Take Control of Your Caesarean Section



It seems that most of us mothers have an idyllic impression of how we will birth our babies and for many, this involves a ‘natural’ physiological birth. We strive to achieve this by preparing ourselves with knowledge, information, resources and preparation for a positive experience and outcome. However, despite our best intentions and groundwork, our birth results in a caesarean section.


The perception of caesarean varies from woman to woman based on her experience and thoughts around the caesarean process. There is no right or wrong value here, it is really based on the experience and views of the individual.


If you have been told by your medical team that a caesarean section is imminent, or you are preparing yourself for any potential outcome, then knowledge is power! Being aware of the possibilities of a caesarean, what may happen in theatre and your rights will help you to prepare yourself if this outcome arises.


After interviewing many clients, a common and resounding observation is that they wish they were more aware of possibilities, risks and outcomes from caesarean births. They felt they had a lack of knowledge around what was going to happen, what their options were for the delivery of their baby and what post-operation issues could arise.


Other mothers reflected on their caesarean experience as a whirlwind of movement, lack of input and feelings of being out of control. These mothers feel that they were not equipped with the tools to mentally, emotionally and physically prepare them for a caesarean.


Another frequently posed outlook was that they wish they had more postpartum support. It is widely known that most of the postpartum focus is on the baby, often leaving the mother and her needs forgotten. This makes the caesarean recovery period more challenging and physically and mentally difficult for a new Mother.


My goal is to provide you with the knowledge and resource you need to help prepare for a looming or potential caesarean.


Preparing For Your Caesarean Section


Birth Plan – Whether or not you are having a caesarean section, creating and designing your own birth plan is super important. A birth plan will show your medical team your wants and needs and this will lead to you feeling respected, informed and included in the decision making process around the delivery of your baby.


Some key things you can include in your birth plan are:

  • Request that you walk to the theatre room, rather than be wheeled in a chair or bed

  • Allow labour to begin naturally

  • Asking for two support people in the theatre room

  • A request for a maternal delivered caesarean

  • A request for a natural or gentle caesarean

  • Mum or Dad to announce the gender of the baby

  • Delayed cord clamping


Breathing – Breathing techniques can also be a useful during a caesarean. Correct breathing posture and techniques can still be done when you’re in theatre and should be considered as it will ensure that oxygen is getting to every part of your body to promote faster healing and recovery. It will also ensure that your baby is getting enough oxygen.


You can read more about the recommended breathing techniques here: https://www.shereennielsen.com/post/breathing-your-way-through-labour



Hypnobirthing techniques – Hypnobirthing is becoming increasingly popular and is widely accepted and used by many expecting parents. Hypnobirthing is the art of preparing your body and mind for a relaxing and calm birth. It is highly successful and has helped many women and their partners to have an empowering, calm and confident birth. With hypnobirthing, you use hypnosis tracks, meditation or music, those breathing techniques, visualisations, soft touch massage and relaxation techniques to support. Most families think that hypnobirthing is only warranted if having a natural physiological birth however, with the right information, knowledge and preparation, you can use hypnobirthing strategies even when having a caesarean.


You can find out more about Hypnobirthing on the Hypnobirthing Australia website: https://hypnobirthingaustralia.com.au/



Allow labour to begin naturally – I mentioned this in the birth plan suggestions as something you can discuss this with your care provider to find out if this is at all possible. The reason you should consider this, if possible, is that the hormones released during a normal, physiological labour play an essential role in bonding and breastfeeding once you birth your baby. Waiting for labour to commence naturally will also help to ensure that your baby is ready to be born and avoids early birth.


In an article titled, Care Practice #1: Labour Begins on Its Own, it states:


During the last part of your pregnancy, your baby's lungs mature and he or she puts on a protective layer of fat, taking on the characteristic chubbiness of a newborn. Researchers now believe that when a baby is ready for life outside his mother's uterus, [their] body releases a tiny amount of a substance that signals the mother's hormones to begin labor (Condon, Jeyasuria, Faust, & Mendelson, 2004).“


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948087/


You can also read more about the hormones that are released during labour here:

https://www.nct.org.uk/labour-birth/your-guide-labour/hormones-labour-oxytocin-and-others-how-they-work



Ask for two support people – Again, this was recommended in your birth plan as a request to support you during your caesarean. Ultimately, the answer to this will be the decision of the anaesthetist, but you should consider asking your care provider to put a request into having two support people during the c-section. Having a doula as well are your partner during the birth of your baby will offer you a high level of support from non-medical professionals and will also help with any complications post caesarean. For example, you need to consider that your baby may be taken to NICU so having one support person stay with you and one stay with your baby will help to create comfort for you.



