are not going to be appetizing. I always have a stash of snacks for my husband or my sister and myself. I also pack hard candy to suck on because some of the pain medications can cause dry mouth.
• Don't forget your list of telephone numbers.
• Have some cash on hand. Change for the drink machine or snack machine.
  
• Car seat. Hospitals will not let you take your baby home without one.
• I always pack outfits for my babies to wear and I also bring a few of my own blankets to use. Be sure to pack your baby's going home outfit.
• I'm normally preoccupied with other things but I do try to bring some form of entertainment like a book, my journal, magazine and music. You can also bring a CD to be played in the OR of your c-section. I was going to do this but then decided not too.
• If you have other children make sure you have somethings for them to do if and when they come to visit. Colors and coloring books, games, or small puzzles. You want to choose things that will not make a lot of noise, and that will occupy their time.
  

Cesarean Recovery: Tips to get your bowels moving

In 1997 when I had my first baby by cesarean section I had no clue as to what my recovery would be like. All I knew was that I felt like I had been run over by a Mack truck and that I could barely move. For the first two days I was confined to a hospital bed and gorked out on drugs. I was not allowed to eat any solid food at all because I was told it would make me sick. On the third day I was told I needed to get up and move around and have a bowel movement, yet I still wasn't allowed to eat solid foods. So on the this day I was given stool softeners, prune juice and eventually a laxative to get things moving. The nurse assured me that as soon as I pooped and they knew my bowels were moving I could have solid food AND that if I could not poop, well they were not going to let me go home from the hospital until I did.

Let me just say, that 12 hours of stool softeners, prune juice (that they heated for me so it would taste better) and a powerful prescription laxatives did the trick. Things got moving alright and I can testify that it was one of the most painful, humiliating experiences of my life. After a few hours of becoming one with the toilet in the neighboring bathroom with excruciating stomach cramps with a eight inch incision in my abdomen I was finally allowed some solid food - lumpy cold mashed potatoes.

When I got pregnant with our second son Jack five years later I did some research to better facilitate my recovery that would not leave me starving or spending valuable time I could be spending with my baby on a commode. Here are just a few of the things I did that you might want to try too after your cesarean section.

• Drink, drink, drink. As soon as you get into recovery start on the ice chips and then gradually move to sipping water or fruit juice. A study done in Turkey found that cesarean section mothers who had fluids early on in the recovery process had a return to bowel function much sooner than those who waited to have fluids.
• After surgery, ask to eat as soon as possible. I don't suggest eating a heavy meal from the local fast food joint but there is really no reason you can't have some soft solid foods, fruit, or vegetables a few hours after surgery if you feel up to it. Eating will get your digestive system working again after major surgery.
• Some doctors will not allow you to have solid food until you are passing gas. This may be harder to do than it sounds. Need to fart, pack some gum in your hospital bag. Chewing gum has been shown to speed bowel function after a cesarean section. Also, don't hold back unless you really want to be in some serious pain. If you have guests come to visit you and your newborn baby, warn them that you are just going to be ripping them as mother nature allows.
  
• If you are having a lot of pain from gas, which may present as pain in your chest and shoulders, request a rocking chair in your hospital room if there is not one already there. Rocking has been shown to eleviate pain from gas and help pass it which in turn gets the bowels moving. A study done in 1990 showed that rocking mothers had less gas pain, walked faster and left the hospital one day sooner than cesarean section mothers that did not rock. I can testify from my personal experience that rocking worked with my last three cesarean sections.
  
• Get moving as soon as you can. The more you move after having a surgical birth the faster you will heal. Just take things slow. Moving around your room and walking the halls will also get your digestive track moving, and it will also facilitate passing gas. Remember don't hold back! If you are walking the halls and a good fart slips, blame it on your nurse or partner. You will most likely be on drugs and no one will care what you say and will think its funny.
• Take the stool softeners as soon as possible. Don't wait until they are needed. If you wait until then, its too late. Keep in mind you do not want to put any straining and pushing on your back end after having abdominal surgery.
• It's likely you will experience some constipation. Until things are flowing like they should you may want to discuss cessation of your prenatal vitamins with your doctor if they are high in iron with your doctor and go to eating iron rich foods. This may not be possible depending on how much blood loss you had during surgery so don't just stop taking your iron because you read this here on the internet.
• My last tip is try avoiding taking medication that has codeine it. Codeine is one of those pain relievers that stops you up. As my husband would say "it will make things hard as a rock". See what options you have in way of pain management that will not cause you additional discomfort down the road.

