Every time I hear that someone I care about has an unexpected c-section I am sent back to those early days with Nathan 3 years ago. After my water broke I was induced and quickly - in literally just minutes - went from a few extremely mild contractions to full-on hard labour. Add to that the fact that it was the middle of the night so I had not slept and he was "sunny-side up" (occipital posterior) and it took every ounce of determination to make it through the rolling contractions. For those who haven't heard that term it means when the contractions are right on top of one another so the mom doesn't get a "break" in between. Good times. I finally had an epidural when I reached 7 cm and started to involuntarily push.
It took another 9 hours until I reached the pushing stage. Thank goodness I had that epidural!! I pushed for 2 and a half hours and consulted with the OB on-call. She recommended a c-section. Nathan was still facing up with his chin hyperextended and his head tilted toward his shoulder. Any one of these positions would have warranted a c-section.
Little did I know at that time that the hard part was yet to come. I'm not sure what was more difficult during that time: the physical recovery process or the emotional aftermath. It took me until the birth of our twins 2 and a half years later to finally feel like I was completely over the whole experience. I don't want anyone I care about - or anyone, for that matter - to go through that so I'm writing about it in the hopes that I can be of some help.
New moms are likely going to have all the normal and often challenging things to deal with. The following are things many first time moms experience: she likely had a long, hard labour, is learning how to feed her baby, is having major hormonal fluctuations, is experiencing emotions that she may not yet be able to understand or explain and is just plain exhausted.
In the case of an unexpected c-section the mom is now recovering from MAJOR abdominal surgery. AND trying to feed her baby (which is uncomfortable and painful at first), AND not getting enough sleep (which is necessary after surgery), AND she very well may have extreme emotions regarding the actual birth experience. People often think that c-sections are no big deal since they happen so often. I didn't think they were such a big deal until I had one myself. No one is truly prepared for this experience when it happens, even in the case of a planned c-section. You just don't realize how difficult it's going to be.
What can you do? (advice for dads but also applicable to the new mom's family and friends)
Emotionally: Give her the space and time to feel what she is feeling. Listen to her when she talks and validate what she is saying. Tell her that she did a fantastic job in labour and she is amazing for enduring such pain to ensure the safe arrival of her baby. If she gets angry about anything, let her and don't argue back. It may take some time but she will start to feel better emotionally once she starts to feel better physically. If not, then just let her talk. And talk, and talk...... Clint let me talk for many, many months. So did my mom, my sister and my best friend. It is sometimes all that helps.
Physically: Help her get in and out of bed (ask the public health nurse to show you how to do it properly). Help her get comfortable day and night to feed the baby and then pass the baby to her. Take the baby after feedings so that she can nap at least once during the day in the early weeks. Bring her healthy meals where she is most comfortable. Set up everything she needs within arms reach of her "comfy" spot (TV remote, water, granola bars, pain meds, cell phone). Make sure that any baby items are close by where she sleeps too (burp cloths, diapers, wipes, extra sleeper and diaper shirt). Have the baby sleep in your room with you (if you both agree) and set up a change table area there as well. Change the baby before or after feedings so she doesn't have to bend over to do it. Take them to their doctor's appointments and always carry the baby, diaper bag and the car seat for her. Arrange for family and friends to come and HELP (bring meals, do grocery shopping, do laundry, house keeping). If you are a friend or family member who wants to help, BE SPECIFIC about what it is you are willing to do to help (bring a meal, pick-up Starbucks, bring diapers, hold baby while she showers, get groceries, etc.) so that she can decide if she wants/needs it. Encourage her to say no to visitors if she is not up to it or, better yet, say no for her. Make sure she eats regularly and has a shower every day so that she can feel human.
Advice for the new mom
1. Take your meds! When I had my first c-section I wanted to avoid the narcotics they administered as I thought I would do some irreparable damage to my baby. Yes, you want to get off the meds as soon as you can but you are no good to your baby in those early days at home if you are in so much pain that you cannot function. I took Percocet the first time and Oxycontin the second time. This is the really good stuff and they wouldn't give it to you if it wasn't safe. BTW, my babies are all fine!! Once you are at a stage when you can manage the pain a little better alternate taking tylenol at one time and advil a couple of hours later being sure to follow the advise from the doctors and public health nurse on dosing.
2. Try to nap at least once a day in the first few weeks. Even if you can't fall asleep, some time in bed alone can do wonders for your recovery. Feed the baby and pass him/her off to whomever is there to help at that time to burp, change, etc. and try to go right to sleep. This is actually the easiest way to get a nap in because all the oxytocin in your body from breastfeeding will make it almost impossible not to fall asleep!
3. Take any help that anyone offers. People don't offer if they don't actually want to help. If someone offers to bring you a meal, accept it. Even if you won't eat it that day you can save it for the next day or freeze it for some other time. Anytime someone comes over have them do small things for you like carry the laundry, empty the dishwasher, get you a drink, or hold the baby while you go to the bathroom.
4. When people do come to see you tell them that your house is now "self serve". If they want coffee, water or anything else, they need to get it themselves. Tell them that you seriously don't care if they help themselves but that you are just not up to playing hostess. Our house is still self serve and our twins are 6 months old!!
5. Do not feel any guilt over having a c-section. And do not feel any guilt over feeling upset about having a c-section. This advice would is really applicable to any mom who didn't have the birth experience they were hoping for. This was the most difficult thing for me to do. People who have not had an unexpected birth experience don't understand how traumatizing it can be and think that you should simply be happy because you got a healthy baby. Of course you are happy you got a healthy baby!!!! But it is normal and completely ok to be upset that the birth experience and your first few days together did not go how you imagined they would go. Grieve for that loss because it is very real for you whether anyone else understands it or not. Remember that there is at least one other woman out there (me!) that knows exactly how you feel! You will bond with your baby and it will get easier. Give yourself permission to feel whatever you may feel.
6. Don't play the "what if?" game with yourself. I played that game for many months. "What if I hadn't been induced? What if I hadn't fallen the week before he was born? What if I'd asked to go home for a few hours after we first went to the hospital? What if I hadn't gotten the epidural? What if I had changed into a different position? What if I hadn't gained so much weight?" And on, and on. The truth is that you did what was best for you and your baby with the situation that you were in at that particular moment. You may very well have not had any choice in the matter even if it was presented to you that way. Some babies just won't be born the old fashioned way no matter what we do. If you need to blame someone, blame everyone BUT yourself (and your partner and baby, of course). Blame the nurses and doctors if you need to. Blame the protocols of the hospital. This is not your fault and it is ok to be upset about it.
I came to the realization some months after Nathan was born that we both may have not survived his birth had he been born 100 years ago or even yesterday in a 3rd world country. The c-section rate across Canada is between 25-30% and mother and infant mortality is at a all time low. In addition, VBACs (vaginal births after cesareans) are becoming more and more accepted by health care professionals. VBACs are typically successful anywhere from 70-90% of the time depending on the reason for the initial c-section and I personally know 4 women who have had successful VBACs in the last 3 years. I had planned to have one too up until my water broke with the twins and they were still in breech positions. While I struggled for quite some time with my first c-section and attempted to get the twins in position for a VBAC, it was not meant to be for me. At the end of the day I am thankful for the birth experiences I had as I feel they made me stronger both physically and emotionally. I have three beautiful, healthy children and only a small, very faint scar remains.
