Archive for the ‘cesarean-section-delivery’ Category

A Cesarean Plan

Wednesday, July 6th, 2011

Cesarean is often the last thing we want to think about during pregnancy. Most of us think it will not happen to us. Having a plan, an idea of what to ask for, to know there are ways to bridge the gap between Plan A and Plan C can be very beneficial to both mother and baby.

There is no way to make a cesarean just like a healthy vaginal birth, and frankly, that ought not be the goal. It can be however a much more family centered, family bonded, more respectful and humane experience.

Speak to your provider ahead of time about needs and desires. If you know you are having a cesarean ahead of time, meeting with the Nurse Manager and the anesthesiology department can be useful in obtaining what you want. Have the conversations, create partnerships.

Below is my latest version of a family centered cesarean plan  that can be used for a planned or unplanned cesarean delivery. All requests may not be feasible in all areas, but even small changes can be helpful.

It may be copied and pasted into your own document for personalization, however I do ask that you credit the source if you are an educator, doula or related professional using it as a sample.

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Name: Jane Doe

Estimated Due Date: January 1, 20XX

Care Provider: XXXXXX

We are seeking to make a cesarean delivery as special, low stress and family centered as possible.In the event a true emergency and general anesthesia is needed, I understand that some of my requests cannot be honored.

JUST PRIOR TO/DURING DELIVERY / RECOVERY –

  • I would like to meet each staff member in the OR by name who will be participating in the cesarean.
  • I may ask my _________ for aromatherapy to help with nausea, surgical smells and stress.
  • I ask that only essential conversation be allowed.
  • I would like to play ______ music in the OR if it won’t be a distraction to those performing surgery.
  • I would like my ______________ to take photos and/or video of the birth of my baby.  I respect that the surgeon and anesthesiologist may not want the entire surgery on video, however I would like a record of my baby being born to make it as special and personal as possible.
  • Explain all medications that will be used to me. I prefer a bolus and oral medications versus a PCA afterward.
  • Please lower the drape so I may view my baby coming out of me and hold my baby up so I can see him/her at the moment of birth.
  • Request my arms not be strapped down so I may touch my baby freely.
  • I would like my baby to remain connected to the placenta after manual extraction, as the cord will continue to pulsate for some time. I would like my ___________ to cut the cord after 10 minutes post delivery or the cord has stopped pulsating near the umbilicus.
  • I would like my baby placed skin to skin on my chest immediately with basic assessments being done while on me. My husband (partner/family member can hold baby there with a warm blanket over my baby and help maintain the sterile field.
  • I would like to breastfeed in the OR or as soon as possible in recovery.
  • I would like for my ________________ and baby to stay in the OR with me while surgery is completed and remain in recovery with me.
  • If the baby needs medical assistance requiring leaving the OR, I’d like for another person (doula, friend or family member) to attend me in the OR while my ___________________ goes with the baby, so my baby nor I will have to be alone.
  • In the event baby needs to leave the OR, I would like the wipe down towel(s) to be placed against my chest skin and baby to be pressed on me for fluid and odor transfer.
  • Asking for a delay in eye ointment and Vitamin K until after the first hour of bonding time or I am waiving all immunizations and eye ointment.
  • In the event of a hysterectomy, please do not remove my ovaries or anything else that is not medically necessary

REGARDING BABY

  • In the event the baby requires medical attention beyond that of a healthy baby, please inform me (husband/partner/family member) verbally what is needed or will be needed so I can actively participate in choices made for my baby’s care.
  • In the event of  a need for separation of my baby from me:
    • Limit the number of persons who touch or attend my baby to only those on staff as needed and my _____________.
    • Request my baby not be bathed or fully dressed until I have the opportunity to smell, touch, cuddle, etc. with my baby and I am able to participate in the bathing.
    • I plan to breastfeed exclusively, so no pacifier, formula, sugar water should be given to my baby.
  • No tests shall be performed or medications administered, etc. without my ________________ consent & prior knowledge

Thank you for honoring my requests for me and my baby.

Preparing For Birth, LLC

All Rights Reserved 2011

Family Centered Cesarean Plan

Saturday, October 16th, 2010

Below is my version of a family centered cesarean plan – can be used for a planned or unplanned cesarean delivery.

