There is no doubt a woman's body is beautifully designed to birth her baby and a gentle vaginal birth offers the best possible start for her baby. But sometimes pregnancy, labour and birth can, for a number of reasons, take an unexpected turn and normal delivery via the vagina is not safe and caesarean birth may be the best option.
So, how can you ensure a caesarean birth is a positive, gentle and empowering experience?
In Belgium, the rate of caesarean births is around 21%, however, significant variations are observed between hospitals (from 11.8% to 32.9%). The WHO recommends a limit of 10% - 15% so Belgium exceeds this recommendation and the number has been rising steadily. So, it seems reasonable as part of your birth preparation to consider a plan for a caesarean birth.
A caesarean birth, whether expected or unplanned, offers unique challenges and circumstances for you and your baby. It is helpful to recognize that a caesarean birth is still a birth, and you can prepare in advance by including plans for a birth on your terms, even when it occurs in the operating theatre. Of course it goes without saying that you need to discuss your plan in advance with your caregivers to see what is possible in your situation and in your place of birth! It can be challenging to voice your preferences to your healthcare providers, but it is the first step towards creating an empowering birth experience. In the absence of a medical emergency, many gynaecologists in Belgium are happy to accommodate your requests - you may just have to make your wishes very clear.
It is really important that you understand the rationale behind why you are being offered a caesarean birth and own the decision to have one - it is your decision to make after all. If you are unsure of absolutely anything, ask questions and do your own research! Feeling it is the right decision will help you get in the right mindset and be able to fully appreciate the moment of your baby's birth.
What should you consider in your caesarean birth plan?
Your birth plan begins with creating an atmosphere where you can give birth to your baby in a peaceful and relaxed environment. An atmosphere that accepts a caesarean is major surgery but that works in tandem with yours and your baby's physiology. Your aim: to create as many aspects of a natural birth as you can within the operating theatre environment - a gentle environment for a gentle caesarean birth.
Your Birth Partners
Having two support people in the operating theatre is ideal. This allows your partner to stay with the baby if your baby needs special care. They can attend to your baby while a doula, midwife or other family member stays to support you. Your partner can:
Consider asking the theatre staff to introduce themselves when they arrive. There will probably be more people than you expect, all wearing masks and gowns. That little bit of human connection can go a long way for creating a positive experience. The staff should be focused on you and how you feel throughout the experience. This can include keeping the room quiet and using only positive words to explain what is happening.
Be Awake and Comfortable
Rarely an emergency caesarean birth requires a general anesthetic that puts you to sleep. However, for a planned caesarean birth, you can have an epidural or spinal block. This numbs the lower half of your body so you are awake for the surgery but feel no pain.
If you’re anxious or agitated, you might be offered other medication to help you feel groggy and less able to remember things afterward. You can let the anaesthetist know you would prefer to stay alert and involved.
It’s normal to feel jittery or nauseous in the operating theatre. To remedy this, instead of medications, peppermint essential oil on a cotton pad near your face will often do the trick.
Playing your own music can be deeply comforting especially if you’ve been planning something special. Ask to put on your own music. Make your own playlist! You can also be asked for the theatre lighting to be dimmed (not over your abdomen of course your gynaecologist needs good light).
Your abdomen is usually hidden from view during the operation by a curtain, but you can ask to see your baby being lifted from your uterus. Some hospitals even provide a clear drape to maintain the sterile field while allowing you to watch or the curtain can be lowered at the moment of birth so you can see your baby enter the world.
Announcing the Sex of Your Baby
If you’ve been waiting to learn the sex of your baby, ask if the staff can abstain from announcing it so you can discover it yourself when the baby is given to you.
Delaying Cord Clamping
Delayed cord clamping has been proved to offer a baby significant health benefits. It’s become the new normal for vaginal births but the practice isn’t so common for caesarean births. With delayed cord clamping the gynaecologist waits 3-5 minutes before clamping, then cutting, the umbilical cord. This allows extra placental blood to flow to the baby. You can read more about delayed cord clamping and its benefits at: waitforwhite.com/
Ask if your baby can be given to you immediately after birth for skin-on-skin contact, bonding, temperature/heart rate regulation and breastfeeding rather than being handed to the midwife for any routine procedures. This skin to skin contact promotes bonding, which has several advantages. Breastfeeding success is more likely, you'll develop attachment earlier, and your baby feels more secure after entering the world. It’s a great experience for birth partners, too, as they can benefit from skin to skin with baby and provide extra reassurance and support for you.
