Choosing an Evidence Based Hospital

When it comes to finding a hospital, there are some key things to look for to ensure you will be setting yourself up for the most mother-baby friendly care possible!

Today Stephanie and I are talking about questions you can ask on the tour you take of the hospital prior to choosing where you will give birth. Because many doctors only have privileges at certain hospitals, you may want to look into the hospitals early on in your care when choosing a doctor. Stephanie is a doula, lactation consultant and certified childbirth educator so you will definitely want to soak in all of her amazing knowledge!

evidence based hospital

Grab your free download — Choosing an Evidence Based Hospital!

 

Have you taken our quiz?! I have been so surprised by the results so far! Where Should You Give Birth Based on Your Personality?

Is Your Doctor Evidence Based?

Finding an Evidence Based Care Provider—Special ‘Know Your Options’ Series

When it comes to finding a doctor, does it ever make you feel completely stuck? How do you know if they will be right for you?

Today Stephanie and I are talking about why we recommend finding an evidence based care provider and how you can tell if the person you’re interviewing (YES, you should absolutely be interviewing your doctors!) is practicing evidence based care. Stephanie is a doula, lactation consultant and certified childbirth educator so you will definitely want to soak in all of her amazing knowledge!

ob interview questions

Grab your free download — Guide to Finding an Evidence Based Doctor!

Still have questions? Submit them and we will do our best to answer all of them on our Facebook Live this week on 9/20/17 at 1pm CST. We’ll be discussing the major warning signs that your doctor might not be practicing evidence based care and answering YOUR questions.

Have you taken our quiz?! I have been so surprised by the results so far! Where Should You Give Birth Based on Your Personality?

hospital birth

 

Take Our Fun Birth Quiz!

This quiz isn’t meant to be a black and white set in stone determining factor of where you should give birth but it is meant to get you thinking about some of your daily preferences based on your personality and how they might play into your labor experience! Take the quiz and let us know what you think of your results! We’ll follow-up with some great educational content to help you prepare for an informed and empowered birth experience!

Quiz photos by Monet Nicole Birthing Stories

National Infertility Awareness Week – Collection of Birth Stories

This post is sponsored by Theralogix, makers of of the TheraNatal line of nutritional supplements. TheraNatal preconception vitamins contain all the nutrients you need to prepare your body for pregnancy, including folate and vitamin D. For women 35 and over, TheraNatal OvaVite also contains CoQ10. Use this link to get a discount of approximately 15% off your purchase and be sure to listen to my chat with Theralogix at the end of this episode about how their products support women with infertility issues.

Bringing Awareness to Infertility

Infertility affects 1 in 8 couples or 15% of of couples in America according to the CDC. National Infertility Awareness Week strives to bring more attention to the struggle of infertility. At The Birth Hour we feature all types of pregnancy and birth stories and wanted to highlight some of our infertility stories this week.

1. Infertility Journey, Pregnancy and Birth Story

Camille knew going into her marriage that her PCOS had caused infertility issues and she and her husband had a long road ahead. After years of trying, she finally got that positive pregnancy test.

2. Surrogate & IVF Pregnancy & Birth Stories

Nancy and her husband went through cycle after cycle of IVF and eventually decided to use a surrogate to carry their first pregnancy. As fate would have it, Nancy became pregnant the same month that her surrogate got a positive pregnancy test. They welcomed two daughters within weeks of one another!

3. Infertility, Placental Abruption Cesarean, and VBAC Birth Stories

Alexandra Barretta is from Queens, NY. After struggling with infertility, she was able to get pregnant after several IUI’s and 2 IVF’s. Her son was born 6 weeks early due to a placental abruption via c-section.
4. Surprise Pregnancy at 33 Weeks Birth Story
Phuoa and her husband had been trying to conceive for 5 years and she had put getting pregnant towards the back of her mind. She actually didn’t realize she was pregnant until she took a test after noticing a linea negra and by the time she went in to get her ultrasound found out she was 33 weeks along and her baby was born premature the very next week!