Lastly, keep in mind that it is not unusual for you not to have a bowel movement until 3 or 4 days after having a cesarean section. If by day four you are not having a bowle movement then it is likely you will need something to help you go. Discuss using an enema verses a laxative with your doctor if you find yourself in this situation. From personal experience the enema is far kinder to you than the laxative and less painful.

Cesarean Goddess Information

If you have stumbled across this blog, it is likely because you have had a cesarean section, are going to have a cesarean section, or would like to avoid having a cesarean section. The cesarean section rate in the United States is nearly 30% which means at least one woman in four will have a cesarean section. This blog will not be one that places judgment on women who have had cesarean sections nor will it be one that makes it sound like a glorious option. The truth is, I firmly believe if you can have a safe vaginal birth than do so, but for many of us vaginal birth is not an option or something happened during our pregnancies or birth that led to a cesarean section. Some women will choose to have a primary cesarean section, and while that is not something I would do, I support their right to do so. What may be right for you, may not be right for someone else.

Comments and differing views are welcomed, but please don't be rude and disrespectful to other posters. There will be no anonymous comments. If you would like to submit a link or resource or share your cesarean section or VBAC birthstory here please email me at dscvrlife@bellsouth.net and be sure to put Cesarean Goddess in the subject line.

I am not a doctor or a medical professional. This blog is mostly made up of personal experience and research. Please seek medical advice from your doctor or midwife.

A little about the Cesarean Goddess.

You may have heard about me or read about me on a message board. I've been banned from the MotheringDotCom forums for being vocal about cesarean sections and encouraging women not to take extreme risks to avoid them. My screenname on most parenting message boards is OnTheFence. I've had four cesarean sections. My first was an emergency cesarean section after a failed ECV. During that surgical birth it was discovered that I had a mullerian anomaly. Our second child we adopted due to infertility but I went on to get pregnant again and take our third child to term. I had a wonderful cesarean birth experience. During that pregnancy I did a lot of research and talked to hundred of women all over the United States about their experiences and recovery. Our fourth child was born in 2005. I had an uneventful pregnancy and cesarean birth. Our fifth child was born in 2007 at 34 weeks. I had multiple complications and after discussion with my OB decided that it was better for both of us if she exited the womb. My last cesarean birth was not uneventful, I had multiple complications as did our baby. There will be no more babies for me but I hope that I can continue to help women plan and come to terms with their cesarean sections.

Cesarean Goddess aka OnTheFence Cesarean Section Birth Plan

Not a week goes by that I do not get an email from a woman or a doula asking me about my Cesarean Birth Plan that I made over seven years ago when I went to have my second son, Jack (whose birthday is today!). My cesarean birthplan is found all over the net but its start began on MotheringDotCom where I am now banned from their forums. Thanks to the administration at MDC, they feel that OnTheFence is too vocal in voicing her opinion about surgical birth and supporting a woman's choice in how they give birth because it's uncrunchy. Any questions about the birthplan below feel free to write me at dscvrlife @ bellsouth dot net.

*For the locals. The cesarean birthplan below has been used multiple times at Mobile Infirmary by not only me but by others. I have found that they and USA Children's and Women's Hospital are the friendlier hospitals in our area in working with you on giving you and your baby a good experience.

** I am not a doctor. I do not play one on TV. I am not even a nurse. Do not accept this as medical advice. Do your own research and discuss your birth plans with your doctor or midwife. Don't try this at home either!

My Cesarean Birth Plan (June 2005 version) Feel free to copy.

*I want to note that I don't do anything the traditional way, so if you have any questions about why I chose to do something a certain way feel free to ask or email me.

I am having a planned cesarean section the third week of June. My cesarean is being planned for mid-day. I choose to plan my cesareans because my first was an emergency, my anesthesia failed and I felt out of control. When planning I arrange everything in advance, including who administers anesthesia, my nursing care, and who assists my doctor in performing the surgery. I literally have my hand in every decision that is made, including the type of anesthesia that is performed, what drugs are given to me during the actual surgery, and what happens after the baby is born barring no complications.

As this is a planned Cesarean birth we are looking forward to a positive birth experience. We want to participate in this birth to the fullest. We have listed our preferences below; these decisions have been made after research, consultation, and thought. Therefore your help in attaining these goals is very much appreciated.

We would appreciate preoperative blood work and tests to be done on an out patient basis, and hospital admission on the day of the birth.

My sister, ****** , is to stay with me the entire time, even for procedures and administration of anesthesia. [note to readers, I recommend a friend, relative or doula to be with the mother at all times]

I would like an epidural with continued pain relief with a PCAP. [note to readers, I had a failed spinal with my first csection. I had an epidural with my second with continued pain support for 17 hours after surgery through a PCAP that was hooked into my epidural cathetar. I was able to mover around, but did not have anything impairing my brain function.]

