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What if I have to have a caesarean?

Planning for the possibility of a caesareanCaesarean birth is one of those topics that many mums-to-be would rather not think about. In fact, we don’t get to hear very much about them at all unless one of our friends has had one.

When I was preparing for my first birth, I sat in an antenatal class for five sessions before the word ‘caesarean’ was even mentioned. When it finally was, one unlucky lady was sat on a chair in the middle of the room and the rest of us (11 men and women) were told to crowd around her seat. This, we were told, was the way we would experience a caesarean birth. A few minutes were then dedicated to the perils of anaesthesia and how it could cause problems with feeding and bonding and that was it, “class dismissed”.

Needless to say, having had two caesareans, one planned and one emergency, I can say with total honesty that this is so far from the truth it would be laughable if it weren’t for the fact that this sparse, inaccurate level of information is all many mums-to-be hear about caesarean birth. The other piece of information commonly thrown in is ‘its major stomach surgery you know!’. Of course it is, but it isn’t like most women plan a caesarean for the heck of it, they have one recommended for a wide variety of important reasons.

As I tried to inform myself and prepare for my own births, I attempted to find out about this ‘caesarean business’ too — just in case. Quite a few friends had had one and their stories were often quite bleak. It was only as I started talking to doctors and obstetricians who had themselves had caesareans, either planned or emergency, that I began to understand that there was a lot more to it than simply laying back fearful yet passive, surrounded by strangers.

Research clearly shows that being better informed gives women an important feeling of control and this feeling of control plays a major role in how we experience the birth and how we view it after the fact. [Lally et al 2008 ‘More in Hope Than Expectation’]

Antenatal educators have known this for decades, that’s why they devote so much time and effort to teaching us every trick in the book to empower us during our labour.

It is really disappointing that the same importance is not given to knowledge of caesareans too. Beyond anaesthetic options, women do not hope for medical intervention unless it is necessary. But that doesn’t mean we don’t need to know about its possibility and every trick in the book to avoid it, manage it and cope with it — should it happen.

For example, some of the biggest kept secrets in antenatal education are the many positive ways in which we can personalise our caesarean birth.

If discussed in advance, we can hold our baby skin-to-skin in theatre, we can even try breastfeeding there too. We can have the lights dimmed on delivery and our own choice of music playing, or absolute silence if we prefer. But we are not told this, so we don’t plan in advance and when we find ourselves in theatre, we have no idea what is possible.

Of course, some caesareans are ’emergencies’ and some of these things are not possible, but with a good understanding of caesareans, why they can become necessary and what our options are in these circumstances, it is still possible to feel like a participant in the birth even if it is no longer going according to our hopes.

Our birth partner may be able to cuddle our baby skin-to-skin while we remain in surgery for example. It may be possible to have photos taken of the first moments of our baby’s life while we are unable to see her – such photos can be incredibly powerful for women who experience emotional difficulties after an unplanned caesarean.

Ideally, we should be helped to prepare for caesareans just as much as vaginal births, after all 1 in 3 of us will have one.

So, do encourage your antenatal educators to talk about them, don’t be fobbed off with a 5-minute smattering of scary stories.

With knowledge, a caesarean can be a really powerful experience too. One that we can remember positively even if it was not the way we thought our birth would pan out.

Knowledge is power.

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