Planned C-section? Here are 10 Things to Include in your Birth Plan
Updated March 12, 2021
In 2016, the national cesarean rate was 31.9% (CDC). While I am a passionate Vaginal Birth After Cesarean (VBAC) advocate and proactive about reducing the cesarean rate, I am grateful that we have access to this surgery that can save both moms’ and babies’ lives.
C-sections are a reality, and sometimes, a blessing, for many expectant mothers. Even when surgery is your safest option for birth, there can still be feelings of disempowerment, disappointment, fear and overwhelm. Your feelings are valid, friend.
Wherever you are on your pregnancy journey - a first time mom working on a natural birth plan, facing a planned C-section, or planning your VBAC - it’s a good idea to know your options in a cesarean birth, should you need one.
No matter your situation, I’m glad that you found my corner of the internet. As a two time VBAC mom, I’m passionate AF about helping pregnant women learn better, more supported ways to birth. In birth, ignorance is not bliss. Let’s empower you with knowledge.
Making the decision to have a C-section birth is not an easy one, I know first hand. There’s the obvious physical stress on your body of surgery, and the heavy feelings that come along with it.
I’ll begin with explaining why some women choose to have a scheduled Cesarean, the choice between a repeat C-section and a VBAC, and finish with ten options to consider for a Gentle Cesarean.
What are the reasons for a planned C-section?
There are multiple reasons why some families choose to schedule a Cesarean, including:
Placenta previa - when the placenta is low and covering all or part of the cervix
Malformed or injured pelvis
Severe preeclampsia - a serious complication characterized by high blood pressure and signs of damage to another organ system (usually the liver and kidneys)
Genital herpes - it’s dangerous for the baby to pass through the vagina during an outbreak
HIV
The baby isn’t in optimal birthing position - most providers aren’t comfortable with breech vaginal births (reach out to me if you need help finding a provider that IS)
Multiples - again, some providers aren’t comfortable with vaginal delivery of twins +, particularly if the first baby is breech
Other birth defects, issues with the baby or mom’s medical issues
Elective reasons including convenience and fear
Prior Cesarean, with specifics that indicate the risks of a Vaginal Birth After Cesarean (VBAC) outweigh a Cesarean Birth After Cesarean (CBAC)
CBAC or vbac?
Is a repeat C-section (Cesarean Birth After Cesarean or CBAC) safer than a VBAC?
As a VBAC mom, I understand the emotional roller coaster that is deciding whether to plan a VBAC or a repeat C-section. There are times when it makes sense, and may even be necessary, to have a repeat C-section.
Beyond the medical reasons, there are emotional reasons for some women that choose to have a repeat Cesarean. My suggestion is to familiarize yourself with the risks of both VBAC and repeat C-section, then decide what risks you and your family are most comfortable with.
Should you decide to plan a VBAC, be sure to check out this post: How to Prepare for a VBAC (Vaginal Birth After Cesarean). Should you decide to schedule a repeat Cesarean, read on.
What is a Gentle C-section?
A gentle C-section is sometimes referred to as a family centered Cesarean. While it is still a surgical birth, a gentle Cesarean is a more natural experience for the family. The options available to you during a gentle C-section allow you to make choices in your birth experience. In the absence of medical emergencies, many hospitals across the United States are equipped to accommodate your requests - you may just have to make your wishes very clear.
As you review the following options, be sure to include your choices in your birth plan (free birth plan template download here). The last section is on Gentle C-section options.
Gentle Cesarean Options:
1. Adjust medications to be more aware and present.
In some hospitals, the protocol drug cocktail during a Cesarean can leave mothers feeling incoherent and ‘out of it.’ If you want to feel more aware of what’s going on, have a discussion with your provider and the anesthesiologist about an alternative cocktail.
2. Lower or clear surgery drape. Many hospitals across the country now have this option as an alternative to the traditional blue drape, so that you can see your baby being born. Don’t worry, you won’t be able to see the actual surgery.
3. Baby is birthed slower than a conventional C-section. This is an option that creates a more natural feel for the baby upon entering the world.
4. Sounds in the operating room. Would you prefer quiet? A specific playlist that helps you relax? An affirmations track? It’s your choice, and know that you do NOT need to hear about the doctors’ dinner party during your birth.
5. Mom & baby stay together during recovery. It’s important to check with your hospital’s protocol in advance, so that you have plans in place. If the baby is required to go to the nursery during your recovery, who can you designate to stay with the baby? And who will stay with you?
6. Delayed cord clamping. Evidence is supportive of delayed cord clamping, which is waiting until the umbilical cord finishes pulsating before cutting or clamping. Check out more on this procedure here and here.
7. Delayed first bath. Why does this matter? That cheesy-like substance, vernix, that babies are covered in is so good for them. Don’t rub it off - rub it in! Check out the benefits here.
8. Additional Support People. You may want to have another support person your Doula at your planned C-section (yes, we do that!). Be sure to ask your provider and the hospital about OR protocols. This becomes even more important, if for some reason your baby needs to spend time in the NICU. This way, you have a plan where both of you have a support person.
9. Immediate skin-to-skin. If this is important to you, and I hope it is (benefits here), be sure to discuss the logistics of this with your provider and the hospital during your tour. Many hospitals can accommodate your wishes by moving all monitoring equipment to one side of your body, allowing one side to be free of obstruction. In addition, they can leave one arm free from being tied down during surgery.
10. Immediate breastfeeding. This goes hand-in-hand with immediate skin-to-skin, and many women are able to initiate breastfeeding inside the operating room.
How To Prepare For a Gentle Cesarean
Know your options. For any of the options listed above that are of interest to you, I recommend researching further to help you make the decision that’s best for you and your family.
Include your preferences in your draft birth plan (download template here).
Discuss your preferences with your doctor.
When taking the hospital tour (which I highly recommend), discuss each option as it relates to the hospital’s protocol.