How a Birth Doula Can Make Your Cesarean Better
Birth doulas have a stereotype of being these flowy, crunchy, all “natural”, no medication, homebirth-only, people, but 1) I’ve never met a birth doula who actually fits this stereotype. We’re not in it for the birth experience, we’re in it for YOU 2) For reals, we understand the unpredictable nature of birth better than most. The cesarean rate will never safely be 0%. That means that in order to be a fantastic birth doula, one needs to have tools to support and enhance the cesarean birth experience. I learned this very early on
So what do I offer for cesarean births?
Let’s make a Plan C(esarean) - Even the best laid plans for a genital/vaginal birth can be thwarted, so in doula prenatal visits I cover the topic of cesarean. I cover why it might be necessary, what it could be like, what options you could have in the event of a cesarean, and how to make a cesarean plan that would feel at least okay, if not better-than-okay. If you are very scared of having a cesarean birth it’s even more important to make a plan for it. Strangely enough, having a plan for the “what if” tends to take anxiety away rather than feed into it. If the cesarean is planned and expected, I can get even deeper into helping you plan for what will happen on the Big Day.
In-the-moment listening and advice - Most cesareans are not true emergencies. That means there is time to discuss and process a change in plan that happens in labor. If the option to give birth by cesarean is on the table, I can remind you of what options you have and the pros and cons of each option. The choice of what feels right in your bones (keep laboring or choose the cesarean exit plan), is entirely up to you. If you do decide that cesarean is the right or only choice at that moment, I often counsel you to take some time (15-20 minutes or so) to process the change in plans, perhaps have a cry, set aside any disappointment (to be processed later), and get excited to meet your baby. Whenever possible, I want excitement and joy (not shock or sadness) to be what you remember most about the moment your baby was born.
Support in the operating room (whenever we can) - Many hospitals will declare that they have a policy that only one non-medical support person is allowed in the operating room with you. If you have a partner they are the obvious choice for your one support person, but the need for birth support doesn’t stop the moment you enter the operating room. You and your partner can advocate for your doula to come with you during your cesarean. It’s helpful to declare that continued doula support in the operating room is important to you, rather than simply to ask if it’s possible to have your doula with you. When I am able to be present in the OR for a birth, I take pictures, hold your hand, stroke your forehead, help you breathe through the pressure sensations, and help communicate to the anesthesiologist if you’re feeling uncomfortable in any way, such as breakthrough pain, light-headedness, nausea, etc. Along with your partner I can help hold your baby skin-to-skin on your chest, and of course, I can stay with you if your baby were to need more medical support and your partner needed to go with your baby. Not a lot of studies have been done on doulas in the operating room, but the ones that have been done showed that birthing people found the doula to be a very important part of the birthing experience and nurses appreciated the doulas in this role as well.
Offering cesarean recovery tips - Birth recovery is no joke! Cesarean births take longer to recover from on average, but there is a wide range of normal. Some people seem to have very little pain after the first few days and others have weeks of pain and decreased mobility. As a doula, I can offer tips for decreasing pain when you have to cough, sneeze, or laugh (press and hold a pillow over your incision). I will remind you that you can wear a belly binder if it feels like it supports your belly in a beneficial way. I will suggest that you request a prescription for physical therapy so that you can rebuild strength and functionality in your core (believe it or not, it isn’t routine to offer PT after this major abdominal surgery). I will help with human milk feeding in a comfortable position. And, last but not least, I will listen to your feelings about your birth without assumptions or judgment. Some people will have nothing but happy, elated feelings about their cesarean birth and others will have feelings of trauma or unease. There are no wrong feelings about any birth, but cesarean birth tends to come with a lot of assumptions that can feel annoying, frustrating, and hurtful.
This article just scratches the surface of how a doula can be invaluable for a cesarean birth experience. Did your doula prepare you for birth in the operating room? Did your doula help you process a cesarean birth? Was your doula able to support you in the operating room? Tell me your story!
