Unplanned Cesarean Birth - When Plan C becomes the Best Choice.

I work with expecting mothers. I educate families, help them prepare for their upcoming birth and we invest a lot of time talking about their birth preferences, worries, anxieties, and wishes. Before I continue to write this blog, I want to make one thing clear: a cesarean birth is NEVER the easy way out. It is never the lesser choice. It is not something to be frowned upon. It is not a choice that needs an explanation. It is birth.

We need to acknowledge that a c-section may be a woman’s Plan A. It may be the desired birth. We don’t need to understand the Why. A doula has a place in the support of families that are welcoming their child via cesarean birth, or “Kaiserschnitt” as it is called in Germany (Kaiser means emperor). As a doula, I am here to support all births because all mothers deserve to feel empowered throughout their unique journey. Being “in control” feels different when you are giving birth in the operating room. This is why I pay a lot of attention when preparing my clients for their upcoming c-section. I pay the same amount of attention to the possibility of a c-section when talking to my clients that wish to give birth vaginally. Sometimes, a cesarean is not a choice.

Most of the women that hire me do so because they are planning for a vaginal birth. Quite a few of my clients are mothers who are seeking a VBAC (vaginal birth after cesarean). I work with many first time mothers as well, and a c-section is usually the single most important thing they all want to avoid. I always ask my clients about their wishes and “hard No’s” and the cesarean birth is often listed as a hard no. The absolute last resort. Why is that, I wonder? Is it truly because of the inherent risks or is it in part because society has led us to believe that a cesarean is a bad thing? Is it because they are worried about the surgery and the recovery, or maybe we see a cesarean birth as a sign of weakness, not having accomplished the vaginal birth we longed for? I have heard from mothers who say that the c-section felt like “an embarrassment”, as if their bodies failed them. I am here to tell you that none of this is remotely true or accurate. Sometimes your Plan C is your single best choice.

I have supported a lot of births, and never once did a cesarean mean failure. It meant life. Your unplanned c-section becomes your best choice when it means that it will save your life or the life of your unborn child. This does not mean that an unplanned or emergent cesarean is not traumatizing. It does not mean that you should not grieve your “dream birth”. It also does not mean that every unplanned cesarean was indeed necessary. I have learned that a mother that is well educated about the possibility of a cesarean birth is a mother than can make empowered decisions that leave her with an overall better birth experience, regardless of the way her baby enters the world. This is why we need to raise awareness. We need to prepare and strategize around Plan C. Knowing what you would like to happen if your baby is born in the OR can make all the difference and it will help inform your providers. Knowing under which circumstances you are ok with your Plan C becoming your Plan A is a conversation that should happen when preparing for birth.

So, let’s take a look at what planning for Plan C means. For my clients, it means that we will talk about all possible birth journeys. We will talk about interventions, and we will talk about cesareans. My clients will understand what it means to undergo surgery, what to expect from their recovery and how they can make decisions ahead of time. They will know the risks and the benefits. We will inquire about hospital policies and procedures so that they can choose to birth at a hospital that can meet their wishes in the case of. We will define what those wishes are. Immediate skin to skin, lowering the drape during birth, pictures in the OR, music or aromatherapy, vaginal seeding, gentle cesareans. Unless your c-section is emergent, you usually have choices. Even in the event of an emergent c-section, there are still choices to be made. Who will be with the baby after birth, how will we document these hours for the mother, what about breast-feeding? Formula? Pacifiers?

I want to work on taking the scary out of the procedure by providing information and raising awareness. It is not easy. It is not fair. But sometimes it is necessary. C-section mothers are some of the strongest mothers I know. They don’t need pity, they need to be elevated. We don’t need to feel sorry for them, we should be in awe of them. It is time to change the dialog and recognize the strength these women display! No, I do not want to normalize cesarean birth but I want to normalize preparing for one so we can make sure our wishes are taken into consideration regardless of the way we give birth to our babies. I hope that reading this blog can help you think about your Plan C. I also hope that you won’t need to implement it.

Thank you to Stacy, the amazing woman in my cover photo and Jessica Mann Photography in Virginia, who took this image.

“Wear your Scar with Pride”