More information about cesareans - avoiding it, or waiting till labor starts on it's own, and recovering faster

Here's a website that summarizes a few main points about cesarean recovery, as well as trying to avoid an unecessary cesarean, or waiting till labor starts to do the cesarean. Many cesareans are scheduled at 38 weeks gestation.

http://en.allexperts.com/q/Childbirth-3495/c-section-recovery.htm

The assumption is that the baby will be fully developed by then, and the doctor won't likely be caught off guard by having to do an operation for a woman who goes into labor before the scheduled time. Evidence shows that not all babies are fully developed by 38 weeks, and that waiting for labor to start before doing the cesarean lowers the risks of the operation to the baby. Even sheduling at 39 weeks has benefits over 38 weeks.

There are many ways parents can get involved in decision making even for high-risk births. Decide what's important to you and your family and discuss that with your caregivers.

Here's the excerpt from the website :

"Expert: Elayne Glantzberg - 12/21/2007

Question
Hi Elayne,
I will be having a c-section in June when I deliver my first child. I wanted to know if you had any recovery information and tips to make this post op easier? Thanks for any help you may offer!

AnswerMy first tip would be to do everything you can to avoid this primary c-section, including getting several second opinions. It is vanishingly rare for a woman to have a complication requiring cesarean delivery that would be detected this early in pregnancy. Even a complete placenta previa can often self-resolve by term.

My second tip would be to wait until you go into labor before having the c-section, if at all possible. Babies born by scheduled c-section, without labor, are 2-4 times more likely to support from respiratory problems requiring a stay in the NICU, and are 3 times more likely to die in the first month.

Going into the surgery, discuss with your doctor the possibility of a more gentle cesarean, one in which the uterus is not completely removed from the body. Sometimes some of the dissection of your internal organs can also be avoided or minimized, particularly if you are not undergoing an emergency c-section. This will help minimize your pain and your risk of internal adhesions later on.

After the surgery, do not be afraid to take your pain medication. Even if you are breastfeeding, your milk will not come in for at least 2 days, and possibly longer due to the shock of the surgery to your body. During this time, your baby will not get any significant drug amounts through your milk. You need to get out of bed and moving around as soon as possible, to speed up healing and prevent blood clots from forming.

Try to get back to eating and drinking normally as soon as possible. Your body needs the nutrition in order to heal itself. Most doctors prefer to wait until you pass gas before allowing you to eat again, since this indicates that your bowels have "woken up" from the shock of the surgery; however, for some women this can take up to 36 hours, and going that long without food is very bad for anybody recovering from surgery, let alone a new mother. Lobby for at least a liquid or soft diet to begin within hours of surgery.

Some kind of support on your incision will help you stay comfortable and mobile as your heal. Remember that this operation will involve slicing through your abdominal muscles, making everything from sitting up to rolling over to sitting down a nightmare. Some women wear a special post-operative belly binder in the hospital and after they return home, and you can discuss this possibility with your doctor. Another option is the new C-Panty, which provides a built-in silicone compression panel to support your incision and help speed healing.

However things go for you, good luck! "

Making cesareans gentler and more mom and baby-friendly

Here's some useful new information for women who will be having cesareans :


From http://www.guardian.co.uk/society/2005/dec/03/health.medicineandhealth

" Obstetrician, Professor Nick Fisk has pioneered this groundbreaking approach to surgical delivery called "skin-to-skin caesarean", or "walking the baby out" partly in response to the rising caesarean rate. "And while couples having normal deliveries have been given more and more opportunities to be fully involved in childbirth, very little has been done to see how we could make the experience more meaningful for those having caesareans."

As Fisk started to examine the conventions of surgical delivery, he was struck by how easily they could be challenged. Why, for example, did they need to be done so quickly, when slowing them down would give the parents more chance to participate in their child's delivery and might give the baby a gentler experience of coming into the world? Why, too, was it so important for the parents to be screened off from the mother's abdomen? And was it really essential for the baby to be whisked off for an immediate medical examination, rather than delivered into the arms of his mother?

"What I realised was that caesareans were done a certain way because they've always been done a certain way, but in fact they can be done differently - and in a way that parents love," says Fisk. Other doctors are sometimes shocked when they hear what he is doing. "They say, but surely you have to get the baby out fast so she can get oxygen straight away? And I say, when the baby is being born she's still attached to the umbilical cord and is still getting oxygen from the placenta. Caesarean birth can be gentle, just as vaginal birth can be gentle.

"Obstetricians are too hung up on getting from the point of incision to the birth of the baby as quickly as possible: that's been the benchmark of a skilled surgeon. But I'm challenging that because, from the baby's and from the parents' point of view, it's not very helpful.

" I've never known a baby born by my method to have problems - going straight onto the mother's chest helps regulate breathing."

Smith, who works closely with Fisk, says it's a hit with parents. "They feel more involved, which gives them a better start to family life. Breastfeeding is easier to establish, and you can see how much calmer the baby is."

Question about the end of pregnancy

Q. I'm almost 38 weeks and not dilating?

I will be 38 weeks on Saturday and I am STILL not dilating. My doctor's appointment was yesterday; he checked me and said my son is still pretty high up there. I haven't dropped at all but I feel terrible. My whole pelvic region feels so heavy (almost like someone hit me) and it aches badly. I'm scared I will be overdue again (was 10 overdue with my daughter) and my need a C-Section in the end. With my daughter I was overdue but at least (around this time) a cm or 2cm dilated.

Has anyone gone through this with a subsequent pregnancy? In my mind I thought, this one would go a lot quicker but I'm losing hope and my fear seems like it may become a reality. I had an all natural birth with my daughter and I wanted to experience it again with my son. I'm scared I will have to go through getting pitocin and so forth. Any suggestions, words of encouragement, anything?

To add I have been having BH's constantly that have been getting pretty painful, but still nothing!
I just am getting frustrated because I am very uncomfortable, even more so than my other pregnancy.


Answer :

It's normal to feel anxious towards the end or pregnancy. Try to do relaxing things to help yourself feel grounded - go for a nice walk, have a warm bath, sip some herbal tea, talk to your baby, breathe.

Not being dilated or having dropped is totally meaningless bits of information. You're 38 weeks. You're not in labour yet, you don't need to be dilated. Your baby doesn't need to have dropped. It will drop when it's ready, and your body will open when it's ready.

As for being overdue, actually the normal range of birth is from 3 weeks before the due date to 2 weeks after. So if baby wasn't born by 2 weeks after the date, you would be overdue. Women and doctors today are so overly focused on times and dates, they expect babies to be born by that due date. Also, the due dates are estimated based on the average woman's cycle of 28 days. If your cycle is longer than that, you're date of ovulation would be later, and your due date should be later. Some doctors take that into account, some don't.

There are many ways of getting labour started naturally once labour is already imminent (meaning that it would start on it's own anyway in the next few days). One of the best ways is sex.
Oxytocin is the hormone involved in love, sex, labour and breastfeeding. So kissing, making out, nipple stimulation, sex and orgasm can make your body produce oxytocin which can start labour.
Prostaglandin, which is is semen is the hormone which softens the cervix. So that can help start labour too. Don't have intercourse after the water breaks though.

There are lots of other natural ways to start labour.
You can find them just by doing a Google search.

Have fun and do find things to help you relax. Feeling anxious can actually stop labour.
If you have any further questions, you can email me.

Asker's Comment: Thanks! I'm just going to be patient and wait it out.