5. Pregnancy and Birth with Type 1 Diabetes

Kate is a 35 year old Type 1 Diabetic, diagnosed at the age of 25. She’s insulin dependent, and uses a medtronic insulin pump and glucose sensor to manage her blood glucose. She was categorized with unexplained infertility and after 5 years of trying, conceived a baby through IVF. She was only able to transfer one embryo at a time to prevent the risk of carrying more than one baby as a Type 1 Diabetic. Their third (and last) embryo took, and she now has a beautiful baby boy!

6. Surrogacy: Carrying My Brother’s Babies

When Tiffany’s sister-in-law had to have a hysterectomy after a postpartum hemorrhage with her first birth, Tiffany almost immediately offered to be their surrogate for a future child. After some time passed and lots of planning and discussion, they decided to go down the path of surrogacy with Tiffany carrying her brother and sister-in-laws next child. It turned out to be two babies instead of one and soon Tiffany was pregnant with their twin boys!

7. Gestational Carrier Birth Story

After multiple methods and attempts at getting pregnant the best diagnosis doctors could give Sarah was “unexplained infertility.” While her infertility journey has been incredibly frustrating, especially being unexplained, Sarah never gave up her dream of becoming a mom. And after almost 9 years of infertility, a miracle happened; her and her husband were blessed with two beautiful twin baby girls through the amazing gift of a gestational carrier.

gestational carrier birth story

8. Pregnancy & Childbirth after PCOS

Marissa Lawton discusses getting pregnant with PCOS (polycystic ovarian syndrome) and dealing with fertility treatments and the anxiety she dealt with about infertility, about whether a fertilized egg would be viable, how many babies she would carry and whether her baby would be healthy throughout her pregnancy.

Do You Need a Doula? And How to Find One

Advancements in technology, industry, and business have brought about many changes within the last century. Society has likewise evolved both for better or for worse. Among these evolutions has been a big shift in the standard process of childbirth. Back in the day it was fairly normal to live near extended family and close friends, so it was very natural to have many of them support a woman during labor and delivery. As we have changed over time, it is now more common to live far away from family and delivering in the hospital has become the norm. A side effect from these changes is that mothers have lost the standard support team of women around them while they labor. A possible replacement for this lack of support is to hire a doula. Despite the myriad of positive benefits of a professional doula, only a small percentage of women utilize them. Many newly pregnant women often wonder if a doula is a worthy investment.

Benefits of having a doula

Many studies have been conducted that show the positive effects of doula support, although currently only about 6% of women use one. These benefits include, but are not limited to: decreased labor time; and a lower rate of epidurals, c-sections, pitocin administration, and instrumental assistance during delivery. A Mother who hires a doula also tends to have a much more positive view of her experience. When she feels safe and protected, she lets go of fear (which interferes with progression). Stress levels decrease, and natural oxytocin levels rise, thus encouraging labor advancement. After babies are born, they are more likely to have higher apgar scores (Hodnett, Gates, Hofmeyr, Sakala, & Weston, 2013), and there is an earlier initiation of breastfeeding as well.

Do I need a doula?

There are many known benefits of doula support during labor, but do you really need one?

The large majority of women deliver babies in a hospital and are left to the care and attention of a medical team. A staff may be concerned and aware of a mother’s physical and emotional needs, but they are often distracted by their duties as part of hospital procedure and policy. A nurse, midwife, and doctor all have their own specific tasks to complete—monitoring the baby’s vitals, reading charts and logs, making sure mom is hydrated, and has good stats, etc. They are preoccupied with the safety of mother and baby and are also overseeing a large number of other laboring women at the same time. They will be in and out of the room constantly, and even monitoring moms from machines in the hall. Think of all that is going through the minds of these healthcare workers during delivery.

Making sure baby’s position is optimal, providing perineal support, trying to prevent tearing, coaching mom how to push, monitoring baby and mother’s vitals, assisting the baby when it emerges, making sure the baby is breathing, checking apgar scores, cleaning things up, performing sutures, baby care, delivering the placenta, avoiding hemorrhaging, and keeping things sterile. They have so much going on mentally and physically that although they may be sympathetic to the mother’s needs, they cannot be too preoccupied with them. Plus they have other patients simultaneously.

