What can and does happen when you don’t take the time to fully prepare emotionally, mentally, and physically for the birth of your child?
What happens when you leave decisions up to the care providers and you don’t know all your options?
Why aren’t people reaching out to the experts in normal birth to get more information?
So I posted these questions on the Facebook page of San Diego’s International Cesarean Awareness Network: I am looking for moms who either:
1. Did not take a childbirth class and ended up with a C-section
2. Took a class but didn’t feel prepared and ended up with a C-section
3. Feel that your lack of knowledge contributed to the reason you had a C-section
What I’d like is for you to tell me what you would tell a first time pregnant mom what you wish you had known to help you avoid an unnecessary Cesarean birth. Below is what these moms posted
- “I took a Bradley class with a great birth educator. But I think that I needed a better understanding of the actual birth process and a better understanding of my own anatomy to better prepare. My twins didn’t fully descend and engage and I believe now that had I known more about my particular pelvic anatomy, I could have sought out more prenatal and labor assistance for positioning for a successful vaginal delivery.”
- “I would tell first time moms to decline an induction if mom and baby are healthy. That baby is coming out sooner or later! I’m confident the onslaught of interventions before my body was ready is what led to my unwanted c-section. (I had 2 membrane sweeps, Cervidil, pitocin, a Foley bulb, two manual breaks of my water and never got past 5cm.)”
- “I took a Bradley class and felt really prepared in terms of the birthing process and knowing what was (probably) going to happen. However, I wish I had known more about successful positioning of baby and I think having a doula would have saved me A TO N of stress and pain during labor. Ended up with a c-section after 72 hours because my baby was posterior and couldn’t come down under my pelvic bone and her head was beginning to swell.”
- “I did not take classes cause I was procrastinating, and delivered at 35 weeks. I would recommend to first time moms not only taking classes but talking to doulas. If they cannot afford one, to learn more about what you can say no to. I was pressured into having my water broken and was forced to push at 8cm. But because I was unprepared and trusted the nurse things did not go as smoothly as they could have. The more a mother knows the better in my opinion.”
- “I took some hospital classes, but that’s it. First was sunny side up and got stuck, which ended in C section. Also, I had a group of doctors. I recommend getting a Doula, taking classes (at least online) and finding a doctor or midwife who you KNOW will be there. Also, finding a doctor who intervenes as little as possible. My first experience had the doctor break my waters. Dr. Cobb (VBAC) did not break my waters, but he got splashed when they broke while I was pushing… “
- “I took classes and felt relatively informed, but I didn’t know about the problems a posterior baby could present. I also had no clue about c-sections other than the fact that I didn’t want one. I did have a small note on my birth plan in the event of a c-section, but I wish I’d known more about the actual surgery, my options during/after surgery, and ESPECIALLY the recovery. I felt so blind-sided, and the hospital staff told me nothing about after-care.”
- “Took a class. Ended up with a c-section. I was a first time mommy with no clue that it would ever happen to me. It was not even on my radar. What I’d tell a first time mommy is to prepare for it mentally. No matter your birth plan you should be aware that it can happen, but to prevent it do research and understand how to advocate for what you want. If you are not the type to be able to do that, then get a doula to help you understand how to do this and even coach you through it. But I truly believe that if I would have done more research then I would have never had a c-section. I would also tell mom’s to search for a provider with a low c-section rate. To discuss the possibility of things going wrong with your doctor and ask them what they would do in those scenarios. I think we are often just giving our doctors ultimate trust and we need to be more careful about who we bestow that to without having some conversations first.”
- “The nurse delivering me even though my son crowned didn’t know he was posterior till after I pushed for hours and she finally got the midwife on hand. I don’t think one can stress enough how important position is. Or learning how to tell what position the baby is in just in case the nurse doesn’t check.”
- “I am in a similar boat with these other mamas. I took hospital classes to prepare me for birth and I read all the standard books. However, I ignorantly thought that since my mom nor my sisters had c-sections, I wouldn’t either so I did not even consider it a possibility and foolishly was not mentally prepared for it.
- “My biggest lesson learned? Labor at home as long as possible! And get a doula! “
I was in labor all day on a Saturday. Like a good first time mom, I timed every single contraction and by Saturday night, I made the foolish decision to go to the hospital. Hours later (after all the paperwork) they checked my cervix and sent me home because I was barely dilated. Got home at 3am exhausted and my water broke 20 minutes later. I am convinced that my water break was premature due to the cervical check. And after I felt the post water break contractions, I knew the ‘labor’ I was experiencing before was a walk in the park and I could have handled the earlier day’s contractions. But what did I know? I had never been in labor before. That is where having a doula may have helped.