Ask Questions – Amongst other feedback from interviewees, many mothers reported their lack of knowledge around caesareans and the postpartum process and care. Remember that there is no silly question. The only silly question is the one that is not asked! If you are unsure of any processes around your caesarean, be sure to ask your Doula (if you have chosen to have one) of any member of the medical team. Where possible, it can help you to research caesareans. You can find out more about caesareans here:


https://www.pregnancybirthbaby.org.au/planned-or-elective-caesarean



Caesarean Options – Believe it or not, you actually still have options when it comes to how your baby is delivered via caesarean. We know of the typical approach and this is for a medical practitioner to gently pull your baby from the incision in your uterus but did you know that in some circumstances, you can request or opt for a gentle/natural or a maternal caesarean? You may be wondering what these are and are keen to know more.



A Natural Caesarean birth is when you watch your baby being born via a natural caesarean and allow your baby to gradually and slowly push their way out of the incision. The delivery is still guided by the medical team to ensure your baby doesn’t become stuck or stressed but ultimately your baby is supported to manoeuvre their own way out- this is commonly referred to as ‘walking the baby out’. A slow caesarean birth actually helps the fluid to be squeezed out of the baby’s lungs similarly to a vaginal birth.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/



In 2017 Dr Felicity Plaat, an expert Consultant Anaesthetist from London stated:


"Natural Caesarean Section" -- in which women enjoy enhanced contact and bonding with their baby just as they would in a vaginal birth -- is safe, popular and feasible, and is not encouraging mothers to request C-section birth when it is not medically necessary. She also went on to say that this technique is associated with increased breastfeeding rates.....”

https://www.sciencedaily.com/releases/2017/06/170605085401.htm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/



You can watch a Natural Caesarean in these videos:


The natural caesarean - a woman centred technique - https://www.youtube.com/watch?v=ZGmjEtvM7B8


This Is What a "Gentle" C-Section Looks Like — and It's Beyond Incredible

https://www.youtube.com/watch?v=t2OxqhZieR8


Gentle Caesarean

https://www.youtube.com/watch?v=wv22YoUpt2Q



A Maternal Assisted Caesarean is when you lift your baby out of your uterus and place your baby on your chest for immediate skin-to-skin contact. This form of caesarean isn’t for everyone as you are a part of the procedure. Additionally, it is not possible for everyone to have one and is not routinely offered however, if you are scheduled for a caesarean and are interested in this possibility, you should again discuss this with your health care provider.


You can read more about maternal assisted caesareans here:

https://www.bountyparents.com.au/expert-advice/maternal-assisted-caesarean-deliver-baby/


You can also watch a recording on a maternal assisted birth here:


Maternal Assisted Caesarean Section

https://www.youtube.com/watch?v=ZNW-Q9i6K4k



After your Caesarean


Establish Skin-to-Skin – Also well known as ‘kangaroo care’ is “a natural process that involves placing a naked newborn on the mother’s bare chest and covering the infant with blankets to keep it dry and warm” (https://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/).



The benefits of skin to skin contact are widely known but unfortunately, is not often routinely offered to women who have a caesarean section. However, it is definitely possible and should be done too! In a randomised Cochrane study in 2016, it was summarised the benefits of early skin-to-skin care included:

For mothers:

  • Longer and more effective breastfeeding; more likely to exclusively breastfeed

  • Less breast engorgement/pain at three days

  • Less anxiety three days after birth

  • Higher satisfaction—mothers were six times more likely to want the same care in the future when they held their babies skin-to-skin rather than swaddled.

For babies:

  • More effective suckling during the initial breastfeeding session

  • Less crying– babies who received skin-to-skin care were 12 times less likely to cry during the observation period

  • Heart rate, breathing, and oxygen levels were more likely to remain stable

  • A beneficial increase in blood sugar


“In fact, the benefits of skin-to-skin care are so clear that the World Health Organization (WHO) recommends that ALL newborns receive skin-to-skin care, no matter the baby’s weight, gestational age, birth setting, or clinical condition (WHO, 2003). Skin-to-skin should begin immediately after birth and continue uninterrupted for at least one hour or until the first breastfeeding session for mothers who are breastfeeding.”


https://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/



Before you have your procedure, you should talk to your health care team about this option and include it in your birth plan too.



