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Hi Aileen - thanks for posting your story. Sorry it's taken a while to respond - stuff got buried...
I'm sorry your cesarean experience was so difficult. Thank goodness for your midwife! What was the reason for the cesarean?
The question about pre-EDD cesareans is a touchy one, and the decision should be weighed very carefully. For example, there are cases where women with previa have chosen to go into labor, knowing they would require a cesarean. In that case, the question is about which risks are acceptable and which are not - so, for previa, does the risk of bleeding out and possible maternal (and fetal) death outweigh the benefit of allowing your baby choose their own birthday and ensure their lung development is as complete as possible? Most would agree that it would be more advantageous to schedule it. Typically, a doctor would not want to risk the possibility of going into labor, and would try to balance this with keeping the woman pregnant as long as possible; therefore they usually do it between 38-39 weeks.
Most other reasons to schedule are not as easy to predict, for example, breech - a breech baby can flip anytime, even during labor. A baby in a transverse lie could do the same, although there may be added risks to laboring with a baby that is transverse, so if labor begins while the baby is in this position, a cesarean is indicated. In a normal pregnancy, since we know that due dates can be off by at least two weeks either way (not to mention that some moms carry their babies longer or shorter than others, and that sometimes even diet can influence this), it is always better to let the baby pick their own due date unless something unusual comes up.
I'm sorry your cesarean experience was so difficult. Thank goodness for your midwife! What was the reason for the cesarean?
The question about pre-EDD cesareans is a touchy one, and the decision should be weighed very carefully. For example, there are cases where women with previa have chosen to go into labor, knowing they would require a cesarean. In that case, the question is about which risks are acceptable and which are not - so, for previa, does the risk of bleeding out and possible maternal (and fetal) death outweigh the benefit of allowing your baby choose their own birthday and ensure their lung development is as complete as possible? Most would agree that it would be more advantageous to schedule it. Typically, a doctor would not want to risk the possibility of going into labor, and would try to balance this with keeping the woman pregnant as long as possible; therefore they usually do it between 38-39 weeks.
Most other reasons to schedule are not as easy to predict, for example, breech - a breech baby can flip anytime, even during labor. A baby in a transverse lie could do the same, although there may be added risks to laboring with a baby that is transverse, so if labor begins while the baby is in this position, a cesarean is indicated. In a normal pregnancy, since we know that due dates can be off by at least two weeks either way (not to mention that some moms carry their babies longer or shorter than others, and that sometimes even diet can influence this), it is always better to let the baby pick their own due date unless something unusual comes up.
-Rachel
-----Original Message-----From: ajhcfamily <aileencorso@...>
To: icanofbuffalo@yahoogroups.com
Sent: Thu, 22 Jan 2009 3:41 pm
Subject: [icanofbuffalo] Re: Repeat Cesarean Moms: Oxytocin and Caesareans
[I sent this message last week but it never showed up...here goes again]
Thank you for posting this. It gave me a lot to think about regarding
my own and my baby's experience in the hours after my cesarean. I did
not have a repeat CS (only 1 child so far). My midwife ensured that my
daughter was brought to me in the recovery room to initiate
breastfeeding. I remember my daughter suckling at the breast and my
midwife and husband holding her to my breast given my
weakness/anesthesia. I do remember the nurse manipulating my breast
and baby's mouth. I was just thrilled to see my daughter since they
told me she would be in the nursery until my anesthesia wore off. My
midwife ensured she was in a little basinet next to my bed and
received her check up next to me. She was then taken (with my husband
following) to the nursery for a bath.
Given that we planned a homebirth and transferred during labor, I
certainly was not expecting to NOT be holding my baby within minutes
of birth, skin to skin, allowing breastfeeding to initiate slowly and
of course to not have my daughter bathed within hours of leaving the
womb. The pictures of her first bath still horrify me. She is
obviously screaming. My husband said the whole thing lasted less than
minute or two, but I still hate the thought of being half-dazed while
my child was somewhere else being handled and "washed" instead of next
to her warm, familiar, and oxytocin producing mother. I digress a bit...
To return to the topic, I think it is very wise to bring these
questions to mothers minds given that there is a chance of a surgical
birth even when we do not expect or plan for it, as in my situation. I
would have liked to be more prepared with my list of priorities for my
own care and newborn's care in the event of a change of plans. Thank
God for my midwife and her help, but honestly I think she was almost
as physically and emotionally drained as I was.
Another thought is the importance of beginning labor in order to allow
as much of the natural process to occur as possible, and as much of
the good hormones to do their work. Can someone who has a medical need
for a CS such as placenta previa, like the original person asking the
question, try to start labor in order to wait for the body to say when
it is ready and to start the flow of hormones? I ask also because I
know a lot of planned CS (medically necessary or not) occur before the
due date. My labor began 16 days after my due date and my daughter did
not appear a bit "overdue" to the docs/midwives. If I had a medical
reason for CS during my pregnancy and went in a week or two early, she
would have been 3-4 weeks early although no one would have ever known
that since the due date is often the one of the last possible delivery
days for many docs.
I forget if I have even introduced myself on this board, but I do
enjoy reading and am hoping to make a meeting.
Aileen
Thank you for posting this. It gave me a lot to think about regarding
my own and my baby's experience in the hours after my cesarean. I did
not have a repeat CS (only 1 child so far). My midwife ensured that my
daughter was brought to me in the recovery room to initiate
breastfeeding. I remember my daughter suckling at the breast and my
midwife and husband holding her to my breast given my
weakness/anesthesia
and baby's mouth. I was just thrilled to see my daughter since they
told me she would be in the nursery until my anesthesia wore off. My
midwife ensured she was in a little basinet next to my bed and
received her check up next to me. She was then taken (with my husband
following) to the nursery for a bath.
Given that we planned a homebirth and transferred during labor, I
certainly was not expecting to NOT be holding my baby within minutes
of birth, skin to skin, allowing breastfeeding to initiate slowly and
of course to not have my daughter bathed within hours of leaving the
womb. The pictures of her first bath still horrify me. She is
obviously screaming. My husband said the whole thing lasted less than
minute or two, but I still hate the thought of being half-dazed while
my child was somewhere else being handled and "washed" instead of next
to her warm, familiar, and oxytocin producing mother. I digress a bit...
To return to the topic, I think it is very wise to bring these
questions to mothers minds given that there is a chance of a surgical
birth even when we do not expect or plan for it, as in my situation. I
would have liked to be more prepared with my list of priorities for my
own care and newborn's care in the event of a change of plans. Thank
God for my midwife and her help, but honestly I think she was almost
as physically and emotionally drained as I was.
Another thought is the importance of beginning labor in order to allow
as much of the natural process to occur as possible, and as much of
the good hormones to do their work. Can someone who has a medical need
for a CS such as placenta previa, like the original person asking the
question, try to start labor in order to wait for the body to say when
it is ready and to start the flow of hormones? I ask also because I
know a lot of planned CS (medically necessary or not) occur before the
due date. My labor began 16 days after my due date and my daughter did
not appear a bit "overdue" to the docs/midwives. If I had a medical
reason for CS during my pregnancy and went in a week or two early, she
would have been 3-4 weeks early although no one would have ever known
that since the due date is often the one of the last possible delivery
days for many docs.
I forget if I have even introduced myself on this board, but I do
enjoy reading and am hoping to make a meeting.
Aileen
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