Hi Ladies,

I came across this article and thought it was a good one. I was also
hoping it might prompt some discussion!

My question is, for those of you who have had repeat cesareans, what
are some things you did to prepare for it (even if it was unexpected)?
Did they help? Anything you would change?

http://mothering.com/sections/experts/buckley-archive.html#oxytocin

Q: I am 35 weeks pregnant and was working with wonderful midwives with
the hopes of a VBAC. I, unfortunately, have placenta previa, so my
hopes for a VBAC are gone. After seeing "The Business of Being Born",
my question is this: All the talk of oxytocin makes me a little
worried. Is there anything that I could do to compensate or balance
the lack of oxytocin because of the cesarean? Do Braxton Hicks
contractions create any levels of oxytocin that cross the placenta?
Would nipple stimulation work? My midwife suggested that I start doing
daily stimulation, but would that work? Thank you so much; any ideas
would be helpful.

A: It is wonderful that you are thinking about this with your upcoming
birth. It is true that your own oxytocin levels will be lower with a
cesarean, but perhaps it is helpful to remember that one of the roles
of oxytocin is to contract your uterus to birth your baby, which will
not be necessary for this birth.

Equally important are the psycho-emotional effects of oxytocin, which
is released within your brain during labor and in the minutes and
hours after birth. These are also very important as they will ensure
that you fall in love with your baby (and vice versa) and will also
help with early breastfeeding.

You can help to increase your oxytocin (and therefore pleasurable,
calm, and connected feelings after birth) by keeping your baby skin to
skin after birth and, I would suggest, for the following days. This
will help to soothe your baby also, increasing his or her oxytocin
levels and reducing stress hormone levels. You may find that your baby
is slow to wake up to breastfeeding, but you will help to prepare for
this also with skin-to-skin contact.

Note that it is your baby who will initiate this when ready. I would
recommend that you are very sensitive and respectful toward this
important action, and not allow anyone to force your baby on your
breast. If things are slow, you can encourage your baby to use his or
her early newborn reflexes to crawl up your body and find your breast
when you are both skin-to-skin and settled. This will be much easier
if both you and your baby are unwashed because the smell of your
breasts will help to guide your baby.

Some of the problems with immediate and ongoing skin-to-skin contact
are the hospital protocols: often the baby is sent to the nursery, so
you may need to discuss this with your care providers and formulate a
specific plan for the hours after birth. You would need close support
to hold your baby, either from your husband or perhaps your midwives,
because you will be affected to some extent by the anesthetics used
for the cesarean.

There are other suggestions for having a good cesarean in my new book,
and I also recommend the following websites:

* Sarah Buckley, Gentle Birth, Gentle Mothering: A Doctors Guide
to Natural Childbirth and Gentle Early Parenting Choices (Berkeley,
CA: Celestial Arts, 2009)
www.sarahjbuckley.com/html/new-gentle-birth-gentle-mothering.htm
* "Caesareans: Making Informed Choices":
www.birthrites.org/BookletIndex.html
* International Cesarean Awareness Network www.ican-online.org

Many blessings for a beautiful cesarean birth.