A Doula’s Purpose

Conversely a doula’s primary purpose is to provide emotional, physical, and informational support for the mother for the entire duration of labor, and afterward. She will be solely focused on you and at your side continually. But what if you have a partner, sister, mother or friend with you? It is highly recommended to have support from people you love and trust. Yet keep in mind that your support group is not always specifically trained in how to care for a laboring woman, no matter how much they love you, whereas a doula is. In order to become a certified doula, a candidate must meet many qualifications. DONA International, “the international leader in evidence-based doula training, certification, and continuing education,” requires that a doula meet the following criteria:

  • have a minimum of 28 hours of labor support time logged
  • read several required textbooks on labor and birth
  • attend at least 3 births and be evaluated by a doctor, nurse or midwife, and the mother.

This knowledge and skill set put into practice is truly invaluable in knowing intuitively how to support a laboring mother.

Doula Services Prior to Delivery

A doula will usually meet with a client about two times prior before the mother goes into labor. During these meetings, she will get to know you a bit, get a feel for what your birth vision and preferences are, and help with a birth plan. She can address any concerns and fears you have about birth, and offer educational materials to review. She can learn about your personality and what calms you, as well as what gives you a boost when you are tired, and how you best anticipate needing support.

A good doula will also be well connected to the birth community for additional support and education. This can be a great resource for women wanting to gain more childbirth education and to get involved with other moms and resources in the area.

Doulas Stay With You the Whole Time

The best thing about doulas is that they are usually available as early as you’d like them in the process, even from the first few contractions. They can come to your home and be with you while you labor there, then transfer with you to the hospital. One of the main advantages to hiring a doula is that you meet her and know her before you go into labor, whereas your nurse and perhaps the doctor on call at a hospital can be complete strangers. Having your doula with you can help you feel more at ease when you arrive. Another advantage is she will stay right with you whereas doctors and nurses, and sometimes even partners will be in and out throughout the process.

Doulas Support Your Partner Too

Doulas are also valuable resources for  birth partners. A doula does not replace a partner’s support; rather she assists both parties. She can allow the partner the main role of offering words of encouragement and emotional support while she provides some physical support, and vice versa. She can offer suggestions of what a partner can do to help mom. She can also support the partner should he start to feel anxious or overtired. In one recent study, it was recorded that on average, doulas touched the laboring mother 95 percent of the time, as compared with less than 20 percent by male partners. This in no way discredits the helpfulness of a partner, but rather sheds light on the fact that a doula and a partner have different primary roles. In the end she will be able to read signals from mom and partner of what their needs are in the moment.

A doula’s job is to be there for the mom and to encourage a safe and satisfying birth experience. She provides three kinds of support—informational, physical, and emotional.

Physical Support from a Doula

A doula draws upon her knowledge of many different labor positions and offers suggestions to the laboring mother to help ease discomfort and keep labor progressing. She can offer massage or counter pressure, adjust mother’s temperature with blankets or cool washcloths and fans. She can help to implement breathing and relaxation techniques, and will offer verbal reassurances. She can offer ice chips, drinks, and food if the hospital allows it. She remembers things mom might not think of like to use the bathroom frequently. She knows mom’s preferences and will guard the atmosphere so it remains as calm and peaceful as possible. This is invaluable, especially when the mother is focused and does not want to be bothered with details.

Doulas Offer Informational Support

A well-trained doula will be aware of the hospital policies where the mother is delivering, and will know what kinds of things are allowed and/or prohibited. She can offer advice and information if the mother has concerns or questions. A doula can be a liaison between the staff’s medical jargon and the procedures that are happening. Should unexpected complications arise, a doula can offer extra information, advice and encouragement for big decisions.

Emotional Support from Your Doula

Should some unexpected things arise during the course of the labor, a doula can offer emotional support and encouragement, especially if a c-section or epidural is ordered. She can help to ease fears and guilt and allow a mother to process her potential anxiety or confusion.

Keep in mind that a doula is not only valuable for mothers planning a natural birth, but for all kinds of deliveries. Birth can be an unpredictable event. Even if you plan on getting an epidural or having a planned c-section, a doula can offer tremendous emotional guidance during the process. She can help to aid in your comfort level both physically and mentally. She can be aware of the details that are happening while you are “in the zone.” If a lot of information is being thrown at a mother all at once, and she is already overwhelmed, it can be hard to process and remember what is being said. A doula can be a valuable second set of eyes and ears to absorb information and help answer your questions.