Sample Cesarean Plan PDF

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We are trying to make a cesarean delivery as special and intimate as possible for us even though we did not have the desired vaginal birth.

DURING DELIVERY / RECOVERYIn the event a general anesthesia needs to be performed, I understand that some of my requests cannot be honored.

  • I would like to meet each staff member in the OR who will be participating in the cesarean.
  • I may use aromatherapy to help with nausea, surgical smells and stress.
  • I would like to play ______ music in the OR if it won’t be a distraction to those performing surgery.
  • Explain all medications that will be used to me. I prefer a bolus and oral medications versus a PCA afterward.
  • I would like for my husband (partner/family member) and baby to stay in the OR with me while surgery is completed and remain in recovery with me.
  • If the baby needs medical assistance requiring leaving the OR I’d like for another person (doula, friend or family member) to attend me in the OR while my husband (partner/family member) goes with the baby so I won’t have to be alone.
  • I would like to take photos and video of the birth of my baby.  I respect that the surgeon and anesthesiologist may not want the entire surgery on video, however I would like a record of my baby being born to make it as special and personal as possible.
  • Please lower the curtain and hold my baby up so I can see him/her at the moment of birth.
  • Request my arms not be strapped down so I may touch my baby freely.
  • I would like my baby to remain connected to the placenta after manual extraction, as the cord will continue to pulsate for some time. I would like my ___________ to cut the cord after 10 minutes post delivery or the cord has stopped pulsating near the umbilicus.
  • I would like my baby placed skin to skin on my chest immediately after basic assessments while in the OR. My husband (partner/family member can hold baby there with a warm blanket over my baby.
  • In the event of a hysterectomy, please do not remove my ovaries or anything else that isn’t medically necessary.
  • I would like to breastfeed my baby as soon as possible in recovery.

REGARDING BABY

  • In the event the baby requires medical attention beyond that of a healthy baby, please inform me (husband/partner/family member) verbally what is needed or will be needed so I can actively participate in choices made for my baby’s care.
  • Limit the number of persons who touch or attend my baby to only those on staff as needed and my husband (partner/family member).
  • Request my baby not be bathed or fully dressed until I have the opportunity to smell, touch, cuddle, etc. with my baby and I am able to participate in the bathing.
  • Delaying immunizations, even eye ointment and vitamin K.
  • I plan to breastfeed exclusively, so no pacifier, formula, sugar water should be given to my baby.
  • No tests shall be performed or medications administered, etc. without my (husband/partner/family member) consent & prior knowledge

Thank you for honoring my requests for me and my baby.

Tell NBC What YOU Think – ICAN meets mother-sized activisim

Sunday, February 7th, 2010

http://blog.ican-online.org/2010/02/07/mother-sized-activism-nbc/

The International Cesarean Awareness Network wants you to get involved and speak your mind about what you think of the NBC “Live in the OR” piece from last week. Here is the link to ICAN’s official response.

The only way that mass media will be responsible for what they put on the airwaves is for real people, the  consumers to speak their minds.  Please click on the above think and go for it. Be heard. It does make a difference.

“Elective” Cesarean – If you had one…..

Friday, February 5th, 2010

There is much in the news and in community talk how women are signing up for cesareans electively. I am very intrigued by this assumption and believe there is much misinformation regarding the topic out in the public for consumption. I am seeking to shed some more light on this topic.

Though this is not a scientific survey, I believe your experiences can help others in understanding why women are making this choice, as well as, potentially aiding other women in informed decision making.

If you have had or are planning an “elective” cesarean, I appreciate you answering this informal survey.  Answers can be submitted via confidential email to desirre@prepforbirth.com. By responding you are agreeing to allow me to use the information anonymously in a future blog, writing or other educational medium.

  1. Was your “elective cesarean for a medical reason?  If so, what?
  2. Was your “elective” cesarean for a non-medical reason?  If so, what?
  3. How were you given informed consent?
  4. What information were you given in the cesarean consent for benefits, risks, consequences, and alternative for you and your baby?
  5. Were any words such as: Easier, safer, painless, no big deal, not risky, saves vagina or less pain used to describe potential experience?
  6. Were you told your cesarean was necessary and found out later it was coded as elective?
  7. Did you ever feel pressured or led by care provider to choose cesarean?
  8. After your cesarean, did you feel you were consented fully enough prior to the surgery?
  9. Did the cesarean “do” or live up to what you were told for you and your baby?  How so?  How not?
  10. Would you make the same choice again or would you “go for” a VBAC?
  11. What country do you reside?

