Ask a Doula: How can a doula assist my family during a planned, medically necessary C-Section?

A doula assists a birthing family in the OR at Abbott Northwestern.

A doula assists a birthing family in the OR at Abbott Northwestern.

We are excited for our first “Ask a Doula” post to have responses from not one, but two of our Collective doulas! On the heels of April’s International Cesarean Awareness Month, a mama on our Facebook page asked, “How can a doula assist my family during a planned, medically necessary C-section?”   Women having a necessary surgical birth still have choices for this important day! If you know you’ll be having a surgical birth, interview several providers and find one who can help you have the cesarean birth experience you want.  If you’re interested in learning more, check out this video on the  Natural or Family-Centered Cesarean movement being implemented in the UK. 

Our first doula response comes from Karrie Nesbit CD(DONA), CLC, HCHD: 

When considering a planned surgical birth, getting the information you need to make informed decisions is critical.  A doula will ensure you understand all of your options, and because a doula is not accountable to your provider, she will provide you with unbiased information to help you make the decisions that are best for your family.  With such a wide variety of birthing options available nowadays, it can be comforting to speak with a doula about her experiences with different birth techniques, providers, and birth places.  In short, if you are not completely comfortable with the options you are getting from your provider, a doula can help you find more of what you are looking for with other providers or birth places.

Once the decision to have a surgical birth has been made, your doula will prepare you for what you are going to see, hear, smell, and feel during the birth.  I find that for most families, just knowing what to expect takes away a lot of the anxiety.  Sometimes the  hospital staff forget to explain the details, or they explain them in a way that is not calming or easily understood.

In the operating room, your doula will explain procedures as they happen to reassure, comfort and calm everyone throughout the process. She will help you understand the circumstances immediately following the baby’s birth. If the partner needs to leave the operating room with baby, the doula will remain with momma. Whether in the operating room or recovery room, your doula can help facilitate skin to skin and breastfeeding.

Above all, doulas encourage and help you to speak up for what you need and want for your baby’s birth.  No matter how your baby comes into the world, the presence of a doula will help you to look back on your baby’s birth as a positive and empowering experience.

Our next response comes from Gina Picht with Partners in Birth: 

Sometimes when a family finds out they need or chooses a planned Cesarean birth, they stop thinking of it as a birth.  It becomes a procedure, a “section”.  Something that the doctors do to them, not them birthing their baby.  A doula’s role becomes the keeper of the birth, bringing the focus back to the family and how they can best work with their circumstances to welcome their baby is a gentle, interactive way.

Your doula will likely meet with you before the day of surgery to review options, which some families are surprised to learn they still have!  Cesarean birth is more and more viewed as an experience that can be tailored to a family’s wishes.  Hospitals and even doctors themselves handle the surgical experience in their own unique way.  It is worthwhile to ask questions beforehand to better understand what options may be available to you.  Your doula can arrive early with you and help keep you relaxed through the preparation process, giving massage, using scented oils, dimming lights, and offering guided visualizations, just as in labor.  As questions are asked of the family by the medical staff, the doula can help give context for those questions, and help get more information when needed.

When the mother goes into the OR to get anesthesia, the partner is usually left alone outside the room.  Your doula will stay with your partner during this time and can be a calming presence in an unfamiliar time and environment.  Most often, the doula is allowed to join the family in the OR where she continues her support, using massage, her calming voice, and maybe a scented oil to mask any surgical odors.  If desired, the doula can narrate the procedure to some extent, letting the family know at what stage the surgery is and when the birth is close.  The time it takes to get to the baby can seem incredibly short, and the doula helps the family participate emotionally in the process, anticipating that moment when the baby is born.  She can encourage the screen to be lowered so the family can see the baby when it’s born, and advocate for the mother’s hands to be unstrapped so she can touch and hold her baby.

In certain cases the mother will feel ready to attempt nursing while the surgery is being finished.  If not, the doula can assist with this in the recovery room.  If the baby needs to leave the OR for any reason, the partner usually goes with the baby so the doula will stay with the mother.  She can help the mother process the experience, and go to get updates on the baby’s condition, maybe bringing back photos to help the mother stay connected.  Of course as soon as possible, the doula will encourage the mother and baby to reunite, facilitating skin-to-skin contact and breastfeeding.  And lots of photos!

A Cesarean section is still a birth.  In the end, a family is born, and a doula can help bring the focus back to that family.

Karrie Nesbit is a doula and lactation counselor who recently relocated to sunny Southern California. Find out more about Karrie at Birth, Etc.

Gina Picht has been a birth doula since 2001 after the birth of her second (and last) child. She is Treasurer of The Childbirth Collective and lives in Eden Prairie.  She believes all women already know how to birth.

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