Postpartum Doula Services

Many doulas will offer care for postpartum mothers and charge an hourly rate. Their tasks can range anywhere from breastfeeding support, emotional support, physical care and healing of mother, to cleaning, cooking meals, or taking care of the baby so mother can rest. They will usually offer services up to a certain amount of time (like 4 hours), and some will even offer to sleep over and help with night feedings for an extra fee. The postpartum period can be a difficult time, especially for brand new moms, and the aid of a doula can be very valuable, so it’s something to consider. Even knowing the option is available can put one’s mind at ease.

An Example of a Positive Doula Experience

Elaine Stillerman of Massage Today tells of her positive experience with a doula.

“I called Ilana when I became pregnant. She came to my home to interview me and my husband about our hopes for the big day. Ilana took copious notes in the attempt to get to learn my likes, dislikes and what would be most helpful during labor. She gave us a realistic list of items I would need to make my labor more comfortable. Since then, I have provided my clients with that invaluable list and offer it in my textbook.

When the day came, Ilana had just returned from another birth she had stayed at for 13 hours. She had been home for two hours when I called. “Don’t worry,” she said, “I’m on mommy time.” My water broke and I went into active labor within minutes. The contractions were coming one after the other. She asked to hear a contraction. Did this mean put the phone on my abdomen? Or did she want to hear the sounds I was making? By this time, all rational thought was out the window. “What?” I asked. “Let me hear a contraction,” she repeated. Mine were silent. “I’ll meet you at the hospital.”

Once there, she directed my husband to get a different nurse and a private room for me. She disappeared for a few minutes and came back with a pile of waterproof pads and clean gowns. She opened her bag of goodies and asked if I was hungry or thirsty. And she held me. She massaged me. She danced with me. When the pains got intense, she took my face in her hands and said, “Give me the pain. Give it to me.” And the pains lessened.

When I felt I was losing strength, she told me to relax my feet and let Mother Earth’s power help me. She stayed by my side for 19 hours, encouraging me, honoring my efforts and nurturing me. And when my son was born, she told me how magnificent I had been. A week later, Ilana came to my home for a visit, bringing lunch, gifts, pictures and my birth story. We shared a life-affirming experience and I wasn’t going to let her out of my life since she had been such an important part of it.”

If this sounds like an experience you’d like to have, it is worth looking into hiring a doula.

How to find a doula

There are a few resources to help with finding the right doula for your specific needs. You’ll want to read reviews, choose several options, and then interview them to get a feel for the right fit for your personality. Here are some places to look.

  • Dona.org – Doulas of North America
  • Cappa.net– Childbirth and Postpartum Professional Association
  • Alace.org– Association of Labor Assistants and Childbirth Educators
  • Birthcenters.org– National Association of Childbearing Centers
  • Doulamatch.com– online database of certified doulas, where you can search by state, years of experience, and price.

Doctor or Midwife Office- many offices have a list of doulas in the area or that they have personally worked with before. This is a great sign that the office is mother-centered and practices evidence based birth!

Hospital—Similarly, some hospitals have doulas on staff full time that they offer to laboring mothers.

What does a doula cost?

A doula’s services can range anywhere from about $300-$1800. They will usually charge a down payment upfront and then collect the rest after delivery. Many doulas are willing to work with you on price if you are not able to afford their fee. Some believe that every woman has a right to have the support they need. Don’t rule someone out just because their fee is high. Check with them first and see if it is flexible, or if they would accept a payment plan. Many insurance companies are now helping to cover the cost of doulas as well, so check there to see if you qualify.

Having a baby is in itself a monumental accomplishment. A doula can provide the additional physical, emotional, and informational support a mother needs to navigate labor and delivery more easily. A mother’s birth experiences are some of the most significant she will have in life. Consider enlisting the aid of a doula to make it the most positive experience you can.

Sources:

  1. Bolbol-Haghighi N, Masoumi S, Kazemi, F. “Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial.” Journal of Clinical and Diagnostic Research. 10. 9 (2016):QC14-QC17. Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial-PubMed-NCBI. Feb. 2017. https://www.ncbi.nlm.nih.gov/pubmed/27790526
  1. Stillerman, Elaine. “In Honor of a Doula.” Massage Today. Dec. 2008. Massage Today Digital Issue. Web. Feb. 2017. http://www.massagetoday.com/mpacms/mt/article.php?t=38&id=13902

This guest post was written by Austyn Smith.

