Caesarean Birth Plan

When I first embarked on this TTC journey, I imagined conceiving quickly, having an uneventful pregnancy, and a natural delivery.

HA.

By the time I was pregnant again, there had been so much pain that I truly believed nothing else could go wrong–except, perhaps, having another miscarriage.

SIGH. How naive I was.

Once I made it to the second trimester, I had my heart firmly set on a midwife-led delivery in UCSD’s birthing centre. From the age of 14, I feared having a caesarean ever since my mother elected to have one under elective general anaesthetic to deliver my sister. Mum woke up mid-surgery and although she wasn’t able to move, she could feel e.v.e.r.y.t.h.i.n.g. and had no way of communicating this. To top it off, the surgeon cut my sister’s scalp. When she was handed to my stepfather, she had a stitch in her scalp and the surgeon was, apparently, smoking a cigarette.

This was Spain in 1991… And a lot has changed since then. But, me? have a caesarean? AS IF.

Famous last words. As with so many things on this journey, I’ve had to adjust my expectations.  I learned around 19 weeks that I would bring my baby into the world via my belly, and I have been grateful for the time to make the adjustment.

Now all I really hope for is the following:

1. That Baby V will be delivered safely;
2. That she will be healthy enough not to need extra care;
3. That I will not need an emergency hysterectomy;
4. That I will be able to breastfeed.

If I can have those four things, I will be over the moon!

See, there’s something quite calming about knowing when she will be born. Whenever I’ve felt ratty about being stricken with terrible acid reflux / carpal tunnel / fatigue, I’ve reminded myself it’s just x more days, and it’s easier to bear. I am more productive, knowing there’s a deadline to finish everything I need to get done before her birth, while pacing myself accordingly. I know exactly who will lift this baby from my body. I find it reassuring to know she’ll be delivered in a controlled environment. I’m not looking forward to the spinal block but I’m neither scared of the procedure nor the post-operative pain. And I will minimize the risk of trauma to my nether regions and pelvic floor.

The Type A side of my personality has done quite a bit of research into caesarean birth plans. Some hospitals permit a gentle delivery, meaning that the baby is pulled out slowly so as to mimic as closely as possible a vaginal delivery. Some studies indicate that a vaginal delivery helps expel fluids from a baby’s lungs, which reduces the risk of having to spend time in the NICU or in nursery care.

Whereas I do love the idea of Baby V being delivered in a calm, dimly lit environment, a gentle caesarean birth is not an option for us: my placenta previa puts me at risk of haemmorrhaging, and my anterior (front) succenturiate lobe means Dr. D will have to cut through it to deliver Baby V quickly. However, UCSD — one of the US’s 11 hospitals designated “baby-friendly” — includes other gentle options as standard.

So here’s our birth plan — feel free to copy it if you would like to. Even if you are planning on delivering vaginally, the feminist in me would encourage you to also research caesarean birth so you are as fully-informed as possible for the big day.

♥

After a bumpy ride, DH and I are so looking forward to finally meeting our daughter. We’ve created this birth plan so we can have the most positive birth experience we possibly can. Thank you for taking the time to read our preferences and, where circumstances permit, for doing anything you can to make them a reality ☺

Anaesthesia / Medication Preferences

• Spinal block.
• ECG dots to be placed away from my chest (for skin-to-skin contact in the O.R.).
• IV in my left arm leaving my right arm free to hold Baby.
• All medications be suitable for breastfeeding.
• No pre-operative sedative.
• Non-drowsy anti-nausea and pain relief medications – I want to be alert for our daughter’s birth.

O.R. Preferences

• DH be present.
• The screen be lowered just before delivery so I may see Baby’s birth.
• Baby be brought to me as soon as she is suctioned, weighed, and measured.
  • Please do not worry about cleaning her up much before bringing her to me.
• Double sutures in my uterus.
• DH accompany Baby to the warming table and be present for her checks.
• DH trim the umbilical cord.
• Immediate skin-to-skin contact. If not me, then DH.
• To breastfeed Baby as soon as possible after the birth.
• To hold Baby when Vitamin K and erythomycin are administered.
• To take our first family photo as soon as possible.

Recovery Preferences

• DH and Baby remain with me.
• DH to stay with Baby, should she and I be separated for medical reasons.
• DH’s parents are welcome to visit us if permitted in Recovery area.

Breastfeeding Preferences

• To nurse Baby immediately following the birth.
• To meet with a Lactation Consultant as soon as possible.
• No supplements (formula, glucose, or plain water) given without my consent.
• Baby not to be given a pacifier.
• All medications to be suitable for breastfeeding.

Postpartum Preferences

• Delay bath and shampoo.
• Keep Baby with me at all times.
• If Baby requires NICU / nursery care, to visit as soon as and as often as possible.
• Have the catheter and IV removed as soon as possible.
• Get up and walk around as soon as possible.
• To eat as soon as I am hungry.
• Take pain medication at regular intervals to stay on top of my pain.
• To nurse (or hold) Baby as she gets the PKU heel prick.

♥

If you, like me, need a caesarean for medical reasons or would like to make an informed decision about your baby’s birth, I highly recommend Choosing Cesarean: A Natural Birth Plan by Magnus Murphy M.D. and Pauline McDonagh Hull. (A much quicker read is The Essential C-Section Guide, which gives a good overview of what to expect.)

♥

The next post — whenever it will be — will introduce Baby V properly.

Love, thoughts, prayers, juju, good vibes all welcome! :)

Over and out.