• Julia

I'm planning a natural birth. Why do I need caesarean birth preferences?

You may be planning or preparing for an entirely physiological birth and have or have not discussed your preferences for this with your care provider. So why do I need to even think about preferences for a caesarean birth? Surely this won't happen to me and if it does then 'it's all gone out of the window' anyway?

First of all you need to be aware that today one in three women in Australia gives birth via caesarean. That's more than 30 percent. Pretty high, hey? One thing is for sure, not all of these women planned their casesarean, the majority probably did not but ended up with an unexpected caesarean birth - I am one of them. So we need to accept that caesarean births are part of the reality of giving birth and it is worthwhile spending some time on this topic as part of your preparation for giving birth. I did not when I prepared for my second birth and when it happened I lost complete control, had no idea what I could ask for or what could make a difference to my birth experience and emotional postnatal recovery. I have learnt from that and therefore include discussion of caesarean births now with ALL of my clients.

Here's the thing: Even during a caesarean birth there are OPTIONS and without knowing them you cannot ask for them. You'll have to hand over the reigns and become a complete spectator of your own birth. Ask yourself how that would feel, in particular if you hadn't planned a caesarean birth and it may have been one of your greatest fear. Fact is, most 'emergency' caesarean births (any unplanned caesarean is called an 'emergency') are not scenarios where your baby has to be born within 30 minutes or less and there is a great rush to get you into theatre. After it has been decided that you need to have a caesarean birth you may be waiting for an hour or so until there is theatre space and there is TIME to express

preferences. In that moment, when all your birth hopes and dreams may have come to and end it can be an incredibly empowering and reassuring feeling to pull your caesarean birth preferences out of your bag and say 'This was not my plan but we did think about this beforehand and here are my preferences. Please discuss with me anything you do not think you can facilitate.' There you are, still an active participant and birthing woman who is shaping her birth experience. Not everything may be possible, some things are depending on the team who's looking after you and their confidence levels (or willingness to accommodate) but you have a much greater chance of achieving things such as delayed cord clamping and taking your baby into recovery as examples if you ask for it and not just once but with everyone who is involved in your birth. Small things can make a tremendous difference in unplanned caesarean births and I can share with you that still to this day I regret not having had the awareness or preferences in place that asked for the drape to be lowered at the time of my son's birth. If I would have been able to witness with my own eyes how he came out of me I believe my emotional healing journey would have felt very different. Often caesarean mothers feel a disconnect in their involvement of having given birth but being an active participant who still makes choices and has to be consulted provides an opportunity to walk away even from an unplanned caesarean birth with a positive birth experience.

And last but not least, if a caesarean birth is something that scares you at present then you definitely should be spending some time on this topic, putting yourself into that situation and asking yourself what would matter to you if such a scenario would become reality. Because anything that is a fear before you give birth asks you to look at it as otherwise it may just present itself with even greater power to you during birth.

To identify your preferences for a caesarean birth a quick google search on 'baby and family friendly caesarean' will likely provide you with many examples that give you plenty of ideas and options to consider. Or alternatively you can of course speak to your doula who will guide you through the process and also be there for you and your partner if you ever find yourself in an unexpected caesarean birth. They do happen.

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