Considerations for Cesarean Birth Jackie Kelleher, CD(DONA)

Considerations for Cesarean Birth Jackie Kelleher, CD(DONA)
1. OR’s are often smaller and more crowded than we expect: 2 surgeons,
each with a nurse, a scrub nurse, a nurse or doctor for the baby, the
anesthesiologist, and sometimes he or she has a nurse—not to mention the parents. Sometimes it seems that something must be wrong if it’s so crowded, especially if the cesarean is unexpected, but it’s the norm.
2. Don’t touch anything green (or blue, or whatever color sterile drapes they’re using)
3. A note of caution: we are often under the mistaken impression that
cesarean birth is gentle and easy–kind of like opening a zipper and
lifting the baby out. In truth, it’s a very small incision (for good
reasons) but it is sometimes challenging to get the baby out through it. There
can be a lot of pulling and tugging and on occasion a vacuum or forceps are used.
4. Have someone else who you’re close with waiting in the waiting
room. This way if for any reason a baby needs to go to another room,
The partner is not in the unfortunate circumstance of choosing between two people he cares so deeply for. It’s unlikely this would happen, but
sometimes baby goes to the nursery and mom is still in the OR–where
does Dad go? It can be an awful choice to make.
5.Oneresponsibilityof thebirthpartneristobesurethatthebirthingmother’spain level is at 0. It is normal to feel pressure with an epidural–like dentistry with novocaine. But pain is out of the question and not to be tolerated.
6. Dad: know that they will usually not “invite” you into the OR
until after mom is prepped. This can take a while, and can be really unnerving, because you worry that they’ve gone on without you. I don’t know of it ever happening, but it’s ok to ask someone to check.
7. Some anesthesiologists automatically administer some IV
painkillers for the mother for afterwards. This can have a devastating
effect on bonding and breastfeeding in particular, as the mother may sleep for several hours. If this does not appeal to you, make it clear that
you don’t want it up front. This is not to say that you don’t want pain meds (you do), you just don’t want them through the IV, which can leave you sleeping during the first hour or two post-op, when ideally you’ll be holding and nursing the baby. The edpidural or spinal is still working at this point, and you can use any of the other pain medication options without as much of an effect, or at least not sleep through the baby’s initial wakeful period.
8. It takes about 10 minutes to deliver the baby (longer if it’s multiples), then about an- other 30 or more to close. During this time, they’ll examine the baby and then keep
him under the warming lights. This is usually more out of routine than necessity. Once it’s established that he’s fine, request that dad hold the baby. It’s important to talk to him
—his whole world has changed, but he knows your voice. It will calm him down. Try holding him skin to skin under your shirt. If this is not possible, just hold him close and talk to him a lot. Mom, you talk too. Dad should bring him over for you to touch and kiss.
9. Request that you all go to post-op together. This will
need to be discussed ahead of time, then again at the hospital and with
some frequency. If the cesarean was scheduled and if possible, have a doula or lactation counselor present in post-op to help with the initial breastfeeding.

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