Ask the Midwife: Gentle C-Section

I was born at home and both of my sisters have had natural childbirths in the hospital. I was planning to have a birthing center birth with midwives but at my ultrasound I was told that I have complete placenta previa and I will need to have a c-section. I’m now 30 weeks, I have found a doctor that I really like and the hospital is so-so. Here is my problem, I’m 28 and have never had a need to be in a hospital for myself. My only hospital experience is when my dad died, so hospitals for me are about sickness and death, and I’m bringing in life. I am terrified of surgery and hospitals. I know that the chances of the placenta moving away from the cervix is slim. Can you help me prepare for a c-section?

Hi Hospitalphobic. Thanks for writing in and sharing your fears with me. For those reading and do not know, a complete placenta previa means the placenta is covering the opening of the cervix, so not only can the baby not come out the vagina because the placenta is in the way, but if one was to start dilating it could result in an excessive amount of bleeding. A complete placenta previa is diagnosed through an ultrasound, is rare and means that you must be in the care of an OB and prepare for a surgical birth because your pregnancy is considered high risk.

Firstly, I want to express the gratitude for the fact that we do have hospitals and excellent surgeons that are around for necessary cesarean births, for which you are in need.

Let’s look at the layers.

The process of mourning the passing of your father is important to honor, and seeing a mental health professional is wonderful idea to make sure all the many feelings you are having are acknowledged and heard so they are not collapsed onto your child’s birth story. A therapist, social worker or psychologist will help you to process your grief of your dad’s passing while opening up your heart to your new child.

Here are a few things to consider in order to differentiate your childbirth birth experience from your father’s passing.

Choose to birth at a different hospital than the hospital where your father passed. Find a mantra to realign your mental and emotional body with this healthy event. For example: “I am here to birth my family safely and with joy.” Ask your partner or a doula to remind you during the surgery that you are at the hospital to birth your family. This will help your mind from wandering and allow you to stay in the present moment.

I hear from many families that they equate hospitals with sickness and death. The good news is that you are a healthy woman with a healthy pregnancy and need the support of an intervention to birth your baby safely. Many hospitals are starting to wake up to the bad press and are making efforts to redesign and create new protocols that are bringing humanity and connection back into low risk childbirth. Check out which local hospitals take your insurance and then find out how each of them handles non-emergent cesarean births. (Remember, there is a big difference between an emergency and a non-emergency cesarean birth.).

A few questions you can ask are:

  • Can I have my ipod with my playlist playing in the surgical room?
  • Can I have a see through surgical drape or have the blue drape lowered to watch the birth of my child?
  • How many people can be in the surgical room for the birth of my child?
  • Will someone be able to tell me everything you are doing to my body so I can be part of my child’s birth?
  • Will my partner be able to photograph and/or video the birth of my child?
  • Will you delay the cutting of the cord?
  • Will my partner be able to cut the umbilical cord from the placenta?
  • Can I have all IV access on my non-dominant arm and ECG leads on my back so I may hold my baby skin to skin on my chest?
  • Will my child be able to go skin to skin immediately after birth while being sutured?
  • Will my child be allowed to try breastfeeding in the OR?
  • If I need an anti-nausea medication can I have a non-drowsy one?
  • Can I choose to not have a sedative so I may be present and remember the birth?
  • Are you comfortable with me “seeding” my child after the birth? (Seeding is when a sterile gauze is inserted into the vagina and then wiped onto the baby to help with seeding baby with healthy bacteria. The research is still incomplete on this subject but there is a lot of new information about the benefits of healthy vaginal bacteria for
    a newborn.)
  • Are my baby, partner and I able to recover together in a private room after the birth?
  • How soon after I give birth will my catheter be removed and will I be able to eat?

I am happy to hear that you have found a doctor that you like and trust which I believe is the key to a grace-filled birthing experience. Birth, no matter how it happens, is a sacred event. In support of having the birth be respectful and enjoyed, invite the medical staff to be part of this memory by asking them to refrain from non-medical chit chat.

Remember, doctors are loving people who not only want to help you have a safe birth, but enjoy watching a family being born. I hear that having a surgical birth is not your first choice. You get to mourn the loss of your ‘ideal birth’ while embracing the one the universe has chosen for you. And if you can find a way to open up your heart and mind to this choice, you will find that the hospital staff will respond in kind, and your birth will be filled with grace.

Photo courtesy of Melissa Jean Photography.

For more than a decade, Elizabeth has practiced midwifery, expertly combining her diverse body of skills in pre and perinatal psychology, acupuncture and communications to passionately educate and inspire women to understand their bodies and birth experiences. With a degree in Child Psychology from Tufts University, Elizabeth is uniquely in tune with the full spectrum of family needs around birth and baby planning. In addition to serving Los Angeles based families as a practicing midwife – both at home and in her well established Silverlake Birthing Center, GraceFull Birthing Center, Elizabeth has been passionately dedicated to supporting and inspiring women for more than a decade, as celebrated by People, ET, In-Side Edition and CBS News. In addition to directly serving Los Angeles based families, Elizabeth is featured as a leading expert on shows including VH1’s Love and Hip Hop Hollywood and Tia & Tamera. Elizabeth serves on the Ergobaby Medical Advisory Board. Find Elizabeth’s birth planning guidance in the GraceFull Birth Plan at Best Ever Baby.

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