Cesarean Birth Postpartum Recovery

Whether you have a planned or unexpected cesarean section birth, the recovery can present challenges for any woman and being prepared for certain possibilities can help relieve you of added stress. After all, this is major abdominal surgery affecting nearly one-third of women in the United States and even higher numbers in some other countries; c-section prep and recovery are definitely worth thinking about and planning for, no matter what kind of birth you have in mind.

In Hospital Cesarean Recovery

If you know ahead of time that you will have a c-section, here are some things to bring and what to expect of your stay after delivery.

c section birth

What to bring to the hospital

Aside from your normal hospital bag, these few extra items might be helpful.

  • Nice shampoo and lotion. Your favorite shower items can be a nice way to treat yourself.
  • Clothing. Definitely do not pack anything restrictive that could cut into your incision area. Maternity pants, sweats, and robes are all good options. These high-waisted panties have great reviews for c-section comfort and a bit of support.
  • High fiber snacks. Many women report some degree of GI pain and discomfort following surgery, and constipation is not uncommon. Having some fibrous foods on hand to eat during your stay can aid in normalizing your bowels. Pack some easy snack items to munch on between meals. Apples, oranges, pears, berries, nuts, and dried fruit are all good options. Remember to drink as much water as you can!
  • Slip-free shoes. Slippers with rubber soles or flip flops will be handy when you go for laps around the floor and to the bathroom. It may be difficult to regain your balance post-surgery because you use all those core muscles that are currently on the mend. So make sure your shoes have good grip.
  • Fabric wrap for your waist. Purchasing a belly band or bringing some stretchy fabric to wrap snugly around your waist can really help with added support when you are moving around post-surgery. Even coughs and sneezes can be quite jarring to your incision area, so having that core stabilization is nice. It also helps to encourage your abs to come back together after separation during pregnancy (diastasis recti). Holding a pillow tight around your stomach when coughing or sneezing can also help ease the pain, but having a wrap or belly binder allows you to have support and free up your hands for holding your new baby.

What to expect post surgery

Hospital policies vary but a three or four day stay is most common. Recommendations for getting up and walking will vary based on the type of anesthesia you were given as well as how your body responded to it, but it’s not uncommon for the staff to have you up and walking around after approximately 12 hours. If 12 hours post-op falls in the middle of the night they will probably keep the catheter that was placed for surgery inserted and wait until the next morning. Some hospitals don’t suggest getting up to walk until 24 hours following surgery. This is something to discuss with your doctor to decide what is the best course of action for you personally.

Mobility After Cesarean Birth

The reasoning behind getting you up and moving as soon as is safe is to encourage good blood flow to your extremities and prevent clots. Walking will also help with digestion, but will likely wear you out, so don’t overdo it. Taking a lap around the floor every couple of hours is probably sufficient.

While you’re still in the bed you’ll likely wear cuffs around your lower legs that occasionally pump up with air and squeeze tight. These compressions lower the risk of blood clots when you are less mobile.

pospartum recovery cesarean

Gastrointestinal Issues

Some women may feel very gassy and bloated. This can make it uncomfortable to try to pass gas as well as cause discomfort to your incision area where the muscles used for bowel movements are still healing from surgery. Answering questions about whether you’ve passed gas or had a bowel movement yet can be embarrassing but the staff needs to know your GI tract is back up and working to ensure you don’t have any complications there.

Your first bowel movement can be a nerve wracking event. The act of pushing can be painful to your healing muscles so you’ll be given stool softeners beginning right after surgery to help minimize the amount of pushing required. Many women report the anticipation of pain during a bowel movement was much worse than the actual pain experienced while some women do experience severe discomfort.

Anesthesia, surgery, narcotic pain relievers, and decreased mobility can all contribute to constipation so it’s important to take the stool softeners regularly, drink plenty of water, eat wholesome fiber rich foods, and be as mobile as your energy and pain level permits to help alleviate possible GI issues.

