Birth Doulas and C-Section Births

The birth community in Halifax, Nova Scotia got incredible news this week with the announcement from the IWK Health Centre that birth doulas are now able to support parents in the operating room for c-sections! The return of birth doulas to the operating room has been the result of ongoing advocacy from doulas in the Halifax area, recognizing just how important it is for families to receive ongoing support from all members of their care team regardless of how their baby is born.

Those of us who are doulas couldn’t be more excited and we understand exactly what difference this support can make for families. But for those of you who are new to this space or considering hiring a doula yourself, I’ll help break it down for you. Why would you want a doula during a c-section?

Let’s begin by talking about unplanned c-sections. Unplanned c-sections take place when a family is otherwise planning to birth their baby vaginally, but plans change during the course of labour. Only a small percentage of these c-sections are true “emergency” c-sections, even though it is not unusual for health care providers to refer to all unplanned c-sections as emergency c-sections. For instance, people sometimes change their plans because labour is taking much longer than they expected and there does not seem to be continued progress toward a vaginal birth. While situations like these are not planned ahead of time, families often have time to discuss their options with their health care providers knowing that both the birthing person and the baby are doing just fine. In some circumstances, a medical problem arises for the birthing person or the baby that requires an emergency c-section to happen quickly.

So how can a birth doula support families during unplanned c-sections? One of the first ways that a birth doula can support c-section births is by having conversations with you during your prenatal visits about your wishes for your birth. While some families prefer not to discuss the possibility of c-section during their prenatal visits because they’re concerned that even talking about a c-section can distract from the planning and preparing they are doing for a vaginal birth, it can be helpful to talk about what your preferences would be if plans change. A birth doula can help you learn more about the process – from getting an epidural to what to expect in the operating room – so that you can feel more mentally and emotionally prepared if something were to change. Your birth doula can also talk to you about your preferences for birth if, for whatever reason, your baby must be born by c-section. For example, you may have preferences about who will hold the baby after birth or want to plan about what role your partner will play. In our experience, one of the things that can make unplanned c-section births feel traumatic for some families is the lack of decision making and agency that sometimes happens when birth plans change unexpectedly. By thinking about your back-up plans in advance, your birth doula can help you figure out how to make your birth feel special even if things don’t go exactly according to plan. Your birth doula can also help advocate for you in the moment and explain things to you when other health care providers are busy getting ready to make the move to the operating room.

As birth doulas in Halifax, we are also now able to continue to support you in person in the operating room! Once in the operating room, your doula will take a seat with your partner or other support person next to your head and the anaesthesiologist who administers your medication. Your birth doula can provide support to both you and your partner, describing what is going on in the room, reassuring you that your health care team is doing their best for you and your baby, and advocating for you as needed. We can help guide you through some gentle breathing exercises, think of visuals or affirmations to focus on, or otherwise just be a calm and familiar face in a setting that otherwise feels pretty unusual! While your health care providers are busy tending to your body and your baby, it’s important to have people who are there to support you mentally and emotionally. Our focus is on making sure that you and your partner or support person feel as safe and comfortable as possible. And once your baby is born, we can help support you to see and hold your baby even though you do not yet have full use of your body and can help your partner to hold the baby close to you while the surgery is completed. We can also start having conversations about your c-section recovery so you know a bit more about what to expect and can make adjustments to your postpartum plan.

Now, let’s talk about planned c-sections. Some people know in advance that their baby will be born by c-section and have the opportunity to plan in advance when their birth will take place. C-sections are sometimes planned for birth of multiples (twins, triplets, or more), for breech births (where a doctor comfortable with breech vaginal births is not available), for births after a previous c-section birth (though vaginal birth after caesarian [VBAC] is an option for many), or for other medical reasons. Families also sometimes have personal reasons why they prefer to birth their baby via c-section even when a vaginal birth would otherwise be an option for them. Birth doulas can support planned c-section births in many of the same way that we do for unplanned c-sections – by discussing c-sections and your preferences during prenatal visits, by providing emotional support and encouragement in the operating room, and helping you plan for your recovery. One thing that is perhaps a little different with planned c-sections is the pace. Because things tend to move a bit slower and calmer when a c-section is planned, your doula may be able to help you get acquainted with the operating room before the procedure begins, support you during the insertion of an epidural, and facilitate conversations between you and your health care team. There is a move in recent years toward the practice of a “gentle caesarian,” where you can request that lights are dimmed, conversations are minimized, music is played, and other things to help create more of an atmosphere in the operating room. Your birth doula can help you explore your c-section options in advance so that you can incorporate elements that feel important into your birth plan and have conversations with your health care providers early and often.

While c-section births have a bit of a bad reputation in the birth community for being a source of birth trauma, it’s important to recognize that c-sections births do not have to be traumatic for families. Whether your c-section birth is planned or is the result of unexpected changes to your birth plans, you still deserve to have an experience that feels meaningful and empowering to you. Birth doulas can work with you to ensure that no matter how you birth, you feel empowered to make the decisions that feel right for you and your baby, and you can birth in an energy that feels beautiful and sacred. We’re so excited that this support can now extend to families whose birthing journeys take them to the operating room, so they can receive the same tender, encouraging, and supportive care that birth doulas provide to the rest of birthing families.

Interested in the birth doula support we offer? Check out our birth doula support packages here: https://www.beltanebirth.ca/birth-doula-support