birthED

View Original

birthEDucated - Family Centered Cesarean

The term “Family Centered Cesarean” gets tossed around a lot in hospital and birth settings as a thing that many hospitals claim to offer. While we have seen a lot of family centered cesarean elements offered in our local Twin Cities Hospital - we rarely find that these types of births are offered as a standard practice. Many times families have to know the things to ask for in order to get all the elements that we know as doulas and childbirth educators really do make all the difference to the birthing family.

We are hoping that if we arm enough families with the information of what is possible during a cesarean surgical birth, slowly but surely all the area hospitals will begin matching their policies to what every family should be offered regardless of whether they have a birthED handbook in their bag.

Recently a lovely birthED family was preparing for their VBAC after their first born was born via cesarean. They did ALL the things and made such intentional choices along the way. Selecting Roots Birth Center as their birth location, hiring a doula, getting bodywork, and taking our birthED VBAC Prep class. As it goes with all birth - the baby does get to have a say in the process. This sweet second born baby decided to sit butt down in a breech position and refused to move even after two attempted ECVs (External Cephalic Version), chiropractic, and acupuncture/moxibustion.

When the decision they were faced with now became whether they could find a doctor willing to provide vaginal breech birth or to schedule a repeat cesarean birth (CBAC) it wasn’t much of a decision at all since the area doctors sadly are not trained in and do not perform vaginal breech birth.

The planning of the surgical birth began and included multiple elements. First, the family wanted to find a doctor they trusted who would offer them the following elements:

  1. Planned cesarean as close to the due date as possible to ensure baby was fully ready to be born.

  2. Welcome their doula throughout the birth and postpartum

  3. Give them space and time to ask questions and provide full consent or refusal of all the elements during the birth

They also needed to find a hospital and anesthesiolgist who could provide them their list of needs:

  1. Doula present continuously from arrival, to spinal placement, throughout birth, and in postpartum without separation at anytime.

  2. Walking on their own into OR.

  3. Music of their choice played throughout labor.

  4. Heart rate monitors on the back and sides to make room for baby on the chest.

  5. Arm rests that are NOT with arms strapped down.

  6. Communication of what is happening at each stage of the birth.

  7. Clear drapes to see baby immediately when born.

  8. Delayed cord clamping as long as possible in an open incision/OR type setting

  9. Very little separation of baby - if baby is well baby should be put on the warmer only for a few seconds then immediately placed skin to skin on birthing persons chest.

  10. TAP Block for pain relief to avoid pain requiring narcotics.

  11. Freedom that if all is well to leave on the earlier side from the hospital to get home to their older child sooner.

This list of wish items are things we have seen plenty of times in the past decade of birth work in the Twin Cities - but it takes a certain magic wand to make them all happen at once. Our hope is that ALL cesareans not requiring general anesthetic would have these elements as their standard offering.

Luckily this family found these items and this doctor/team at United Hospital in St. Paul.

Join us as we walk through their planned repeat cesarean …

Thank you to this family for allowing us a sneak peek into their magical day! Also thanks to…

Nicole Stecker RN (Nurse)

Brett J. CRNA

Dr. Corcoran (OB)

The whole team at United Hospital