Cesarean Birth |Tips for Doulas

Originally posted September 2011:

This morning (shortly after posting the video below) I got the call and raced out the door to attend my final certifying birth. We had anticipated a Saturday morning cesarean arrival but this little girl wanted to pick her own birthday, which was just fine with everyone involved! (Going into labor helps increase the odds that baby was ready to arrive, decreasing the chance that baby was not quite baked and will need interventions. It also provides baby with the lovely benefits of those contractions to help stimulate and squeeze their lungs.) This baby girl came out healthy and perfect and beautiful, and I was honored to be able to attend and witness (and photograph) her arrival. Hopefully I provided some doula support, too. 🙂

Having only been in the OR for my own cesarean birth (which left me few memories as I was under general anesthesia!) I was a bit nervous. I watched several videos online so I would know what to expect from the logistical and medical standpoint. I spoke with doulas who've attended births at this same hospital, and asked moms what their own cesarean birth experiences were like. If they had doulas (or didn't!) I asked what best helped or what type of support did they wish they had received?

When I arrived (only an hour before this eager little girl arrived!) I was shown where to get scrubs, shoe covers, a hair cover, and a mask. Sometimes the partner and doula can accompany the mother in while she receives her spinal or epidural, sometimes not. Either way when it's time you'll be ushered into the OR (as I was by the anesthesiologist) and everyone will be prepping. The advice I wisely followed was to not touch anything on, under, or behind a drape! I didn't know if I would be restricted to one part of the OR but I was pleasantly surprised to essentially be given free access to wherever I wanted, as the mother and OB had already discussed her wishes regarding photographs. The anesthesiologist at one point grabbed my camera to snap photos and suggested what he felt were the best vantage points for shots. The doctors promised me they would give me warning before the "good shots" and everyone was incredibly welcoming. There are a lot of cords and wires on the floor and some areas with drapes so I was careful to not accidently trip and yank on anything!

For anyone uncomfortable or squeamish, it's good to be aware that a cauterizing tool is used and this causes a burning smell. It can be alarming for parents, so let them know it's perfectly normal! A doula suggested putting a drop of peppermint essential oil inside your mask (and the partner's mask) if there's concern about it making anyone queasy. For partners that may be concerned about seeing the procedure, a stool is provided by the mother's head and a drape is raised so the surgical area isn't visible. If you DO want to watch the birth then let the anesthesiologist know and the drape can be lowered at the right time. If you are especially curious and the staff is comfortable with it, you can even ask to take photos of the birth (if mom so desires. Always check with mom!!)

Once baby is out they will quickly examine the baby, ideally within the mom's line of sight or on her chest if possible. Some hospitals are doing skin-to-skin in the OR but that may not always be possible. If mom is not able to hold the baby right away it's nice for the partner and doula to make sure one person is with mom reporting back the lovely information about height and weight and the other support person is staying with baby. We were able to go back and forth so I could share photos of the baby with mom and also capture some video while trying to make sure mom and baby were neither alone!

From the OR mom goes into the recovery room for some observation time before being taken to her postpartum room. Some hospitals will take the baby to the nursery at this time but more are recognizing the importance of keeping baby and mom together! If mom wasn't able to have baby latch on in the OR then in recovery she can try, with a lot of pillows to assist with positioning. This is also where mom and dad can unwrap their sweet bundle and spend some time skin-to-skin, counting all those tiny toes and fingers.

The very helpful anesthesiologist also asked if we had an iPhone or iPod, but we did not. He kindly supplied his own and asked for music requests, which can be a nice distraction for parents as they wait for their little one to emerge. Check with your OB to see if this is an option.

Having only attended this one cesarean birth I have just barely begun to learn how to best support parents. The video below has some fantastic ideas for how to have a more gentle cesarean birth and I highly encourage you to check it out and talk with your doctor about your options to make your baby's arrival even more special. I hope some of these tips will help other doulas and moms, too! I'm incredibly grateful to the many people who provided their insights, helping me to better serve parents through their birth experience.

Here's an excellent link for how a doula can help facilitate skin-to-skin in the OR.