I would like the catheter put in after anesthesia is administered.

I do not wish to have medical students present during our cesarean. [For my last birth in 2007, I did allow students after I met them. I have rule, I have to meet you before you get to see me naked.]

My arms are not to be strapped down unless general anesthesia becomes necessary during an emergency. [ It is customary during surgical births in the USA to strap the arms down, like you are Jesus Christ, to the operating table. Not all doctors or hospitals do this, but it is the "norm".]

I would like the option of viewing the birth either by lowering the screen or positioning a mirror. [ In 2007, I had my head on a pillow and the screen lowered. I didn't like it.]

I welcome conversation during the delivery process. [ Some people request music, dim lights, and no talking at all. It's really up to you. ]

If my baby needs assistance during the delivery process, if possible please use a vacuum verses forceps. [ I've had one baby delivered with use of the vacuum with no visible problems or effects. I know too many babies harmed by forceps, in vaginal and surgical births, this is why I have made this request.]

We would like to take photos of the birth as it occurs. [ This will be up to your doctor or hospital, most doctors can have hospital policy waved. You can also video your birth with permission from the doctor. Don't ask your nurse, she will tell you no.]

I would like to see the baby immediately after birth if at all possible. I would also like to be given the baby or have it held near me in the OR.

No mind-altering drugs are to be administered without Kim’s expressed permission. I am aware that some hospitals routinely sedate the mom for the repair portion of the surgery. It is important to Kim not to feel drugged or be unable to remember the events of the birth. Kim would like to avoid having nausea medications administered unless absolutely necessary, Zofran is preferred if the need arises. [ Phenegran makes most people drowsy and can interfere with nursing after surgery. Also, sedative are often administered in the IV routinely before the surgery to "calm" the patient and during the suturing phase. If you need them, go for it, but if not, you can ask that they not to be given]

If at all possible we would like that the baby’s father, Jeff, be able to cut the cord. [ I am not asking that he trim it at the warming table for baby, but actually enter the sterile field to cut the cord. My OB is going to try and accomadate this request, with respect given to the sterile field. *Jeff was unable to do this but he didn't seem to care.]

Kim prefers that the outside incision be sutured with stitches and not staples. [ There is a small risk of infection from sutures, however I think the benefits outweigh the cons. I have had both, and the stitches left me with a nicer cleaner incision, and I felt as if I was held together better.]

Kim wishes to have the baby with her in recovery so that she can breastfeed immediately. [ readers note that I request to recover in a Labor & Delivery Room so that I can have my baby immediately and have my husband and sister with me (or other guests) Find out your hospitals policies about recovery areas, some will not allow you to have your baby or your partner with you.]

NO EYE OINTMENT is to be administered to our baby at ANY TIME. Kim, the baby’s mother has been tested for all STDs and was negative and since this is a cesarean birth our baby is at no risk of eye infection. This has been discussed prior to the birth with our baby’s pediatrician. [you will have to sign a waiver stating it is for religious reasons at certain hospitals, if you need a church affiliation tell them you belong to the Church of Kim...lol]

We have refused the Hepatitis B vaccine at this time.

We do consent to having the Vitamin K shot administered to our baby. [Some people opt out of this, do your research.]

All tests and procedures are to be done in the presence of one of the baby’s parents, and with our expressed consent, barring no emergency situation. [In 2007, we did have problems at our baby's birth that required immediate medical attention. However they did allow my husband to be there the entire time.]

Please do not bathe our baby. [note to readers, bathing a baby after delivery can often lower their temperature, resulting in having to go and stay in the nursery. Cesarean birthed babies already have a disadvantage to vaginal birthed babies because they tend to have a harder time maintaining their temperature, this is why we forgo the bath, and do one later that I can participate in seeing and/or being involved in.]

If our baby is a boy, do not circumcise. [our boys are intact and we have had no problems]

[ we are expecting a girl, but just in case!]

Our baby will be breastfed. Please do not give our baby pacifiers or bottles.

We would like our baby to room in with us. Kim will have someone with her at all times to assist her with the baby in anyway. [note to readers, most hospitals will not allow rooming in for cesarean birth mommas unless they have help, this is the hospitals policy I am going too]

Do not come and take our baby to the nursery unless we request it. Any procedures or pediatric checks can be done in our room [if they tell you they have to be done in the nursery it's BS, you are paying the doctor $100 a visit, they can visit your room]. This includes ultraviolent light therapy for jaundice. [ note to readers, if they tell you they can't do the therapy in your room, they are bull shitting you. I specifically note this because my babies often get jaundice do to ABO incompatibility.]