We got back to the hospital, I made some standard uninformed decisions regarding interventions and ended up with a C-section just before midnight. I was scared to death until I heard the first little cries of my daughter. Thankfully my recovery was not that rough either although we did struggle with our breastfeeding relationship at first.”
- “This may be paranoia, but I feel like hospital classes are biased. I would never take another hospital class again. They talked about c-sections for 5 seconds. It was never apart of the conversation.
- .it was barely discussed.”
- “Gotta second the posterior baby issue – I took Bradley and felt unprepared in terms of baby positioning and my providers did nothing but tell me to check out the spinning babies site (which, in 2011, was tough to navigate). I think everyone thought she would turn in labor, but she didn’t. I would also say to absolutely hire a doula and not rely on a volunteer one. Lastly, the BRAIN acronym or something similar – have it on hand, give it to your partner, use it.”
- “I would say “Get a doula!” I took a class, learned a ton, felt prepared, and I think the biggest thing that would’ve made a difference was having a doula. After 10 hours of fast and quick and hard labor I was too tired to try too many positions and I think a doula might have been able to get me to push in a position that would’ve helped me to deliver vaginally. (He wouldn’t move with any pushing and wouldn’t get low enough to have any other help. His umbilical cord was being squashed over his shoulder so his heartbeat was not rising between contractions. I also think he head was not in the right position as his cone head was off to the side slightly which is why I think a doula would’ve helped.)”
Thank you to all the moms who shared. Having a baby is a miracle but if you don’t understand all the ins and outs of pregnancy, and how birth is managed in a hospital setting, your baby’s birth can end up being a traumatic experience. So in summary, these moms on San Diego’s ICAN Facebook page generously gave me the idea for:
10 Things I Wish I’d Known Before I Gave Birth:
- Positioning the baby is key. A posterior baby in labor can cause a myriad of problems and complications. Watch this video from Spinning Babies.Spinning Babies Parent Class from Spinning Babies on Vimeo.
- Decline an induction unless there is medical evidence that your baby is better off outside of your womb than inside a bit longer. The baby will come when it’s ready. Be patient.
- Hire a doula who knows techniques in labor to help baby get into the optimal position; and to support and encourage you during labor.TALK IT OVER: Questions to ask if Induction is recommended.
- Why are you recommending induction of labor?
- What are the risks to me & my baby if I wait for labor to begin naturally?
- Do research studies confirm that inducing labor in this situation is safe & will reduce my risk of an unhealthy outcome?
- Can we try more natural methods of induction before using drugs?
- Is induction likely to be successful for me?
- Is my cervix ripe? ( women who are induced before their cervix is ripe are more likely to have cesareans, even if cervical ripening drugs are used.)
- Take a childbirth class early beginning in your 5th or 6th month. Do not procrastinate! It is important to prepare early in case something unexpected happens. Preparation is physical, emotional, and even spiritual.
- Hire a doctor who will attend your birth. A lot of doctors hire hospitalists to be on call so they don’t have to be. That means you don’t know who will be attending your birth. Hospitals hire hospitalists for convenience for OB-GYN’s who don’t want to be on call daily, cost-effectiveness, and other reasons. But that hospitalist knows nothing about you or your preferences and practices according to their own and the hospital policies. You maybe unprepared for how they deal with you and your labor and birth.
- Ask your doctor for their induction rate and their cesarean rate. Get it on paper, not just his/her word. One of my recent students was told by her doctor that her Cesarean rate was 10%. She practices in a hospital that has a 35.8% Cesarean rate, so I find it really hard to believe her rate is as low as 10%!
- Learn about Cesareans (What Every Pregnant Woman Needs To Know About Cesarean Section) and what happens during the surgery and how best to recover. Just because you don’t want something to happen, doesn’t mean it’s not going to happen. Learn everything you can to understand it and how to avoid it. Write a Cesarean birth plan so that your baby’s birth is a beautiful, joyful experience, not a traumatic one.
- Labor at home as long as possible. I always tell my students to use this Active Labor Formula.
- Take a class outside of the hospital. The general consensus is that those classes are biased and give minimal information and training. Most, but not all hospital classes, teach you how to be a good patient. Make sure it has a minimum of 5 classes that are at least 2 hours long. Don’t waste your time with a one day class!
- Know your informed consent questions and the BRAIN acronym. Benefits – Risks – Alternatives – Intuition – Nothing. If you’ve been told you need a test or a procedure, ask them:
To describe the test or procedure and the expected outcome.
What happens if it doesn’t work?
What are the risks and the benefits?
What are the alternatives?
Risks and Benefits of the alternatives?
What if we wait and do nothing?
Can we have time to discuss it and talk about it?