Uterine Recovery

Following all types of birth the uterus needs to contract in order to expel any remaining blood or tissue inside of it. Some women report no noticeable afterbirth pains (the uterine contractions that occur after baby is born), while others experience such strong ones that they equate them to labor pains.

Whether yours are mild or strong, they serve a purpose. It’s important for your uterus to begin the process of shrinking back down to its pre-pregnancy size. The nurses will need to assess the size and firmness of your uterus but palpating your abdomen. This is typically a fairly uncomfortable assessment whether you’ve had a cesarean or vaginal delivery. They have to press down hard to accurately assess the size of your uterus as well as how firm it is.

A shrinking, firm uterus is what they are looking for, whereas a ‘boggy’ uterus could indicate a problem requiring medication to help it contract more. The act of pressing down on it through your abdomen can help it along as well, and while they don’t usually have to press down very long it can be painful. The nurses will use this time to assess your level of bleeding as well. We recommend this afterbirth tincture.

Postpartum Bleeding

Many women are surprised to learn that following a c-section you will still have very heavy vaginal bleeding, just like vaginal deliveries. This lasts for about 4-6 weeks and the protocol is the same—no tampons allowed, only big absorbent pads. Your caregiver will likely provide some large mesh disposable underwear to use after delivery. These are a great option for the first few days following birth as they typically don’t irritate your incision site or put any pressure on that area the way some underwear elastic can—basically they are glorious! Stocking up on these as well as large overnight pads (these are our favorites) is a good idea since you’ll be changing them frequently the first couple of weeks.

Passing some heavy clots is fairly normal. The rule of thumb is generally if you pass a clot smaller than your fist, it’s okay. Anything larger—call your doctor.

preparing for cesarean

Cesarean Incision care

Following surgery, your incision will be covered with a bandage that usually isn’t removed until the next day. Your incision will either be closed with sutures (dissolvable or non-dissolvable), staples, steri strips, or surgical glue on your abdomen. Staples and some types of sutures will need to be removed by your doctor a few days after you’re discharged. Before being discharged you will be given incision care instructions specific to your type of closure.

Keep in mind that your incision will look very different immediately after surgery than it will eventually. Most incisions will shrink down considerably and flatten to a thin line. Itching and tenderness around your incision is normal but annoying, anything more severe than that would warrant a call to your doctor. Try this spray or salve for expedited healing and scar reducing.

Advocate for Yourself at the Hospital and Home

Recovering from surgery, adjusting to new motherhood, getting the hang of breastfeeding—the first few days after a cesarean can be stressful and overwhelming. It’s important to make your needs known to the staff. If they don’t know your wishes, they can’t follow them. It’s your job to advocate for yourself and your new baby. Be open and clear with the hospital staff and expect the same from them—you’ll both benefit from respectful and clear communication. Never be afraid to request a new nurse if you aren’t receiving the care you feel you need or even if your personalities are not meshing well.

You never get the first few days with your new baby back again and they’re too precious to have marred by having someone around who puts you on edge, this goes for visitors and family as well. While well meaning and excited for you, visitors and family often end up putting more strain on mom than support. If friends want to come see the new baby make them earn the visit! Have them hold the baby while you take a shower or nap. Fold a basket of laundry while you chat. Fix some lunch or start a freezer meal in the oven for you. Have older kids? Ask friends to take them to the park for a hour and let them peek at baby when the come to pick them up.

You might be surprised at how eager people are to help when given specific tasks! But if the thought of a house full of people fills you with dread then don’t put yourself through it. Ask your partner or a supportive family member or friend to spread the word that you aren’t ready for visitors yet but appreciate everyone’s well wishes and put a sign on the door with the same sentiments.

what to pack for hospital

Breastfeeding after a Cesarean Section

The first few days, your breasts produce a nutrient-dense, antibody-rich yellow liquid called colostrum. Colostrum is nature’s first perfect food for baby and provides all the nutrition, immunity, and vitamins your baby needs. Colostrum usually transitions to mature breast milk within 2-6 days of delivery. It’s not unusual for milk production, or ‘coming in’, to be delayed following a cesarean due to the use of IV fluids and other medications such as Pitocin. Once this occurs your breasts will be much larger and you may experience some engorgement. The best remedy for the discomfort of engorgement is removal of milk from the breast by the baby. Your baby will signal the amount of milk she needs your breasts to make and your supply will normalize. There are wonderful breastfeeding resources to be found here.

