Doulas & Caesarian Birth

A lot of people believe that a doula is only useful if a natural, holistic, vaginal home birth is the goal, but it’s not the case.  Quite the contrary!  As birthing mothers and their babies are all different, so doulas offer support in all variations of birth, including Caesarian sections.

A Caesarian is the ultimate in birth intervention since it is the last resort (or should be) medical approach.  So is a doula still useful if a mother is having a C-section?  YES!

First, let’s ask a couple of questions:

  1. Is the C-section planned?
  2. Are there any pre-existing medical conditions?
  3. Is the C-section a doctor’s recommendation or a personal preference?

If a C-section is planned, then birth is not likely to begin spontaneously.  The process will be medically induced and on the mom’s and doctor’s schedules.   When labour is allowed to begin and progress naturally, the body and brain have time to release all the necessary hormones that are crucial for cervical dilation, pelvic opening, and baby descending.  Plus, we have to remember that baby is also getting some of the hormones that mom is releasing, so in a way, they are already communicating with each other about the upcoming process!  AMAZING, huh?!  C-section babies often need more time to get breathing on their own, get adjusted to being outside the womb (because they didn’t have the hours of prep), and can take a bit longer to start breastfeeding.

If there are serious medical conditions that cause a caregiver to recommend a C-section, then it can be beneficial to follow those recommendations.  However, the choice is still mom’s!  If a caregiver is recommending a C-section for a subsequent birth because a prior baby was a C-section, it is still possible to have a vaginal birth after Caesarian (VBAC).  My mom did it after two C-sections!  There are many factors that can affect the outcome of this including how much time has passed since and method of uterine stitching that was used in the previous birth, whether this birth has been induced or augmented, and general health of the mother, but if a mother really wants to try to have a VBAC, it should be encouraged!

And if the C-section is a personal preference, we should first ask “why?”  Is it a fear of pain?  A scheduling matter?  Or a worry that birth will destroy your vaginal tissue?  Whatever the case may be, the opportunity to birth one’s baby should be celebrated!  No need to dread it.  The fear of the pain is what makes the pain worse.  Knowing that it’s pain for a purpose and perfectly natural can make so much difference.  As for scheduling, well, we can’t control everything in life (I know, I wish we could too sometimes).  And about destroying the “downstairs business”, there are ways to heal and return things to normal — they may be a slightly different “normal”, but pelvic rehabilitation does exist and it is important.

Despite what the movies and TV might make us think, a vaginal birth is a lot more peaceful and calm than a surgical birth.  Surgery is SURGERY afterall.  There’s the bright operating room, probably 6-10 medical professionals in the room, anesthetic, IV tubes and needles, heart monitors,  stitches, and then recovery time.  It’s definitely not the “easy” way out of birth.

“So what? Where would a doula come in then, VANESSA?” — you
Ok ok, I’m rambling.  Doulas provide parents with information and education on the birth process, including Caesarian birth, and postpartum procedures.  If ultimately a mother decides that a C-section is right for her and her baby, then she will have made that decision from an informed place.  Sometimes, depending on the anesthesiologist, a doula will be allowed in the operating room.  A doula will be there to help keep the birth process a human experience, keep the calm and normalcy.  She may describe what is happening on the other side of the curtain in a calm manner.  She may whisper in mom’s ear that this too is a beautiful birth experience and that her baby will soon be in her arms.  She may remind the partner to go with the baby and talk to her while the nursing staff clean baby up so she has a familiar voice to connect with.  She may tell the partner to open up that shirt so baby can get on his/her chest ASAP.  And after the operating room business is complete, a doula will be with you to help establish breastfeeding and additional bonding with baby and then do a postpartum visit with you a day or two later to make sure all those things, and healing, are going well.

Moral of this (long) post:  Don’t underestimate the usefulness of a doula!  Besides knowledge, a doula can provide confidence and comfort in an otherwise stressful situation full of unknowns.

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