Ask if the IV catheter, oximeter and blood pressure cuff can be placed on your non-dominant arm and the electrocardiographic leads are placed on your back. This leaves your chest clear so you can hold your baby skin to skin on your chest.
Ask if all newborn procedures (e.g. weighing, vitamin K injection, dressing, etc.) can wait until after you’ve gone back to your room and had the opportunity to bond and breastfeed with your baby.
Talk to Your Baby
You and your partner can help ease your baby’s transition into the world by talking to them when they arrive. Hearing the sound of you and/or your partners voice is incredibly comforting for them and begins the next stage of your relationship. You might like to consider having a towel/blanket that you have slept in available to put over your baby soon after birth, helping to transfer your skin flora to baby (as with skin-to-skin).
Exteriorizing Your Uterus
Surgeons sometimes move the uterus out of the body to examine and repair it. However, research shows that this in no more effective than repairing it inside your abdominal cavity. Removing the uterus to repair it is tied to increases in nausea, vomiting, longer time to first bowel movement and postpartum pain. It is a worth inquiring about your gynaecologist's preferences
In a vaginal birth the final stage is the birth of your placenta. It is easy to forget that placenta delivery is also part of caesarean birth. As long as there’s no medical reason why your placenta needs to be sent away for testing, it can be given to you.
If you’re planning on placenta encapsulation, this can still be part of your plan. Your midwife can keep the placenta on ice for your partner to bring home. If you didn’t plan on encapsulation, it’s still nice to be given the chance to see this incredible organ your body made to keep your baby nourished in the womb. You can request a quick look before it’s whisked away, or ask a support person to take a photo.
How can a KG Hypnobirthing Course Support You In a Caesarean Birth?
KGHypnobirthing (KGH) can turn a scary and clinical experience into a safe and empowering one – knowing how to have a calm, confident and informed caesarean birth experience allows you to feel some of the benefits of a natural birth and have a positive birth experience, even if your birth takes an unexpected turn. There are a number of ways to emulate a natural KGHypnobirth in theatre. Here are some ideas for you to consider:
In labour and birth the hormone oxytocin is the star of the show and the amount you produce in labour dictates the strength, length and frequency of your surges (contractions). This is essential for a natural birth - but oxytocin can also support you when you are having a caesarean birth. Doing all you can to feel safe and happy will help you release the feel-good 'love hormone' oxytocin (it is not released when you are feeling scared or unsafe) which will in turn pass to your baby.
Whether the caesarean is elective or unplanned, you may feel apprehensive - you may have concerns about your baby’s health or your own and it is a major operation so somewhat significant! The calmer you are, the lower your stress levels will be, the more oxytocin you release and the calmer your baby will be. Breathing is the key to staying calm:
Oxytocin also plays a major role in bonding with your baby so the more of it you can have at the time of birth the better! And as oxytocin is also released in response to touch ask for a kiss, hand or reassurance from whoever is with you.
KGHypnobirthing affirmations / scripts:
Photos / affirmations cards:
Relaxations for a Caesarean MP3:
The KGH caesarean audio collection helps you prepare for your baby’s birth so you see it as a happy and positive event, and this makes a huge difference to your baby’s life. The audio includes:
You can purchase your caesarean relaxations at:
A KGHypnobirthing course provides the tools to support you through labour and birth regardless of how it unfolds. If you find yourself in the position where a caesarean is necessary, then you can be confident that the KGHypnobirthing techniques learnt on a course are also beneficial in the operating theatre and can give your baby a positive start in life.
A Positive Birth Story...
If at first you don't succeed (in finding a doctor who truly listens to your wishes and involves you in the decision-making process) try, try again! Kasia's story of the caesarean birth of third child is testament to everything you have read in this blog and how changing just a few details can change everything. Kasia's made small changes and her third birth was transformed into a healing, and most memorable birth experience. Read her story here at: www.thevillage.be/gentle-welcome-via-cesarean/
I love the writing of Dr Sarah Buckley! Check out Sarah's article on caesarean birth: 'How to have the Best Caesarean Birth' at: sarahbuckley.com/how-to-have-the-best-cesarean/ (Accessed 14th February 2023)
KG Accredited Hypnobirthing Teacher