Macclesfield Positive Birth Group- Complications and Caesarean section

Complications and Caesarean section

This information is the result of Macclesfield Positive Birth Group Meeting on the 25^th November 2020 vis zoom.

Katie Gardiner has been a midwife for 9 years at Macclesfield hospital, she has been a private midwife for 4 of those years and also teaches Hypnobirthing to her clients.

She talked to me about the process of Caesarean section and complications in labour over a zoom chat.

She told me that the reasons for a c-section birth when elective are due to a medical reason for mum or baby,  this pregnancy is the women’s 2^nd or other number baby and maybe the first needed intervention or was traumatic so a c-section is best for mum to be, or baby is breech and may not be able to be turned.

Elective c-sections are not the same as emergencies, they are slower and more controlled. They can help women feel in control and prepared.

A planned c-section would be planned for the 39^th week of pregnancy. You will be given a date and have a reop appointment where bloods are taken and you are given an anti-sickness table to take home with you. The night before the day you are due to go in you can eat then take the ante sickness table. Once you go into the hospital sometimes you are told what time you will go to the theatre, sometimes you have to wait depending on how many other women they have in that day.

You can take things with you to help you relax and create a calming environment. Such as your own music or positive birth affirmations to be played in the room or into your ears through ear phones. Speak to your hospital about your options. Your partner will be there with you in the theatre unless you need to have a general anaesthetic which is rare.  Your partner should be able to film or take photos during the birth. You can even have the screen taken down so you can see if you want to. It’s your birth so you always have options.

An incision will be cut into the belly, just above the pubic hairline. Some consultants and hospital allow gentle c-sections where the incision is made then its hands-off, if the baby needs help the consultant may massage your belly to encourage baby out the incision themselves. In this case, you may be given a serotonin drip which allows the uterus to contract to help baby push down.  A slow gentle c-section helps to squeeze baby which is what happens when they birth virginally, this helps to squeeze out any mucus in their lungs. This birth does take time, up to an hour and a half, so if it’s something you want to happen talk to your hospital so they can book the time slot in theatre.

Babies born by c-section will be placed on your belly or chest if the cord is long enough so they can have skin to skin with mum. Delayed core clamping is allowed also.

Once mum has had sutures then they are moved to recovery than the postnatal ward. There will be numbness in the legs for mum for about 6 hours and for this reason you will have a catheter inserted so you don’t need to get up to use the bathroom in this time.

Most ladies stay in hospital for 2 nights but you can go home the next day if you are able to get up and about. But you need to take it easy, even going up and down stairs can pull on your stitches. The stitches or sutures will dissolve and they will be covered in a dressing which the midwives encourage you to keep clean and remove on day 5. 

You need to keep taking pain relief every day which will be liquid morphine to start with then paracetamol every 4 hours. You will also be given and shown how to give an injection for 10 days which helps to stop the blood clotting. You will also have compression socks to wear for 6 weeks, but if you are up and about you may be able to take these off before then.

You are always offered a debrief after a c-section, it’s your time to ask questions and understand what happened and why it happened. If you are not ready when it’s first offered, you can wait and do this at a later date.

Instrumental delivery

There are two types of instruments use.  Ventouse and forceps.

Ventouse is like a little suction cup. This would be used if you are in the 2^nd stage of labour, you are 10cm but the baby is a little high still. The doctor with your permission will attach a suction pad on to babies head and gently bring baby down. Sometimes these babies have ahead ache afterwards and need a little bit of paracetamol, they may have a read mark or even a cone shape to their head but this goes within 12 hours.

Forceps are like big salad servers (Katie’s description). This is used if you are fully dilated but baby isn’t visible. They can be used to help rotate and bring baby down. These are normally performed in theatre because sometimes the women will be given a spinal block and if forceps are not helping the doctor can quickly and smoothly move into preforming a c-section.

Once baby arrives a midwife will come to you at home on day 1 and again at day 5. We recommend that if you have any stitches ask your midwife to have a look at them and to check that they are healing well.

You can help the healing process by taking arnica tablets, resting and eating well.

Perineal massage is recommended to help reduce the risk of tears. The link shows you how to do this.

Perineal massage link to more information

Remember being informed can help you feel empowered and in control.

If you have any questions please contact myself, Saffron at saffron@saffronsyoga.co.uk or Katie k.gardiner@nhs.net

Jenny

I also spoke to Jenny that is chair of Macclesfield Maternity Voices Partnership, join the Facebook page here.

This group work towards improving maternity services. They ask for patient feedback if you are currently pregnant or recently had a baby in the Macclesfield and Cheshire area please email Jenny any positive or negative experiences you have had. Then this data can be used to keep improving the service.

She is currently setting up listening events with different topics such as breastfeeding support, care of women with gestational diabetes and women who have had a miscarriage.

Jenny can be contacted by email, macclesfieldmatvoices@outlook.com.