Planning your c-section means you are going to meet your baby!

Whether you are a first-time parent, scheduling your c-section or pregnant for the fourth time, planning a c-section birth can come with a full range of emotions. You may feel relieved, excited, anxious, focused, disappointed, even curious. One of the incredible things about being human is our capacity to experience more than one feeling at a time. People plan cesarean births for a variety of reasons:

• Breech presentation

• Prior c-section birth

• Mental health

• Placenta considerations: placement, accreta

• Previous uterine surgery

• Twins! Carrying more than one baby

Recently I interviewed a mom to ask them about planning a repeat c-section; the good, the not great, and the unexpected.

Michelle had a c-section with her first child. “Having an unanticipated c-section with my first child, while the surgery itself wasn’t complicated, the c-section was traumatic in its unexpectedness.” She went on to say that when she became pregnant with her third pregnancy, she decided to plan for a second c-section for a variety of reasons. One major factor was knowing what day and time she would meet her baby. This meant she could avoid the anxiety of working until labor started spontaneously. She was able to plan childcare for her toddler, and who was going to take care of their dog while she was in the hospital. Michelle also experienced a devastating miscarriage after her first child was born. Understandably, she felt a “tremendous need to control what I could” surrounding her birth experience.

Planning a c-section is different from an emergent, unplanned or emergency c-section because it allows parents time to prepare mentally for what will happen. Being able to know when and how her baby would be born was crucial to Michelle’s mental health during pregnancy, during birth and postpartum. When discussing birth with parents, I like to talk about the “unknown-unknown.” Before anyone goes through childbirth for the first time, it is all completely unknown. Parents who schedule a repeat c-section with their second pregnancy after an unexpected, challenging or traumatic c-section birth the first time, have some knowledge of what is going to happen. This is what I like to call the “known-unknown.” Someone who has had four c-sections will tell you they were all unique. At the same time, having experienced a c-section before, there is a general sense of the process and knowing they got through it.

Planning a c-section looks different for everyone. Some parents want their bodies to go into labor spontaneously and then head to the hospital. Others are empowered to choose a date and time for their child’s birth.

The most important part of this whole process is having a supportive healthcare team. I urge you to have conversations with your provider to find out how planned c-sections work at your hospital. Some doctors and institutions have policies that restrict how many people can be in the room with the birthing parent during surgery. Others allow a doula and support person or partner. Some hospitals make c-section births family or birthing-person centered. These include playing music, dimming lights, allowing baby to be passed through a window in the drape or utilize a clear drape for the parents to see their baby being born. Not all hospitals include these options so it is important to ask your doctor what is available and what you should expect.

Support People can include (but not limited to):

• Doula, Birth and/or Postpartum

• Established therapist

• Pelvic Floor Therapist

• Family or Friends for household support

• Holistic care providers (acupuncture, lactation support)

For some, watching videos of c-section births is helpful for them to see how birth will happen. There are even videos of c-section births recreated through playdough on YouTube that simplify the process without blood and are a great option for siblings as well. Being able to anticipate recovery plans is a huge benefit when planning a c-section birth. Hospitals or insurance can provide belly bands for core stability. Families can focus on creating a postpartum plan that anticipates meals, childcare, and domestic task support.

*Birth is unpredictable.* Even c-section births can offer surprises. What is important is to have an established care team to support you, however your birth experience happens. Being pregnant and making decisions about work, birth, family, and life can be exhausting and stressful. Whatever your feelings are, ***they are valid***. Please take care of yourself by talking to someone you trust, partner, care provider or therapist.

List of Questions for C-section preparation

This is not an all encompassing list but it is a good place to start. Some of these questions will not apply to you. It is also good to know what you want but also what you don’t want. Some parents want skin-to-skin right away and others are happy to wait until their baby is cleaned and bundled up to snuggle them.

How many people can be in the operating room with me?
What is the plan for medication for the c-section? How long will that last after the baby is born?
Is there a separate recovery room, before I go to postpartum care? (Maybe you want to see the room or pictures of them.)
How long do c-sections usually last?
Does your hospital have a pass-through drape to have skin to skin right away?
Does your hospital have a clear drape so you can see your baby being born?
Can I have skin to skin after the baby is born (as long as everyone is healthy)?
Who will announce the baby’s gender? Can grandparent, partner, sister do it?
How long can I stay in the hospital?
If you are chestfeeding, when will I be able to see the lactation consultant?
How long will my recovery be?
What kinds of medications will I be sent home with?

Your planned c-section can be am empowering and beautiful experience, and I hope this helps you find ways to make your planned c-section feel as best as possible.