The Secret About Emergency Cesareans

There's a secret about cesarean births (at least in the USA).

How many people do you know who had an "emergency cesarean"?

Probably a lot, because over 30% of births in the US are surgical vs vaginal. And many of those aren't planned - otherwise known as "emergency cesareans." Right? Wrong.

NOW THIS NEXT PART IS IMPORTANT: If you had a cesarean birth you are ALLOWED TO CALL IT WHATEVER YOU WANT!!! If it was an emergency to you, then it was an emergency. This is not meant as judgement on anyone's previous birth experience.

THIS POST ONLY APPLIES TO FUTURE BIRTHS. When planning for your birth experience it's important to know that there is a vast difference between an URGENT/UNPLANNED cesarean, and a true EMERGENCY cesarean.

A cesarean is typically recommended by your health care provider for a variety of reasons, usually surrounding your safety or your baby's safety. It could be risk of infection, heartrate issues, a less-than-ideal position of the baby making pushing difficult or impossible, and sometimes maternal fatigue after a long labor. Sometimes this is a true emergency situation: all hands on deck, rushing the pregnant person into the operating room with very little time to breathe or think about what's happening.

But many, many times the reasons are URGENT, but not an immediate emergency.

When you believe it's an EMERGENCY situation your fight or flight instincts kick in, typically placing the physical health of your soon-to-be- born infant above your own physical or mental well-being. Welcome to parenthood! You'll do this many, many times in the future years.

The only problem with this scenario is when there isn't a true emergency. Believing you're in an emergency situation when you aren't floods your body with unnecessary stress hormones, which can have a negative effect on you and possibly your baby. It causes the more rational and analytical part of your brain to take a back seat while the fight-or-flight center takes over - this may cause you to not process information appropriately when hearing the risks and benefits of the surgery. Finally, the urgency that accompanies this "emergency" belief causes us to skip steps that might reduce our overall stress and raise our satisfaction with the overall birth experience.

Consider for a moment what a difference it might make if, when your provider suggests a cesarean birth, you clarify that this isn't an immediate life-or-death emergency situation.

• You ask for a few minutes alone with your support person to collect your thoughts.
• Your loved one gives you a big, long hug releasing oxytocin and tampering your adrenaline. They lead you through some deep breathing exercises. You realize that you'll both be meeting your baby VERY soon and excitement begins to set in!
• When the doctor returns to the room a few minutes later your head is clear and focused. You are able to clearly ask questions about the safety and necessity of the surgery.
• You remember to ask how any requests in your birth plan can still be honored: Can they do delayed cord clamping? Is there a clear drape available that will allow you to catch the very first glimpse of your baby? Assuming your baby comes out healthy can you do immediate skin-to-skin?
• You're able to ask questions about what happens after the surgery: How long will it take to finish the procedure and where will your baby be during that time? Will the baby go with you to recovery or to the nursery? How long until you can hold or feed your baby?
• After your questions are answered and you give informed consent you remember to put your ear buds in and start your favorite birth playlist.
• Your partner gives you one more hug and whispers words of encouragement before you're wheeled out of the room and they're asked to wait for a few moments before they join you in the operating room.

This is a MUCH more gentle approach, and you deserve to have the gentlest birth experience possible. Emergency cesareans ARE sometimes necessary and I don't certainly don't mean to invalidate anyone's previous birth experience. April is Cesarean Awareness Month, and with such a high rate of cesarean births in our country, it's important to be fully prepared for this possible outcome.