Did you have a birth plan for your elective c-section?

[dmom]

Lexi:

I know what you mean. I was so scared about my daughter having a BPI that I never considered the after effects to me of major abdominal surgery!

The side effects I had from fentanyl were mainly a terrible feeling of nausea and a feeling like I was going to faint. I felt so cold and clammy and out of control. I really had to fight to get the nurse and anesthesiologist to agree to at least turn it down in my epidural. They didn't want to and gave me a really hard time about it (just what you feel like after surgery - pleading with the staff to make you feel better). They were sure I would go insane with the pain if they turned it down. But once they turned it down and gave me the pills I wanted, I was just fine - (and even gloated a little! ha!)

After the fact, I have to say I preferred vaginal births. But the C-section was necessary for the safety of my daughter - so I was happy I did it.

Incidentally - not that anyone cares, but ...I do know how to spell "vacuum." Not that it showed in my first post! (Brain freeze?!?!)

Janet

[admin]

Thanks, Janet.

At least I'll know to ask about possible side effects before the c-section, so I can be prepared!

Lexi

[KDs Daddy]

I did have a section plan...but it kind of got thrown out of the water when I ended up in the hospital at 34 1/2 weeks.
to make a long story short....I went into labor at 35 weeks and 1 day, they had to stop (try too) my contractions so the doc could get there to do the c-section. Sammantha Diann was born premature at 9lbs 1oz (no mistake in due date).
The incision was from hip to hip and the doc still had to use the vacuum because she was in a bad position.
The child was built like a linebacker,,,monster shoulders....she spent a few days in NICU, needed oxygen, and almost needed a feeding tube but thanks to a wonderful nurse, that worked hard with her to learn to suck/swallow Sammy didn't need the tube. AND she has two moving arms.
After, I dropped the IV drugs for the pills,,,,I too did not like the affects the pain meds gave me. I had uncontrollable shaking, and wanted to puke. I didn't have to fight much,,,by this time, I think my OB was tired of fighting with me!!

[KDs Daddy]

OOOPPPPs,
I'm not KD's Daddy, I'm KD's Mommy

Sorry,
Jeni

[TNT1999]

Jayne, I looked over the template birth plan for c/s and just wanted to say that it's great! I thought that my c/s birth plan was very thorough, but there were things I would've added had I read that template first! Of course, I think my OB and my husband prob. both felt that my 2-page document was long enough! Thanks for sharing this plan --not that I'm planning another childbirth b/c I'm NOT, but it was interesting to read. I saved it and will share it w/future Moms who might benefit from it.

~Tina

[Tanner's Mom]

Jayne,

If possible could you please email me the c/s birth plan as well? I would REALLY appreciate having it and being able to share it with other mothers who have decided to have a c-section.

Thanks so much!

Lisa
Lisa@ubpn.org

[TNT1999]

Lisa, if you click on the first link that Jayne (UK Mom) posted, it brings up the document into Word and you an just save it. That's all I did. ~Tina

[Tanner's Mom]

Tina,

LOL! Okay....feeling like a total idiot. Thanks so much for pointing out the obvious. Somehow I missed that when I was scrolling down the page. Have no idea how. I was just thinking she emailed it to you directly.

Thanks!!!
Lisa

[Tanya in NY]

I have not personally had a cesarean section, but I did have have abdominal surgery right after my BPI daughter was born and had spinal anesthesia (also I'm a labor and delivery nurse that does mother-baby care), so here's my two cents worth.

