The Mother-Friendly Cesarean - A Ceci Jane video debut

I have mixed feelings about writing this post.  I don't want to glorify the cesarean or make it look desirable.  It's become so common to elect for a cesarean section instead of experiencing childbirth.  I honestly believe fear is at the root of this epidemic.  I've been there with my first baby - I get it. But that is not the purpose of this post.

This post is about those women who want and have planned for an unmedicated birth.  They dream of the water birth in the quiet, dimly-lit room, where their baby is baby is placed immediately on their chest.  They want to experience the oxytocin and bonding that is held so precious in natural birth circles.  They want to be empowered through their natural birth.

Every now and then a cesarean birth becomes the only option.  I'm not talking about the mom who didn't do any classes and has placed all her trust in her OB who tells her it's dangerous to go past 40 weeks and her baby is too big anyway.  I'm talking about the mom who truly has no other options.  My graphic designer for Birth Boot Camp, who had a bicornuate, or heart-shaped, uterus.  She tried everything possible to get the baby to turn before finding out why her baby couldn't get head-down, or even butt-down.  It broke her heart to have a cesarean.

Sometimes a cesarean is actually even a better option than a vaginal birth.  I bet that surprises many of my readers to hear me say that.  I've been talking with a mom, who, at 18, gave her baby up for adoption.  She had an episiotomy which led to a 4th degree tear, or into the rectum.  For many years, she has lived with a poorly stitched perineum and has had many issues. She had a reconstructive surgery, but is still dealing with problems and pain. Now, at 9 months pregnant, she's been advised to have a cesarean.  She's getting a second opinion, of course, but she is devastated.  She's been preparing for and looking forward to a homebirth.  The doctor explained that the skin and muscles between the vagina and rectum are paper thin and she has a significantly shorter perineum.  He is convinced that the baby will tear things open as he/she passes through.  He said she is certain to be looking at another surgery with probable lifetime incontinence and even leaking fecal matter through the vagina.  Of course, there is no guarantee that is how things are going to go down, but at some point, you are left deciding which surgery do you want to recover from?  Which possible life-long effects from which surgery are you more "willing" to deal with? I am grateful I was never forced to make a decision like that.  I honestly am not sure what I would choose and it's not my place to tell her what I think she should do.  She is informed and she will make the right decision for her family.

The moms that have been in this position are left mourning the loss of what they didn't have - their natural birth.  All the "at least you have a healthy baby" comments often make them feel guilty for being sad about their birth. It's OK to be sad or disappointed.  If the sadness is interfering with bonding or parenting, seek help.  Talking about it with people who understand will help.

If you are in this situation of having an unwanted cesarean, it doesn't have to look so different from the immediate postpartum vaginal birth.  Many women want their baby immediately and they don't want to delay breastfeeding.  My good friend, Ceci Jane, recently filmed a birth video for a family desiring a Mother-Friendly cesarean.  She called me immediately after this birth, so excited!  She said it was amazing, that it "felt" very much like a vaginal birth. I've worked with Ceci on a number of projects, including Birth Boot Camp (read about her version of recording/editing the documentary-style classes), and I knew she had been asked to film this video a few months ago.  I am honored she allowed this debut to take place here on Banned From Baby Showers. The mother and father were treated with such respect and their wishes were honored.  Rather than spoiling this special video, I'll let it speak for itself.  Grab your tissues.


Uriah Nehemiah from Ceci Jane on Vimeo.

So, you've seen the video, but the question inevitably comes up - What makes this a Mother-Friendly Cesarean?  You are always hearing me talk about the Mother-Friendly Childbirth Initiative written by CIMS.  Many of those steps can be applied to cesarean birth as well.  A Mother-Friendly cesarean is a gentle cesarean, for one.  The baby - and the mother - is not handled so aggressively.  The cord is not immediately clamped, but rather the baby receives all of its cord blood.  Mother has the baby handed to her in a matter of seconds.  In this birth video, baby stayed on his mama's chest for a solid 2 hours.  Baby breastfeeds soon after birth, like a vaginally born baby would.  Newborn procedures, including weighing the baby, were delayed until parents were ready.  Like anything else, if the consumer demands things be done a certain way, eventually, we will see change.  If you find yourself in this situation, where a cesarean is the last - or best - option for you and your baby, request a Mother-Friendly cesarean.

Ultimately, no matter how your baby enters the world, you are becoming his or her parents.  We wish a gentle birth for all babies, but so much of that is about the first minutes and hours of his/her life.  We talk so often about natural birth being empowering, but empowerment also comes from knowledge and making informed decisions and having those wishes and decisions respected. Some of the best mothers I know had cesarean births.  You can still breastfeed, co-sleep, and wear your baby. Ultimately, it doesn't make you a better mother just because your baby came out of your vagina.

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The Effects of a Crowded Room

For years I've been talking about emotional relaxation.  Emotional relaxation is how you feel about your laboring environment.  For example:

Are you confident in your care provider?  

Do you feel that your nurse is supportive of natural birth?  

Is the on-call doctor respectful of your birth plan? 

How is the temperature in the room?  

Are people talking during your contractions?  

Do you feel supported not only during contractions, but between them as well?  

Are your needs anticipated by those around you?  

Do the people at your birth really know how to help you?

How is the lighting?

What does the room smell like?

Are you hungry?  Are you encouraged to eat/drink?