Some women have no additional difficulties breastfeeding following a cesarean than after a vaginal delivery but some find positioning difficult while their incision area is still tender (we love this breastfeeding pillow for keeping off your incision). Utilize the lactation consultants at the hospital as much as you need them while there. It’s a great idea to have an outpatient lactation consultant’s contact info saved already prior to delivery in the event you need more assistance following discharge. Ask friends who have had fulfilling breastfeeding relationships with their children for references to check out before you’re home with a new baby, sleep deprived, and probably pretty emotional.

The International Cesarean Awareness Network has some great info available regarding breastfeeding after a cesarean that can be found here. Kellymom.com is a great breastfeeding resource website in general and wonderful article about breastfeeding after cesarean can be found here.

Recovery at home after Cesarean Birth

recovery postpartum cesarean

photo via @littlewhale3

Bringing a new baby home is an exciting time for everyone, but don’t forget to take care of yourself as well. Your baby needs a cared for mother as much as she needs to be cared for herself. Accept offers of help! People love to feel useful but may not know how best to help or are hesitant to step on toes. Give them direction and don’t be afraid to set boundaries when it comes to having people over. Physically, you’ll need to take it easy for a while. It’s often recommended that you not to lift anything heavier than the baby or drive for 2 weeks. After that, follow your body’s cues and rest as much as possible.

The best way to encourage a speedy recovery is to allow your body the time it needs to heal. Rushing the process can result in setbacks that will only prolong it. Once you feel up to it, which will vary for every woman, light exercises like walking can be beneficial.

Medication After C Section Birth

The types of medications prescribed for pain will vary from doctor to doctor and patient to patient. Ask someone (like your partner) to keep track of what time you take your medications as trying to remember on a sleep deprived brain is probably not the best plan. Many people recommend taking the meds on a strict schedule the first few days regardless of whether you’re in enough pain to feel you need it yet. This is suggested to prevent the pain getting ahead of you and then having to wait for the meds to kick in. Some people prefer to begin a slow weaning process off of the meds sooner if they don’t like the way they feel on them.

Pay attention to your reaction to the meds and to your pain level and make the best decision for your body. Don’t hesitate to call a nurse or doctor if you are concerned about any symptoms. There are many post-surgery symptoms that while totally benign, can alarm you if you haven’t experienced them before. Reach out for information when you need to.

Some women report referred pain in their shoulder during recovery. Not all women experience it, and it seems to be worse for patients who had general anesthesia vs. spinal anesthesia. The pain is due to irritation of the diaphragm, and trapped gas. Anti-gas medication and walking will help. The more regular you can get with your bowels, the sooner the pain will subside.

advanced maternal age

Bed comfort for Cesarean Mamas

Keep that wrap handy for when you get in and out of bed, to help with support. Wrapping before you get up and lay down provides stability and a little bit of comfort. Feel free to even keep it on for a while so you don’t have to constantly adjust it. Some women find it difficult to get up from a flat lying position in bed. Roll on your side first and push up with your hands to prevent straining your abdominal muscles. If this is still too uncomfortable try putting several pillows behind your back and rest or sleep in a reclined position. Your pelvis will be working to get back in its pre-pregnancy position and can ache after delivery. Try sleeping with a special pillow between your knees and ankles to help alleviate some pressure.

Night Sweats

There are lots of hormonal changes that take place right after delivery, and your body is also getting rid of a lot of excess fluid it carried while pregnant as well as any intravenous fluids given before, during, and after surgery. All of these factors combined might have you waking up at night to find the bedding and your clothes completely soaked. For the first couple of weeks, some women sleep on an extra sheet folded in half, or a towel so they can remove it midway through the night to have clean linens beneath them. Others suggest having clean pajamas handy for a quick middle of the night change. Remember to keep drinking a lot of water. It sounds counter-intuitive to replace excess fluid you are losing through sweat, but remember how much water is going toward milk production, so it’s necessary to keep things functioning well, and restore balance.

