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Planning a Caesarean Birth - You Can Still Be In Control - Part 2

Beth

If you haven't already read Part 1, please head over to that one first as this one carries on; after the birth and what happens next.


Cord clamping

 

Cutting the cord has become a bit of a dad thing to do, but I meet just as many dads who really aren’t keen as those who want to! If you are one who has pictured this moment and you really want to cut the cord, make your feelings known. It is still possible in a caesarean birth. If your team are reluctant to let you close enough to do the initial cutting they will often cut the cord long so that you can do a later cut.

 

Something else you might have thought about in your birth plan is delayed or optimal cord clamping. Waiting to clamp the cord to allow more blood to the baby. This can be a delicate balance in a caesarean birth as the longer you wait to clamp the cord the longer you are waiting to be stitched back up with an increase in infection risk. However, this doesn’t make it a reason to clamp speedily. If you want to delay, have that conversation and it should still be an option to wait for some period of time.

 

Feeding

 

Immediate skin to skin after birth is a great way to start off breastfeeding. In the golden hour your baby usually finds their way to the breast to have their first feed. Again, this is something that can be managed in a caesarean birth but you will need a bit more support. Even if skin to skin isn’t immediate for you, as soon as you are able to do it you can help encourage your baby to the breast and to latch. Laid back type feeding positions are great with newborns to allow them to latch so with a bit of help this should be manageable.

 

If breastfeeding is important to you then let your midwife know you want to be supported to feed as soon as possible and want skin to skin with your baby. Hopefully this can all happen in theatre but if not it will be once you are in recovery.

 

If you are planning a caesarean you may be advised to express some colostrum (first milk) in advance and bring this with you. This is a back up in case, for whatever reason, you aren’t able to feed your baby at the breast. This way their first feed(s) can still be colostrum. Make sure your birth partner knows about this and where the milk will stored, it will be frozen, the midwives can help support you to feed your baby with the syringe you will have collected it in.

 

If you feel strongly about not giving your baby formula ensure that your partner is aware and, if baby needs to be moved to the neonatal unit or somewhere else for care, they stay with them and have any colostrum you have brought with you. If you are separated from your baby you will helped to express milk for them.

 

Weighing and checks

 

Once you know your baby is healthy, the next thing on your mind might be how much they weigh. We often have an idea in our heads that baby is born and whisked away to be checked and weighed but in reality this can wait. If your baby is weighed in an hour or two it won’t make much difference at all. In fact, if you have had IV fluid it might be beneficial to wait so your baby’s birth weight isn’t artificially higher due to the extra fluid.

 

The first checks babies routinely have is the APGAR check and this can be done as a visual check by the midwife while you enjoy skin to skin. Obviously if there are any concerns, baby may need more checks away from you but some skin to skin can, literally, work miracles.

 

Final thoughts

 

So if you want to make plans for a caesarean birth the communication is really the key. If your birth will be a planned caesarean you have the chance to discuss your wishes with your doctors or midwives in advance and if your requests are a little outside the norm for your hospital there is time to work out how to make it happen for you.

If you are thinking about how you would want things managed if you have an unplanned caesarean it is still worth having those conversations to know what you can expect and how they can work with your own preferences. It will be a bit more dependent on the circumstances and who is there on the day but making sure your birth partner is clued up on what you would like will really help as they can be your voice and advocate in a situation where you might not feel able to confidently express your wishes. There is no harm in writing a plan/preference list to cover this situation or you might feel that whatever you write as a preference for birth in general will cover the main points in any situation.

 

Whatever happens during your birth or in the lead up to it, don’t blame yourself if things can’t or don’t work out in the way you want them to. You can absolutely have an amazing, positive caesarean birth but it is also ok to feel like you are grieving elements of a vaginal birth that you had pictured. That is why the communication with your team is key. Letting them know how you feel may help ease the path to creating a caesarean birth that feels right for you.  

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