The answers to these questions will impact your labor.  Someone posted on my Banned From Baby Showers Facebook page wanting to talk about prodromal labor and someone else about "longer than normal" labors.  When I hear about a woman having a very long labor, there are some things that pop into my mind, the first one being how many people were in the room?  What did she do in early labor?  Did she watch the clock and wait for contractions to get closer?  Or did she announce it on Facebook and deal with phone calls for the next 3 days?  Did she feel like a watched pot?

My two bits of advice for all my couples in early labor are:  1) Depending on the time of day you realize contractions are regular, SLEEP.  2) Depending on the last time you ate, EAT.  Eventually, you may want to do both of these things and will likely not be able to.  

The 4 top things that women worry about for their labor:  

1) The sounds they will make during labor and birth

2) Modesty and being/feeling exposed

3) Fear of tearing

4) Fear of pooping during the pushing phase

Let's look at this list further.  The only one that is actually a physical fear is #3, the fear of tearing.  The other 3 have more to do with how she is perceived by others in the room.  There are few times in a woman's life where she is more vulnerable than when she is in labor.  She may act like a wild animal, making sounds that might be embarrassing otherwise.   Or, her sounds might be low and sexy -- and she may stop when her mother or mother-in-law comes into the labor, even though those sounds were her "rhythm" and helping her through contractions.  

Very carefully consider the people you invite into your birth.  Often, women feel the need to "perform" for their audience.  Maybe it's for your mother or best friend who never had a natural birth and has been very negative about you having a homebirth.  You feel like you have something to prove.  Maybe you have "media" at your birth, a photographer or are recording a video.  The pressure to "perform" can really hurt a labor.  I feel strongly about recording your birth, but not at the cost of not being able to give in to your labor.  It's just another thing to evaluate and be flexible during labor.

As hard as it may be, you may need to banish these people from your labor.  Most women labor best in dark, quiet, undisturbed places.  The more people involved in your labor, the harder these conditions are to achieve.  Mom needs to feel free to move and vocalize.  We have this idea that if we are vocal, we are not doing well.  This simply isn't the case.  In fact, the opposite may be true.

Of course, there may be physical reasons for a long labor, but the people in the room is something that each couple has direct control over.  Even in a hospital birth, if you don't like your nurse, request another one.  Have your doula or midwife do it if you can't.  If they suggest it, acknowledge that they may able to see something you can't see in the throngs of labor.  Many people don't want to believe that having their mom or sister in the room is slowing their labor, but I've seen it many times over the years.  Hindsight is always 20/20 too. Often, women can't see the effects of the "spectators" until after the birth.

If you feel self-conscious about how you will sound, act, or look, you might consider not having anyone not crucial to your birth team at your birth.  Birth is not a spectator sport!

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Recording Your Birth

Here's a topic I feel so strongly about -- the importance of recording your baby's birth. Yes, I do mean with video or photos, not just writing your birth story.

My sister-in-law, who was at our first birth insisted on taking pictures at Daymon's birth, and I was horrified! Really. I felt angry that she was snapping that camera. She had them developed immediately (this was 1996!) and I put them away, embarrassed.

As the weeks became months, I would find myself thinking about his birth, literally, every day. I would relieve those moments of becoming a mother as I nursed my sweet baby boy. I found those pictures and have spent hours looking at them, thinking about those moments and how I felt as I held my new baby.

I am so glad now that Tamara knew then what I couldn't have known at the time. She kept telling me that I would want these pictures some day. She was so right!

I'm not sure what I thought the pictures would be like -- all 175 lbs of my 9 month pregnant body, exposed. They were so tasteful. So emotional. So tender. And now, so treasured.

We obviously did not videotape his birth, but we knew by the time we were pregnant with #2 how much we loved having those pictures, so we decided to record our 2nd baby's birth with a video recorder. We set up the camera across the room, and while we can hear everything happening, we can't see a darn thing! Still, it's so emotional to listen. Her video, while not the best visually, is the most emotional one of them all.

 By the time we were pregnant with the third baby, we knew that we wanted a great video. To our dismay, at 33 weeks, we found out the hospital had a no-video policy at the time of birth. Are you kidding me? That's like ripping the best pages out of a book! No one was going to take this experience from us! We pulled our records from the hospital and hired a homebirth midwife. We would have paid $100 to have our baby in the hospital, but were now going to pay $2500. This was an expensive video! It meant that much to us. We had a friend do the video and that was her only job. How sad it would have been to have missed that birth.

We did the same for the fourth baby. It is so special, not only for us as parents to have these memories recorded, but also for the child. Our kids are amazed when they watch their birth videos. What an amazing sight to behold -- your entrance into the world. To see how hard your mother worked to get you here.

Still not sure? You never have to watch it. Or, you can keep it for yourself and never show it to a single person. Your choice. But you will not ever be able to go back and record it after the fact. Trust me -- as someone who was so adamant about not wanting pictures, you will not regret having them. Many times over the years, I've heard women comment on wishing that they had recorded their birth, but I've never heard a mom say that she wished that she hadn't. Think about that.

Many hospitals have banned videotaping (is that even the right word anymore?!) the birth for legal reasons. Find out the policies beforehand. That would be so disappointing to be expecting to record or photograph your birth and then be told no. You do not want surprises like that in labor!

And if you still aren't sure, check out this video Ceci did for one of my couples.  Grab your tissues.  It'll be the best 6 minutes of your day. 


Halen's Birth Story from Ceci Jane on Vimeo.

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