Mobility After A Cesarean Birth

For some women, stairs prove to be tiring and awkward to navigate the first couple of weeks. If possible, you might consider setting things up at home so that all the supplies for baby and for yourself will be mostly on one floor. Then stay in that area most of the day minimizing the need to navigate the stairs repeatedly. For other women the lure of being in their own bed on the second floor is enough to make it worth it. Just don’t hesitate to ask for help going up and down, even just having someone walk along beside you can be reassuring.

Keep in mind that your center of gravity has drastically changed and your body is still adjusting to that as well as healing from surgery. It’s not uncommon to feel off balance and it’s better to have help nearby just in case. Consider having pillows handy on both floors should you need to squeeze one against your abdomen while coughing or sneezing. Plan to give yourself plenty of time to recover, should it happen sooner than you planned—it will be a pleasant surprise! Be gentle with yourself.  All women are different. There is no ‘right’ amount of time for recovery. There are no hard and fast rules for a healing timeline. Listen to your body, introduce things slowly back into your routine, and ease into motherhood.

cesarean stitches

photo via @chan_askins

Emotional Recovery after Cesarean Birth

Take time to evaluate your feelings about your cesarean experience. Mothers with planned cesareans have the opportunity to consider this beforehand but may still find themselves overwhelmed with conflicting emotions after the fact. Mothers who had an unexpected cesarean may feel blindsided and it’s important to take stock of all of these emotions and know that they are all valid.

It’s ok to feel disappointed in the way your baby was born. If you had planned for or envisioned things going differently, it’s completely normal to be sad it didn’t work out that way. This does not take away from the love and joy you have for your child. You can be deliriously happy that they are here and still be upset about how they came. Birth trauma may sound like a dramatic way to describe it but it’s not uncommon for women to experience varying degrees of trauma after a cesarean birth whether it was planned or unexpected, or especially if it was an emergency situation.

Your Feelings Are Your Own

Birth is a highly emotional experience and any emotions you have towards your child’s birth are valid and you are not alone in feeling them. Perhaps your cesarean was calm, you felt respected, and things went smoothly—this is the hope for all women experiencing a cesarean. Many women feel at peace with their sections and might not understand why others are seemingly devastated by theirs. Other women are deeply saddened by having had a section and cannot fathom why someone would choose to have one unless necessary.

When speaking with other mothers or mothers-to-be, be respectful of others’ experiences and perceptions of their experiences. Just because you loved your c section doesn’t mean another woman is wrong for disliking hers. Just because you hated your experience doesn’t mean another woman is wrong for liking hers. Evaluate and process your own feelings towards your cesarean and reach out for help.

Find others who can be supportive of your journey of processing your cesarean. The International Cesarean Awareness Network provides support, education, and advocacy for women experiencing cesareans and interested in VBAC (vaginal birth after cesarean.) ICAN can be found online here as well as on Facebook and Instagram. They have local chapters across the world which can be located on their website. Many of their chapters have individual Facebook groups and hold in person meetings for support. Talking to other women who have experienced a cesarean is an invaluable resource for processing your experience as well as planning for a cesarean section or a VBAC.

Birth is hard. Birth is beautiful. Birth is transformative. Take the time to take care of yourself and be proud of what you’ve accomplished and experienced for your new baby.

This guest post was written by Austyn Smith and a very special thanks Laura Shawver and Elizabeth Quinn who provided lots of great information while writing this post.

Resources

  1. Hamilton BE, Martin JA, Osterman MJK, et al. Births: Final data for 2014. National vital statistics reports; vol 64 no 12. Hyattsville, MD: National Center for Health Statistics. 2015. https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf
  2. Althabe,Fernando; Belizán, José M.;  Betrán, Ana P.; Gibbons, Luz; Lauer, Jeremy A.;  Merialdi Mario. The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. World Health Report. 2010; Background paper, 30. Health Systems Financing. World Health Organization. 2010. [January 22, 2017]. http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf
  3. Basar, Birsen; Cift, Tayfur; Olmez, Fatma; Ustunyurt, Emin; Yilmaz, Canan. Shoulder Tip Pain After Cesarean Section. Journal of Clinical and Diagnostic Research. Ausust, 1, 2015 [January 22, 2017]. Bethesda MD: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576593/