“Rate your confidence level when it comes to the labor and delivery of your child.”
It was our first Lamaze class. We went around the room one by one, with all the moms-and-dads-to-be chiming in. There were a lot of 2s, 3s, and 4s, and a handful of 6s and 7s from second-time parents who were a bit more assured.
Then it was my turn. “I’m going with a 9. That’s mostly blind confidence, though,” I joked. I truly had no idea. None at all.
In all of the pregnancy books I’d read, I’d skipped the chapters on C-sections. I assumed those were always scheduled in advance, so I didn’t think the information applied to me. I knew even less about emergency C-sections, a broad term that encompasses all C-sections that are unplanned, unscheduled, and happen when complications arise after labor has begun.
Maybe you’re not dilating quickly enough, or your baby isn’t positioned correctly.
Maybe your baby’s heart rate is dropping, or your own heart rate is dropping.
Maybe your labor has stalled, or your baby hasn’t descended and you’re on day three of labor.
The list goes on.
I learned all this a little too late. I was certain that I would have this perfect, “natural” birth experience. I wrote up my birth plan like all the books said to do. I printed it out and discussed it with my doctor. But life had other plans.
As one of the first of my friends to give birth, I didn’t have many people to compare notes with. After my emergency C-section, I felt confused and alone—with my thoughts and with a slew of Google search results.
On top of all the other new-mother emotions I was experiencing (hello, hormone changes), I suddenly didn’t understand my own body. How did this happen? How could I have been so completely unprepared?
So that you’re more prepared than I was, especially during these incredibly challenging times, here are five things I think every mom should know about emergency C-sections (because even if you’re sure it won’t happen to you, you never know):
1. An emergency C-section can happen to anybody.
While an emergency C-section may not be the ideal delivery experience, with an estimated 1 in 3 babies born via Cesarean, no expectant mom should rule out this possibility, no matter how many natural-birth or Lamaze classes she might take.
In my case, I was fully dilated and had just begun pushing when my son’s heart rate began to drop. When I revisit those memories, it’s as if time stood still. I was wheeled off to the emergency room at the urgent request of my care team, leaving behind my husband and sister who were scared and uncertain.
2. Talk about the possibility of a C-section with your doctor or midwife and consider adding to your care team.
When I think back on all of my doctor visits, never once was the term “emergency C-section” mentioned. We talked about my birth plan, but now I wish we’d talked about what would happen if my plan didn’t work out. I think it’s important that moms ask: “What can I expect in the case of an emergency C-section?”
This will give you insight into your doctor or midwife’s approach to emergency C-sections and create greater trust between you and your medical team. Are emergency C-sections common or uncommon with their patients? At what point in your labor would they begin to consider that possibility? Are you at high or low risk for this, based on your medical history?
It’s also important to have someone in the delivery room to directly advocate for you. When I gave birth to my son a few days before my due date, my doctor was still on vacation, and I didn’t have her in the room like I’d always envisioned.
In my research afterward, I learned that the presence of a doula during delivery can reduce your chance of C-section by 60%. With doula care, you have someone at your side who will advocate for the birth you desire, because let’s be honest: you (physically) won’t be able to, and no matter who you’ve chosen to be with you in the delivery room, they won’t be as well versed in childbirth as a certified doula. (Make sure to check with your hospital about the presence of birth partners and other support people during labor and delivery, as protocol may be different due to coronavirus.)
3. If you haven’t received an epidural, know that you may be put under general anesthesia during an emergency C-section.
“Wait...so I could be asleep while my baby is born?” Yes, this is an actual possibility, and I know because it happened to me.
If you already have an epidural, an anesthesiologist may be able to quickly provide you with additional medicine through your catheter so that you’re numb but awake for an emergency C-section, and your birth partner can be present (if current protocol permits).
If you’ve opted for a medication-free birth, you don’t have that option in a true emergency (e.g., baby’s heart rate is dropping, and a doctor needs to act immediately). In that case, it’s likely that you’ll receive general anesthesia and be put to sleep for your surgery.
You won’t feel pain or pressure while under general anesthesia, but you also won’t be awake to see or hear your baby’s delivery. In these scenarios, no one is allowed in the operating room besides medical professionals. Those coveted first skin-to-skin moments can and do happen, but only once the anesthesia wears off and you wake up.
4. Line up your support team—you’ll need them more than ever if you have an emergency C-section.
There was no way I could have foreseen exactly how much I’d want my mom there to help me during those first few weeks after giving birth. With a long recovery ahead of me and my husband returning to work, it was necessary to have as much help as possible. My mom helped with everything from grocery shopping to doctor appointments.
While support is important for anyone with a newborn, an unplanned C-section can make the first postpartum weeks even more difficult -- especially during social distancing. Moms recovering from C-sections shouldn’t lift anything heavier than their baby, which makes a car seat carrier hard to maneuver. Additionally, doctors generally advise waiting at least six weeks to drive a vehicle after a Cesarean, to give your abdominal muscles time to recover. You’d be surprised to realize how much you rely on those muscles for simple actions like pressing down on the accelerator or brake pedal.
With a C-section, it becomes even more critical that you have a handful of people you can count on. Whether that’s family, friends, or neighbors, have those individuals on standby before you deliver, even if they have to help from six feet away!
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5. Consider your recovery and nursing needs in case of a C-section.
I wasn’t prepared for how uncomfortable and sometimes painful it would be to move around during my C-section recovery. My husband and I live in a small, two-story home (with our bedroom and nursery upstairs), but it was nearly impossible for me to walk up those stairs during the first few weeks. The downstairs guest space quickly became our bedroom and nursery all rolled into one.
Don’t be afraid to switch up your living space during those first few weeks to make yourself comfortable. Prefer to be near the kitchen for easy access to bottles or pump parts? That’s a great consideration, too. Do whatever you can to make it easier!
If you choose to breastfeed, it’s important to start as soon as you can after a C-section delivery and to do so frequently. Don’t be afraid to try out nursing positions until you find one that feels right! The football hold can be especially helpful for C-section recovery moms. Have a couple of names of local lactation consultants on hand in case you have questions as you bond with your baby and get acquainted with nursing.
Between late-night nursing sessions and frequent newborn naps, it can be easy to spend the first weeks of your recovery replaying every detail of your labor and delivery experience in your head. Prepare as much as you can, but be gentle with yourself if the unexpected happens.
There is so much joy that comes with your child’s birth, but it’s completely natural to feel sadness or regret about your labor and delivery experience. Unplanned C-sections can leave you with a lot of feelings to unpack—sometimes it’s easy to see that the decision was in the best interests of the mother and child, while other times it can lead to doubts about your care team and their decision-making.
All of these emotions and doubts are valid and simply a part of processing the events. Find someone you can talk to, journal about your experience, and seek out a positive community. Allow yourself time to heal physically and emotionally. And remember: while your birth experience can feel overwhelming and all-defining in those early days, you have a life ahead with your child that will be so much more beautiful—guaranteed.