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“Obviously, you’ll be having a caesarean” said my husband when I was four months pregnant.
“Er – No! How could you suggest such a thing?!” I responded with hormone-fuelled outraged incredulity.
A hippy at heart – I’d always imagined a zen birth scene with spa birthing pools, hypnobirthing and breathing through the pain, entirely drug free. I was shocked that anyone, especially my husband, could suggest anything less natural.
I was overlooking one teeny-tiny fact…
“Well, with that pelvic surgery you had… I just kind of assumed you wouldn’t have a choice…”
Oh. That.
Yes. I had completely forgotten about that: my teeny-tiny pelvis.
It has caused me problems my entire adult life, despite an operation when I was 24 to minimise the issue. Yes, it did successfully minimise the problem for day-today living, but unfortunately it couldn’t rectify it entirely.
So, it turns out that Husband was being quite reasonable in his assumption. But somehow, wrapped up in my Earth Mother reveries, it had never crossed my mind. Until now.
Obviously, I would indeed need to have a C-section.
I was both gutted and immediately resigned to the fact.
The Medical Opinions
On hearing the details of my medical history, my midwife agreed emphatically with a C-section: “I’m glad to see you’ve got your head screwed on right about this and aren’t going to try to wing it like some delusional hippy Earth Mother. (Ahem!) Far more important that you are both safe and that you don’t cause yourself more problems.”
Well, I had rather hoped she’d be a bit more positive about natural birth – isn’t that what midwives are meant to do? But between the Lilliputian Pelvis and my advanced maternal age (so rude!) – I couldn’t really argue with her logic.
Closer to the birth, a Consultant signed off the procedure without question. He did comment however that there was a possibility that natural childbirth could solve the small-pelvis issue for good.
I found this an interesting perspective. But – he followed up by saying that – if my mini pelvis is “normal” for me, having a baby tunnelling through to permanently enlarge wouldn’t necessarily solve the problem. It could potentially just cause extensive damage and makes the problem a whole lot bigger! Eugh.
And this was assuming that my pelvis played ball – and the baby doesn’t just get stuck. So, the reality was likely to be far more horrific and risky for all concerned.
What was the point of going through many hours of exhausting labour when you had an extremely high likelihood of ending up with an emergency C-section anyway? Not to mention the potential pelvic longterm recovery issues. Far better to elect for the surgery and prepare mentally accordingly.
My view of one very healthy sized baby waiting to come out through the sun roof!
Preparing Mentally
Around seven months pregnant, having largely ignored the whole birth shindig for at least a trimester, it was time to face facts. I did some research so I knew what to expect. I took time out specifically to get my head around having major surgery… and my body’s “failure” to be able to give birth naturally.
The mental preparation was hard. There were tears. After years of problems, multiple miscarriages and now this: I felt once again let down by my body.
I had to had to give myself a good talking to on this point. I should be grateful that I wasn’t living a hundred years ago – when I doubt I would have survived the miscarriages (but that is another story) – let alone get this far.
Even with modern medicine, though, ceasareans come with risks that scared me (even though I knew that, for me, the risks were far greater without one!) It is major surgery, with a long recovery period, and significant scarring to show for it.
Not to mention the logistical issues such as not being able to drive or pick up anything heavier than my baby for six weeks (more of an issue the second time around when there was a jealous toddler in the mix). Nor the additional difficulties it can bring with breastfeeding due to struggles with comfortable positioning.
Take it from one who knows: C-sections are not an easy option. They can literally be a life-saver – but they work better with plenty of forethought and planning.
Where to start?
I began by reading Caesarean Birth: A Positive Approach to Preparation and Recovery.
This comprehensive guide talked me through what to expect and helped me work through the emotional elements. It also introduced me to the lovely concept of the “Gentle” caesarean. (Also called a Women or Family Centred caesarean: all broadly the same idea.)
I trawled the internet and think this gentle concept is best summed up in “The natural caesarean: a woman centred technique” video below. So rather than explaining the concept, I suggest you watch this as it really brings it to life… (Don’t be put off by the first graphic – keep watching – it is worth it!)
Although it is a few years old now, the video was still the best I found. And the advantage is that a lot of what is suggested here had already been adopted as standard practice for elective surgery at my hospital.
A word of caution, if you are considering a caesarean – please don’t just search randomly on YouTube as you could terrify yourself! I recommend this video partly because it is one of the few that I found that wasn’t like an excerpt from a horror film.
Even better, this video changed my whole perception of this sort of birth experience. I actually started to find the concept comforting, realising that non-natural births could also be beautiful experience. It was soothing.
I realised that the important thing was not so much how my baby was going to arrive – but their birth would be magical regardless. The only important thing was to get them here safely.
Creating my Birth Plan
As the weeks passed, I knew I needed to put together a Birth Plan. I wanted one that embraced the gentle, woman-centred concepts and finally created something that I felt comfortable with.
It covers all the areas which are useful to consider in advance. The doctors were happy to go through it in beforehand. They managed my expectations and I amended it accordingly.
You can read the final version of my birth plan – which I updated based on my first experience for the birth of my second daughter – here:
My gentle caesarean birth plan – an example to give you some ideas for things to think about when planning your birth – even if you don’t expect to need a C-section.
Plan C: preparing for an emergency
It would appear that in the Western world at least, caesarean section birth numbers are going up. Perhaps due to the increasing numbers of older mothers like myself.
Our NCT antenatal classes covered caesareans to some extent because I was having the elective surgery; they knew that at least one of us would have a different sort of birth plan. In the end, over half of our group had C-sections – with varying degrees of emergency involved.
I had months to get my head around the C-section experience and it really was a process. It must be very scary to have to face all of those fears around C-sections at the last moment when you already know that either you, your baby or both of you are at risk.
I strongly believe it is useful for all expectant mothers to consider this eventuality as a possible outcome.
If you are planning a natural birth, or are considering an elective caesarean but then decide against, I would strongly suggest reading my birth plan and adding an “In the event of a caesarean” section to your own plan. This will help you to acknowledge that it is a possibility and make your peace with that fact by thinking how best you would like it to unfold, if it does happen on the day.
Hopefully you will never need it, but it is good to be prepared in the moment, in the event that you need to be. This can only help you feel more in control during the birth – and afterwards during your recovery.
Ten months on…
I will be writing about my experiences of the surgery and recovery separately but – spoiler! – fortunately, both of my C section experiences were positive. And as my first baby was over 9lbs / 4 kilos, I have never regretted my decision! It was right for us.
Ten months to the day since my last C-section. My scars have now healed. I have learned to take pride in the very visible markings that shows I gave birth to my babies – even if it wasn’t in the way I had initially hoped for.
Essentially, my babies and I are healthy. And – when it comes to birthing methods – that is all that really matters.
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