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Resolving Emotional Issues About Your Cesarean Birth

12 Mar

Some mothers recover quickly after a cesarean. They resolve and integrate their birth experience as one step towards becoming a mother. Some mothers who have had an unexpected cesarean after a long and painful labor may experience disappointment, loss, sadness, grief, guilt or anger. Often the emotional impact of a cesarean is misunderstood, dismissed, or overlooked. Sometimes mothers have unresolved issues about their cesarean. It is normal to experience a combination of positive and negative emotions.

concept for love, family, and harmony. mother hugging baby tenderly in monochrome

When you are ready, it is important to take the time to process your feelings about your cesarean before you give birth again.

  • Find the right time.
  • Find a safe place.
  • Find someone you trust.
  • Begin to share your cesarean experience.
  • What are the positive things you can think of?
  • Think about what you would like to have done differently.
  • Think about what you need to feel empowered and ready to labor for a VBAC.
  • Talk to your partner about how you feel.
  • Share your experience with other mothers who are likely to understand.
  • Reach out to a cesarean/VBAC support group.
  • Write or draw your feelings in a journal.
  • Hold your baby in your arms and share the positive feelings of your birth experience.
  • Gather as much information as you need to help you understand your cesarean and how to make the changes that you want for your next birth.

For more information about emotional issues after a cesarean download Module 8 of Deciding If VBAC Is Right for You. 

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Resources

Postpartum Support International

The Traumatic Birth Prevention & Resource Guide

Solace for Mothers

Birth Trauma Association, U.K.

Vancouver Birth Trauma

Trauma and Birth Stress, New Zealand

What Are the Odds of My Having a VBAC?

21 Feb

Although three out of four mothers overall who labor after a prior cesarean are likely to have a VBAC, planning ahead, having a supportive caregiver and patient and encouraging nursing care can make all the difference.

Here are some suggestions that may be helpful to you if you are planning a hospital birth: 1_Page_01

Before Labor Begins

  • Think about your VBAC as any other normal labor and remember that the majority of women who plan a VBAC give birth naturally.
  • If you have never labored before or labored and had your cesarean before active labor, the pattern of your labor will most likely be like laboring for the first time. So you will need more time to complete labor.
  • Make sure that you have discussed all of your concerns with your partner, caregiver, and your doula.
  • Find out if your hospital has an “early labor” lounge where you can be observed but not formally admitted to the labor and delivery unit. This will avoid your chances of having routine procedures and limiting your ability to walk and move around in the early part of labor.
  • Avoid an induction of labor unless it’s medically necessary. […]

For Fathers, Providing Support for a VBAC Can Be Challenging

6 Feb

A cesarean can be emotionally difficult or traumatic for fathers/partners. After a long and difficult birth that ended with a cesarean, partners may feel that a repeat cesarean would be safer than planning a VBAC. Some partners may not be sure they can meet the challenge of another possibly long birth.

Father holding newborn baby over black background

Each partner is different and needs to prepare in his or her own way for the coming birth. Partners should take the time to talk about the prior cesarean and define for themselves how they can best support their partners for a VBAC.

  • What advantages do you see for your partner, yourself, and your family if you plan a VBAC?
  • What are the disadvantages?
  • What issues do both of you agree and disagree on?
  • Can you think of ways of working through these issues?
  • Have you thought about accompanying your partner to a prenatal appointment?
  • Would you consider going with her to a VBAC support group?
  • Supporting a woman in childbirth is hard work. Are you worried you won’t be able to give her what she needs?
  • How do you feel about advocating for your partner during labor?
  • Have you thought about having a doula that can guide and support you both during labor and birth?
  • What information or resources do you need to make you feel comfortable about planning a VBAC?
  • You feel strongly that a scheduled repeat cesarean is the safest and easiest way to have this baby. Can you understand why your partner feels strongly about planning a VBAC?

An unexpected cesarean can be emotionally difficult for both mothers and fathers. Providing support for a mother who is planning a VBAC can be challenging. As couples think about their next birth,  fathers/partners should take the time to share their feelings, their concerns, and their differences so that they can provide the best support they can in pregnancy and birth.

For additional resources on planning a VBAC, download, Deciding if VBAC Is Right For You: A Parents Guide from the VBAC Education Project  VBAC Handouts For Parents

 

 

 

A Game-Changer: Toolkit To Support Vaginal Birth and Reduce Cesarean Delivery, Coming in Spring 2016

9 Jan

Unlike previous U.S. guidelines, consensus statements, position papers, and tool kits developed to reduce the high rate of cesareans, the Toolkit to Support Vaginal Birth and Reduce Primary Cesarean Delivery was developed by a multidisciplinary task force of over fifty expert writers and advisers representing physicians, midwives, nurses, lactation experts, childbirth educators, doulas, patient advocates, public health experts, policymakers, and health care purchasers. It is a comprehensive, evidence-based, how-to guide to support vaginal birth and reduce the first cesarean in low-risk mothers.

Developed by the California Maternal Quality Care Collaborative (CMQCC) of the Stanford School of Medicine, the Toolkit includes strategies to lower the odds for a cesarean during labor. The strategies can be implemented by women and clinicians as early as the first trimester. The Task Force acknowledged that most women do not have evidence-based information about labor and birth or about the potential risks of frequently used interventions that increase the risk for a cesarean. So it is critical that communications between providers and pregnant women be frank and comprehensive during prenatal care to help women make informed decisions about how they want to give birth.  365087516311

“ By identifying the major decision points that most impact the risk for cesarean delivery, “ the Task Force found that, “providers can markedly improve patient decision making and improve knowledge deficit.”

The underlying principles of the recommendations include respect for childbearing women’s values, choices, and cultural background. The Toolkit strongly recommends that women should be treated with dignity, respect, and cultural sensitivity throughout pregnancy, labor and birth, and postpartum.

The Task Force has included guidelines and recommendations for all stakeholders in maternity care from hospital administrations to healthcare insurance payers. The strategies that focus on hospital-based care encourage nursing skills which focus on promoting freedom of movement, fetal positioning, intermittent auscultation instead of continuous fetal monitoring, labor support techniques, and non-medical options of pain relief. Doulas are recommended as part of the collaborative healthcare team’s support for vaginal birth and reducing cesareans.

Although the main focus of the CMQCC Toolkit is on low-risk first births, nulliparous, at term, with a single fetus in a vertex position (NTSV), the philosophical principles and specific recommended strategies can be applied to all women giving birth.

While the Toolkit is meant to guide individual hospitals and provider level change in California it also includes guidance for state, county, and hospital system-level change. Hopefully, this game-changer Toolkit will eventually be adopted by maternity care stakeholders across the U.S.