Postpartum Support – Having the right support after your caesarean will help you to recover and feel confident as you begin your parenting journey. Your support person may be your partner, a health care nurse or even your preferred postpartum consultant or Doula. Your support person can help you whilst you’re in hospital, but also at home when you leave the hospital. Your support person may help with washing, cleaning, meals or even bring your baby to you, to reduce the amount of you have to sit up and lift your baby.


From the interviews with clients, the most common report was that they wish they had more postpartum care in the home to assist with daily tasks. Having meals made or delivered, washing done or even someone to hold their newborn whilst they spent time with their other children or to have a shower alone would have ‘saved their sanity’.

If you are considering enlisting in some postpartum help, then I offer this service and would love to assist and support you in anyway necessary. You can find out more about my postpartum services on my website:


https://www.shereennielsen.com/bookings-checkout/postpartum-care-package?referral=service_list_widget


It is also of benefit for you to have post-caesarean support, advice and free counselling 24 hours a day, 7 days a week. This is offered through the Pregnancy, Birth and Baby Helpline on 1800 882 436.


https://www.pregnancybirthbaby.org.au/pregnancy-birth-baby-helpline



Whilst feeding comes naturally for some, establishing feeding can be difficult for other dyads. If you feel like you need some feeding support, contacting the Australian Breastfeeding Association may be of benefit to you.


https://www.breastfeeding.asn.au/



Independent IBCLC’s (International Board Certified Lactation Consultants) are also extremely knowledgeable and supportive with navigating any breastfeeding challenges that you and your baby may be experiencing. If you wish to maintain your breastfeeding journey but are seeking more direction and support, you can find a local IBCLC on the LCANZ website:


https://www.lcanz.org/find-a-lactation-consultant/


Alternatively, I have a list of highly recognised IBCLC’s around Australia so please contact me if you would like some direction in finding the right person for you in your vicinity.


www.shereennielsen.com/contact



Mamma Nurture – Last but not least, it’s all about YOU. It is vitally important for you to take care of yourself. Nurturing your recovery process and allowing yourself time to heal will help you to get back to a position that you feel comfortable with. Taking some time to rest will help improve your recovery period and reduce risk of infection, complications and prolong recovery.


Nutritious dietary intake will help to support your recovery. Key nutrients to pay particular focus on include iron, vitamin c, high fibre foods and anti-inflammatory foods. Many women who have caesareans report constipation and this can cause pain and discomfort in their abdomen. Food which are high in fibre can help relieve or prevent constipation.


It’s equally important to stay hydrated. Particularly if breastfeeding, as breastfeeding triggers an oxytocin release which naturally affects your thirst cues by encouraging you to drink enough water to hydrate yourself and make breast milk. Of course, water is the most common fluids consumed to remain hydrated but coconut water does have added benefits too!


‘Me Time’ – One of the most under-utilised benefits but most necessary is some ‘me time’. Whilst it is common and easy to put ourselves last, it is healthy to put aside daily routine to make way for our mind, body and soul. Have a massage to increase blood circulation and help your wound heal, take short daily walks to boost healing hormones and support your mental wellbeing, or taking the time to have a long and relaxing shower whilst a support person cares for your baby is exactly what you need. Don’t be afraid to ask for help! Take the opportunities offered to you to support you through your postpartum period.



Know that you are not alone! And anything is possible!



Shereen Nielsen



My name is Shereen Nielsen and I am a certified infant and child sleep coach and a Doula, training at the Doula Training Academy. I am also a lecturer and mentor for students on their journey towards becoming a Sleep Consultant, through my on-line internationally recognised sleep consultants course.

If you would like more information about my services please contact me:

Phone: +61419820474

Email: hello@shereennielsen.com

Facebook: www.facebook.com/shereennielsen.adelaidedoula

Instagram: shereennielsen_adelaidedoula



Further resources to support your caesarean birth:


Signs and Symptoms Post Caesarean Wound Infection - https://www.healthline.com/health/pregnancy/post-cesarean-wound-infection


Nutritional Support for C-Section Recovery - https://www.wholefoodhealing.com.au/post/nutritional-support-for-c-section-recovery


Complaints with your birthing experience –

https://www.ahpra.gov.au/About-AHPRA/Complaints.aspx





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