Caesarean Section: Part 1

Caesarean Section: Part 1

April is Caesarean Section Month

So I thought I would do a series of blogs to help you understand a little bit more about your body and perhaps help you to make any decisions about the type of birth that is right for you.

So where do we start?

Well, let me ask you a question – If I asked you ‘How would you like to give birth to your baby?’. Would you have an answer for me? An answer which is based on your understanding of your genetic history and your body – Or would your answer be that which I typically hear all the time –

‘Whatever the Dr says is best, I just want what is best for me and my baby’

I have worked as a midwife in the theatres supporting women and their partners to welcome their babies into the world for elective as well as emergency caesarean sections. As a community midwife I have supported women who have opted to have a caesarean birth over vaginal delivery for reasons unique to them. Fundamentally, the important aspects for women and their partners is information and knowledge. Many women don’t know that it is a choice, but they don’t also know that there are certain times when the choice becomes necessity due to a cascade of medical interventions!

The World Health Organisation (2015) states Caesarean sections are effective in saving maternal and infant lives, but only when they are required for medically indicated reasons.

They recommend caesarean rates should be at population level, however rates above 10% is NOT associated with reductions in maternal and newborn mortality rates. However, it is important to note here that these figures are in consideration of when there are medically presented issues where the mother and or baby risk and do not take into account the psychological impact of issues such as Post Traumatic Stress Disorder (PTSD), tokophobia (an extreme fear of giving birth) or previous abuse.

While a caesarean section can be an essential and lifesaving surgery, it can put women and babies at unnecessary risk of short- and long-term health problems if performed when there is not medical need. To put this in context, in the UK many regions average a caesarean section rate of 30%, with some reaching 50%. So, even if you are planning to have a vaginal birth, it may be a possibility that you could end up with a caesarean section.

Therefore, women need information and to plan for the birth they want, which MUST include OPTIONS when your baby or your body decides not to follow natures plan! Women plan for everything else like a wedding – so with so much at stake, why don’t women plan for birth?

So, with this in mind let me ask you another question –

Do you know how labour works and what parts of the body you need to ensure successful birth?

This may seem a strange set of questions, but there is more to it than hormones and contractions. You may find that there is something preventing you having a vaginal birth so you may not ‘choose’ to have a caesarean section, it is more that is has been chosen for you – which may bring fear of the procedure or the unknown of the procedure.

You may find you have one of the four ‘true’ pelvis’ (Stables & Ranking, 2010). YES that is right – pelvis’ can be shaped differently (See below).
In the UK pelvic imagery isn’t something we use to determine the shape in women having their first baby, or for a woman having a second or subsequent baby seeking VBAC (vaginal birth after caesarean section) who may then go on to have another caesarean section if vaginal birth doesn’t occur.

Then there is the uterus itself – there are deviations such as bicornate uterus or uterine bands which may prevent you having a vaginal birth.

In addition you may have a placenta which lies low in the uterus covering the internal part of the cervix (the opening where baby comes through and referred to by midwives and obstetricians as the OS) which also means you will need to have a caesarean section.

So you see – you may not have a choice, due to some of these factors. However, If you opt to have a caesarean section, it is important to remember that labour is controlled by hormones, so obviously these hormones won’t play a part in the labour itself, and this can include to initiate milk if you wish to breastfeed.

There are things you can do to prepare for this – which I advise all my clients from 37 weeks. This is called milk harvesting and collects colostrum which you can feed to your baby and which will help you in the early days following your baby’s birth.

You may have reasons other than physical ones to have a caesarean section such as a previous traumatic delivery, so you want to avoid a vaginal delivery. Sometimes, it is due to past experiences that you are worried will bring things up for you and which you want to avoid.

I have helped many women overcome these issues using treatments through complementary therapies such as hypnotherapy for PTSD symptoms and pain management, as well as managing anxiety and fear of surgery, so they feel they have choices.

If you would like to find out more about my packages please contact me via email at: [email protected] or alternatively join my free private Facebook Community, the link is here, I would love to see you there.

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