"In 2014 the proportion of [South Australian] women giving birth by caesarean section was 34%, a proportion that has been relatively stable for several years.
Of those who had previously given birth, 31% had previously had a caesarean section. Only 15.9% of women had a
vaginal birth following a previous first caesarean without intervening births, compared with 30% in 1998 (when data first
The main reasons given for caesarean section were previous caesarean section (37%) failure to progress in labour or cephalopelvic disproportion (26%) fetal distress (14%) and malpresentation (11%)." SOURCE
This means that approximately 1 in 3 women in South Australia will give birth via major surgery. This surgery may be chosen in advance as an elective c-section or may happen after labour has started (known as an emergency cesarean).
So how can a Doula help you if you have a Cesarean ?
Here are 6 ways I can support you if you are birthing in Adelaide:
1. I will talk through your options with you and help fill in any knowledge gaps you may have. Options like who will announce baby's sex, who will cut the umbilical cord or will you leave baby attached to their placenta for a while, the benefits of skin-to-skin contact with baby after birth or you might want to discuss your options for pain relief with your care providers. Having a birth plan isn't necessarily about avoiding a certain outcome, it is about going through your knowledge, understanding and preferences and putting them on paper so that those supporting you are on the same page.
2. While you are waiting and being prepped for surgery, I can provide you with relaxation techniques, acknowledge any feelings you may have about this birth, give you a massage and honour the impending arrival of your child. I can support your partner by reminding them to look after themselves so that they are in the best position to look after you.
3. With c-sections there is a greater chance that your baby will need special care and often your partner will go with your baby leaving you alone. This can be a scary and lonely time for you but a doula will stay with you providing continuity of care and may act as a liaison between you, staff and your partner to keep you updated on how baby is doing.
4. If your doctor allows me into theatre with you, I can take pictures of your child being born to create tangible memories of what you couldn't see. I can reassure you and your partner about what is happening.
5. If I can't go into the operating room with you, I will wait for you either in the recovery area or in your room. I might accompany other family members and help explain the process to them. A doula can ease fears and provide comfort at a caesearean birth.
6. After the birth, another advantage of a knowledgeable doula is helping to get breastfeeding established. This can be challenging after a c-section as baby may be sleepy from the medications and you may need to try different positions to avoid hurting your surgery site. If baby has gone to NICU / SCBU, a doula can help get pumping going so you can provide the best possible nourishment for your baby and begin to establish your supply of breastmilk.
7. Finally, once baby is earthside and you have had a few days to get to know each other, you might want to debrief your experience. Having someone who was there to help you remember all the details you might not and to process everything you (and your partner) have been through is important.
The one thing that consistently determines whether a woman has a positive birth, is not how the baby comes out, but rather how she is treated by those around her. Respect is important. No matter what a woman chooses, it is her choice and decision to make on how she will give birth. Its that control and respect that allows her to step into her power and have a positive birth.
Kelly is a birth and postnatal doula in Adelaide. She is currently providing birth coaching and support for women planning an elective c-section or induction on a known date at the Women's and Children's Hospital, Lyell McEwin Hospital, Calvary, Burnside or North Eastern Community private hospitals.