April is Cesarean & VBAC Awareness month, and we know exactly how important it is to recognize both of these ways of giving birth. We know that nationally, around 1 in 3 births happen via cesarean section, and locally that holds fairly true according to the latest available data. While we don’t know the full extent as to WHY the planned hospital birth cesarean rate is so high, “It seems increasingly clear that anxiety and easy access to many medical procedures at hospital may lead to increased levels of intervention, which in turn may lead to further interventions and finally to unnecessary complications (Olsen & Clausen 2023).” All of that is big picture stuff though, and this post is really seeking to speak to the patient side of things. We celebrate ALL births, no matter how they happen. Let’s talk about 3 big areas where doulas can help after a cesarean birth.
Postpartum
The first 6 weeks after cesarean surgery can be challenging. Your body really needs to rest, but you have a newborn to take care of too. Maybe you’re still dealing with pain when you get home and timing medications, or your other kids really want to cuddle but you’re worried they might bust your incision. Lifting restrictions make moving baby, other kids, laundry baskets, etc challenging after a cesarean birth too. Hiring a postpartum doula, even when you didn’t plan to, can be a huge help to your family and your health in those first 6 weeks. Whether you get a doula or not, delegating should definitely be in your wheelhouse, because your body needs TIME to recover properly in this postpartum period at home.
Recovery
Physical recovery is what most people think about after a cesarean birth, and yes that is really important. After that initial 6 weeks, you may want to talk to your provider about physical therapy to work on scar mobilization and pelvic floor therapy too. Yes, even after having cesarean surgery your pelvic floor might need some work. Honestly, I don’t know why pelvic floor PT isn’t a standard referral after having a baby, but that is a blog for another day.
Mental recovery after a cesarean birth is something that we need to talk about more. I often find myself processing with my clients who’ve had cesarean surgery to talk about how things went, even if I wasn’t there for that birth. People react very differently to having cesarean surgery, and we truly believe all feelings are 100% valid. Mental recovery can be very easy for some and others struggle with it for a long time. Processing with a birth professional like a doula or with a therapist trained in birth trauma can be really validating and helpful for some people. This is a service we offer for clients all the time!
Next time
The big question that many people have after a cesarean birth is often, what should they do next time. Should you try for a VBAC (vaginal birth after cesarean), maybe an HBAC (home birth after cesarean), or maybe a planned CBAC (cesarean birth after cesarean) is for you. There is no one right answer that will work for everyone in this situation, and there are many many factors that go into making that decision. As doulas, we tend to nudge people to think about 4 things when they’re discussing what to do for their next birth:
- What were the factors that lead to your cesarean surgery?
- How do you feel about giving birth again?
- Is there information or other support that would be helpful for you to know when making this decision?
- How will you feel about your choice in 10 years?
Everyone answers those questions differently, and honestly there is no one right answer that will work for everyone. One thing we can say with the utmost certainty is that no matter what your choices are, our doulas will be there to support you 100% of the way. We’re working to try to help hospitals understand the value of having your doula in the operating room to support you during your surgical birth too, and will keep pushing for this here locally!
We’re very grateful that cesarean surgery exists, as we’ve seen it save lives. At the same time, we know that it is often over used. We LOVE that VBAC is a truly viable option here locally with many providers, and have seen some amazing HBAC births too. Birth is honestly just amazing in all the different ways it happens. If you’ve had a cesarean birth and want support in any of the above ways, don’t hesitate to reach out to us!