April 9, 2018
Podcast Episode #21: Supporting a Cesarean Birth
April is C-section Awareness Month! On this episode of Ask the Doulas, Alyssa and Ashley talk about how birth doulas provide support during a Cesarean section delivery. You can listen to the full podcast episode on iTunes or Soundcloud.
Alyssa: Hi, welcome to Ask the Doulas with Gold Coast Doulas. I am Alyssa, co-owner and postpartum doula, and we have Ashley Forton with us again today.
Ashley: Hi.
Alyssa: And today the question is, how does a birth doula support my Cesarean birth? And I think that’s a really good question because everyone thinks of a doula’s support during a normal – I don’t want to say normal, but the typical vaginal delivery. And what if someone has a planned C-section, or what if they want a vaginal delivery and end up with Cesarean birth? In their mind, they’re saying, “I had all these ideas about what you do; I paid this money, and now I’m having surgery.” How do you support that?
Ashley: Yeah! So, plans change; birth is unpredictable. Sometimes we do have clients that have a planned Cesarean and still see the value in our support. So we can talk about it two different ways. When you have a planned Cesarean, whenever you hire us during your pregnancy, we’re still there for emotional and informational support throughout the pregnancy, so that can be really valuable. We can also help you come up with a birth preferences or a birth plan for your Cesarean.
Alyssa: What does that look like?
Ashley: When most people think of a birth plan, they think of a labor and vaginal birth, but it still applies to a Cesarean. You still have choices, and you can still kind of customize your experience. So we always talk about a birth plan being a starting point for a conversation with your provider, but you can certainly talk to your provider about, is a pass-through drape an option? Or even a see-through drape? Is there a clear drape so that I can see my baby emerging, if that’s something that you’re interested in? Letting them know if you want to have skin-to-skin contact with your baby right away; is that possible? Have that conversation. Talking about, hey, can I pick the music that’s playing in the room? I’ve got this song in my head that I really wanted to play when my baby is born. Hey, I want to read this poem to my baby as soon as my baby’s born. You can still do a lot of these personal things. Talk to the provider about who you’d like to have in the room. As doulas, sometimes we’re allowed in the OR; sometimes we’re not. But letting your preferences be known and saying, he, I have a birth doula, and I’d really like them to be in the OR with me. Have that conversation with your provider. As a birth doulas, I have been in the OR, but I haven’t been in every single time. So it’s always worth asking and having that conversation. So you can talk about who is in that OR with you; you can talk about what happens immediately afterwards. Hey, I’d like my birth doula in the recovery room with me. You can talk about all these different preferences when you have it planned ahead of time. It’s kind of nice to come up with a game plan before going in, whereas when you’re having a physiological birth, you’re going in for a vaginal birth, and then plans change. Something happens with you; something happens with baby, or you change your mind, and you go in for Cesarean. Sometimes you don’t have that time to plan ahead and say, hey, this is how I wanted my Cesarean to go. So sometimes, it’s nice to have that birth plan already written up just in case. And the way that we support – so let’s say we’re having a planned Cesarean and the birth doula is not allowed in the OR.
Alyssa: Who is that up to, normally?
Ashley: That’s up to the anesthesiologist at the hospital, so they make the final call. So it’s usually a good idea to ask your OB, let them know if that’s something that you want, and then when you see the anesthesiologist, make sure you talk to them about it because they get the final say at most hospitals.
Alyssa: And I think it’s huge to at least ask because I say the same thing to clients who wonder if their insurance covers this. The more we ask, the more they keep hearing this word doula, it will maybe someday be covered by insurance, and it will maybe someday be a norm to have a doula in the OR. So ask! Keep mentioning it!
Ashley: Absolutely. Because you are the consumer; you’re a customer. You are a paying customer, and we know that customer’s voices are important. Hospitals pay attention to those surveys. We know that. So make sure that you make your desires known, and if it’s not an option, let them know in the survey. “Hey, this is something I wanted; it wasn’t an option for me.”
Alyssa: So if you’re not allowed in, what happens?
Ashley: So what happens if we’re not allowed in is we go to the hospital with you the morning of. I’ve had some really fun times hanging out with clients ahead of their Cesarean, you know, just having fun, telling jokes, making sure they’re comfortable and feeling good about what’s happening; making sure they feel safe and secure and being there for any emotional needs that they may have during that time, and then when they go back for their Cesarean, I’m in the waiting room. So I’m there the whole time, and whenever possible, I go back into the recovery room as soon as they’re out of surgery. So what that looks like just depends on the hospital and what their policy is, but if I can go back into recovery, then Dad is there to support the mom, as well, and I’m there to help with breastfeeding, if they want to breastfeed; to see how they’re doing physically and emotionally; how do you feel right now, after that? And spend some time with them there. If I’m not allowed in recovery, then I meet them up in their room. As soon as they’re settled in their room, we still have that few hours of time together to process things emotionally and talk about how you’re feeling physically. Is there anything that I can get for you right now? Can I go get you some extra water? Something simple like that, but most of the time it’s more emotional; helping them process what’s going on; asking questions about breastfeeding. As birth doulas, we are trained to support breastfeeding, so we want to make sure that you get a good comfortable latch the first time. If there’s something tricky going on, we’ll help you get set up with a lactation consultant and make sure that you make that connection. We’ll get you the resources that you need. If all of a sudden there’s a medical concern for you or baby, we’ll make sure that you’ve got the information that you want or need. If it’s out of our scope, if it’s clinical or medical, we’re going to make sure that you know who to talk to. Hey, talk to your OB; talk to your pediatrician. Let’s ask your nurse. We’ll make sure that you’ve got the connections that you need, and if all of a sudden, you’re thinking, shoot, I really feel like I’m going to need some help at home, we can talk to you about how postpartum doulas are an option; let’s talk about that. Is that something that might be helpful? So whatever your emotional and physical needs are, we try to address those, and then we still come do a postpartum visit when you’re home and address all those same things again; spend some time together and see how you’re doing because in a week or ten days, a lot changes when you’re home, especially after a Cesarean; you’ve got a lot of healing to do, and we want to make sure that that’s all going smoothly and that you have what you need.
Alyssa: Thank you for that. If anyone has further questions about how a birth doula can support either a vaginal delivery or your Cesarean, email us at info@goldcoastdoulas.com. Remember, these moments are golden. Thanks, Ashley.
Ashley: You’re welcome!
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