I did have fentanyl and duramorph for my spinal anesthesia. Let me say from first-hand experience and from being a L&D nurse who takes care of mothers after a cesarean, that the Duramorph in a spinal for anesthesia is a wonderful medication to use. It allows you to have much less discomfort than if you were to use a PCA (patient controlled analgesia where you push a button to get some morphine through your IV) or from a continuously infusing epidural. You get the Duramorph in the "shot in your back" that is initially done for the surgery. Nothing is left in your back (like with an epidural) and the medication works for pain relief for 12-24 hours depending on the dosage. Some women get really itchy afterwards, but cool cloths to the face and some Nubain for itching relief in your IV can be very helpful. Sometimes doctors write for a dose of Benadryl for itching relief, but I wouldn't recommend it as multiple doses of Benadryl can impeed your milk production if you are breastfeeding (same with sudafed). Most of my patients (and I'm talking 90% of them) are up walking around the room within 8-10 hours after delivery. Some get up sooner per their own request. Of course, it's not running around the room and it's slow moving because you did just have major abdominal surgery, but you are able to walk to the bathroom to brush your teeth, get into a chair for a position change, pick up your baby to take care of it, and essentials like that. Some hospitals or anesthesiologists do not like to use it because it works for 12-24 hours and therefore has a small chance of affecting your respiratory system for that time period as well. I have been doing L&D for 4 years now and have NEVER had this experience with a patient. Checking on the mother frequently and family members visiting them significantly decrease this chance.

As far as a birth plan, I would highly recommend one. It allows your doctor AND the nurses taking care of you what your wishes are related to the birth of your child. You do have some control here. Your doctor should view the written version and he/she should sign and date it in order to make sure they agree to everything on it. Sometimes they may want to change some things or add some things as a suggestion, so by them signing and dating it, it is considered agreed upon by you and the provider. A signed copy should go in your chart and you should bring a signed copy with you to the scheduled delivery day so there is no confusion.

-what about a baby-friendly cesarean??? (at my hospital, if we can get a private room in the recovery room the day of the delivery, then the baby goes up to the L&D unit for about an hour to do all the regular nursery stuff while the mother's surgery is being finished then when mom goes to the recovery room, the L&D nurse brings the baby down to the mom and stays with her and the baby to help with breastfeeding and bonding, this way the recovery room nurse is not responsible for the baby since they may not have newborn experience)

-if the above is not possible, then what about bringing you the baby the moment you return to the postpartem unit?

-if you are breastfeeding, what about no supplements (bottle of formula or water, pacifiers) while you are in the O.R./recovery room

-if everything is okay with the baby, what about unstrapping one of your arm so you can touch the baby while in the O.R. (what I do is unstrap one arm [the other one usually has the IV in it and I can't reach it]and lay the baby in a blanket on the mom's chest area sideways [the head near one shoulder and the feet towards the other shoulder of the mom] and hold the baby there for mom so she can get a good look and touch her baby; dad can help with this too if he is present for the delivery

-waiting until 1 hour after delivery to put the erythromycin drops in your child's eyes (if it is mandated where you live) so you can see your child's eyes prior to this as it makes things messy and fuzzy for the baby

Forceps and vacuum can be used in a cesarean delivery if the baby is in an "awkward position" according to the doctor. This is less vigorous than in a vaginal delivery, but there is still the potential for issues related to their use (bruising, skin injury, tissue damage, etc.). Talk with the doctor about making a generous transverse abdominal incision prior to attempting to deliver your child. This could cause a bit more discomfort for you after delivery because the incision is a bit larger, but that as a trade off for an uninjured child in my opinion is well worth it. There are a small percentage of c/s deliveries that can result in BPI. Usually, but not always, these c/s are emergency in nature so the delivery of the baby is much more vigorous than an elective scheduled cesarean.

Here's a great website for birthplans:

http://www.childbirth.org/interactive/ibirthplan.html

I hope some of this information is helpful to you. The most important is that you speak with your doctor about important issues for you related to YOUR cesarean. If he/she cannot acommodate your wishes, then you can possible compromise. But if you don't bring the topic up, then you can't expect it to happen like you'd wish. Good luck to you and hopefully you'll have a gentle and wonderful experience. Feel free to email me if you have any questions.

Tanya in NY
(Amber's Mom, 2 1/2 years old, ROBPI)

[solson]

Tanya, thank you so much! Your info was incredibly helpful. I had already read some info on Duramorph but your additional info helped me make a decision regarding it. I needed that perspective to see that I wasnt way off with wanting to request certain things for my c/s.

Thanks again to everyone, this is really helping me! Only four weeks from Monday!