Thank you very much for answering these questions. I am so grateful for input on this subject.

If you would like any information shared and attributed to you as a quote,  please indicate in your email to me.  As stated above, otherwise your identity will be kept completely anonymous and confidential.

Sisterhood of the Scar Revisited

Sunday, January 3rd, 2010

Many years ago I wrote this piece after attending my very first ICAN conference in San Diego in 2005. I read this and part of me weeps for her, for the me I was and for the women who are becoming part of this sisterhood willingly, wittingly or not.  My pain has been transformed into outstretched hands and heart. It has given me a sensitivity and awareness of the birth world I would probably have never achieved on my own had my births been perfect, idyllic and without this trauma.

I love you dear sisters and my life would be far less without each of you.

Seems a long distance the ivory tower to the ground.  The surprise in finding the thorny bushes with burrs that dig deep and puncture again at will? Well meaning onlookers say “Well a hundred years ago you both would have died?”  And the farce begins.  Stuff it down because it is crazy not to be grateful for the surgeon’s hand.  Smile and pretend all the twisted darkness inside doesn’t really exist.  The oft daily chore mixed with joy of caring for a baby whom we are unsure is truly our own.   The continuing assault during lovemaking when a cringe comes from the depths when a loving and hungry hand brushes the incision site.  “How can he think I am beautiful?  How can he possibly want this?”  Another thing of beauty and perfection quashed underneath the burden of the surgeon’s handprint.  Oh no say it hasn’t already been a year.  The birthday.  THE birthday sounds so exciting but terror strikes.  Preparation to be happy, preparation to feel joy.  Preparation not to shortchange our amazing gift of a child under the pain of the surgeon’s knife print.

The anticipated day meant to birth us into motherhood and my child into my waiting hands to my craving breasts, I was birthed into the Sisterhood of the Scar forever.

Radio Interview on Whole Mother show – Cesareans, VBAC & Prevention

Wednesday, August 5th, 2009

Here is the radio interview I did with Debbie Hull of the Whole Mother Radio show.  We talked about the current percentage of cesareans, VBAC availability, where to obtain support, ways to prevent an unnecessary cesarean and much more!

http://archive.kpft.org/mp3/090803_063001wholemother.MP3

What might a cesarean get you? Often more than is bargained for.

Tuesday, July 28th, 2009

This is a  slight re-do from a popular blog post from early 2008. The information is vital and pertinent to the near 1.5 million women (based on previous CDC data) who will have a cesarean surgery this year.

Having a cesarean section will almost always  get you a baby.  Generally there is much more to it and anyone could bargain for or anticipate even in the best of recoveries.

Let me count the ways in no particular order:

  • A scar that in no way makes a bikini look better. Sometimes described as a shelf or a pouch.
  • The feeling of failure, guilt or less than deserving of motherhood.
  • The struggle of living with the huge dichotomy of loving your baby and perhaps hating the birth.
  • Higher probability of losing your ability to have more children either through physiologic secondary infertility, pregnancy complications, self-induced secondary infertility, hysterectomy or lack of sexual intimacy in relationship.
  • Higher probability of difficulty in breastfeeding.
  • Postpartum depression or PTSD, especially in an unwanted cesarean.
  • The feeling of failure as a wife or partner.
  • Having others discount your feelings and needs. After all you “just” had a baby. Really you just had MAJOR surgery, perhaps by coercion, a true medical indication, or completely from interventions and medications.
  • Living with the idea that you failed to pass induction, you failed to push out your baby, you failed because _________ (fill in the blank).
  • Obtaining your records to find what you were told and what was written are different. Could your trusted care provider have lied and cheated you?
  • Simply finding out that no one told you and you didn’t think it would happen to you. That being induced, getting the epidural, allowing AROM, not getting out of bed, etc. is why you had the cesarean. Is maternal ignorance and fear enough to quell what you feel and make it okay?
  • How can you trust yourself as a mother when you ignored your maternal intuition and kept saying yes, because the nurse, midwife or doctor told you to?
  • The way your marriage or partnership takes a turn toward hell or in the least a divided place.
  • Living with dread when a hungry hand sweeps over your scar. Being sexual can be extremely difficult physically and emotionally.
  • Having great fear of becoming pregnant again.
  • Having great fear of going for a VBAC and ending up in the OR at the end.
  • Not being understood and having others say to your face how lucky you are that you got to take the easy way out.
  • Pain.
  • Difficulty moving, walking, getting up, rolling over, coughing, laughing, tending to personal cleaning…. You get the idea. It is surgery.

Though not every woman will experience what is on the list, many do.  For all of these – there a stories layered and interwoven for too many women.

Every thirty seconds a woman is surgically having her baby delivered. Light her a candle. Offer her a meal. Let her speak. Listen to her intently. Don’t judge her. Send her to ICAN. http://www.ican-online.org/.

So what might a cesarean get you? More than a baby!

Thursday, April 10th, 2008

Having a cesarean section will likely get you a baby, but generally much more than you bargained for.

Let me count the ways in no particular order:

  • A scar that in no way makes a bikini look better. Sometimes described as a shelf or a pouch.
  • The feeling of failure, guilt or less than deserving of motherhood.
  • The struggle of living with the huge dichotomy of loving your baby and hating the birth.
  • Higher probability of losing your ability to have more children either through physiologic secondary infertility, pregnancy complications, self-induced secondary infertility, hysterectomy or lack of sexual intimacy in relationship.
  • Higher probability of difficulty in breastfeeding.
  • Postpartum depression or PTSD, especially in an unwanted cesarean.
  • The feeling of failure as a wife or partner.
  • Having others discount your feelings and needs. After all you “just” had a baby. Really you just had MAJOR surgery, perhaps by coercion, or completely from interventions and medications.
  • Living with the idea that you failed to pass induction, you failed to push out your baby, you failed because _________ (fill in the blank).
  • Obtaining your records to find what you were told and what was written are different. Could your trusted care provider have lied and cheated you?
  • Simply finding out that no one told you and you didn’t do the research, that being induced, getting the epidural, allowing AROM, not getting out of bed, etc. is why you had the cesarean. Is maternal ignorance and fear enough to quell what you feel and make it ok?
  • How can you trust yourself as a mother when you ignored your maternal intuition and kept saying yes, because the nurse, midwife or doctor told you to?
  • The way your marriage or partnership takes a turn toward hell.
  • Living with dread when a hungry hand sweeps over your scar. Being sexual can be extremely difficult physically and emotionally.

For all of these – there a stories layered and interwoven for too many women. Every thirty seconds a woman is surgically having her baby delivered. Light her a candle. Offer her a meal. Let her speak. Listen to her intently. Send her to ICAN. http://www.ican-online.org/.

Cesarean Awareness Month

Wednesday, April 2nd, 2008
April is Cesarean Awareness Month http://www.ican-online.org/

What is Cesarean Awareness Month?
An internationally recognized month of awareness about the impact of cesarean sections on mothers, babies, and families worldwide. It’s about educating yourself to the pros and cons of major abdominal surgery and the possibilities for healthy birth afterwards as well as educating yourself for prevention of cesarean section. Cesarean awareness is for mothers who are expecting or who might choose to be in the future. It’s for daughters who don’t realize what choices are being taken away from them. It’s for scientists studying the effects of cesareans and how birth impacts our lives. It’s for grandmothers who won’t be having more children but are questioning the abdominal pains and adhesions causing damage 30 years after their cesareans.CESAREANS are serious. There is no need for a ‘catchy phrase’ to tell us that this is a mainstream problem. It affects everyone. One in three American women every year have surgery to bring their babies into the world. These women have lifelong health effects, impacting the families that are helping them in their healing, impacting other families through healthcare costs and policies, and bringing back those same lifelong health effects to the children they bring into this world.
Be aware. Read. Learn. Ask questions. Get informed consent. Be your own advocate for the information you need to know.
Visit your local ICAN chapter or go to http://www.ican-online.org/