Whether you are planning a VBAC, a primary Caesarean or a repeat Caesarean, the surgical nature of this birth means that there are specific things for you to consider which do not apply to vaginal deliveries. For this reason, writing a separate Caesarean birth plan is advisable.
As you write your Caesarean birth plan, use it as an opportunity to find out what happens during a Caesarean birth both from your care provider and hospital ahead of time. This can help you to prepare for the procedure (both physically and mentally), and negotiate your own wishes for the birth. It is also worth asking about how this birth will affect your future fertility and birth choices – the answer may give you more questions to ask and to make important decisions if you are still unsure about your wishes for your next birth.
In the case of an unexpected or emergency Caesarean, the fear of the unknown, the feeling of being forgotten by those attending the birth and separation from Baby (both visually if the screen obstructs view and physically following the birth and during the recovery period) are common factors in traumatic birth experiences. Writing a Caesarean birth plan whether or not you are planning a Caesarean can help some women to feel that they have all bases covered and that, in the event of an unexpected or emergency Caesarean, they will still be able to have some sense of control and active participation in their birth.
Knowing the categorisation of your Caesarean may also help you in your discussions with your care provider and hospital – in anything but a Category 1 Caesarean, there is likely to still be some time available to gather your thoughts and advocate your wishes, even if your Caesarean is unplanned. Sometimes a Caesarean may seem or feel ‘urgent’ even when it is not. Do not ever be afraid to ask for more time (whether to wait for spontaneous labour onset, to continue labouring/pushing or simply to gather your thoughts and discuss your options with your partner in private) - failure to progress is the second most common reason for women birthing in SA to have a Caesarean, and this is usually determined by an assessment of the clock. You may also ask for secondary confirmation of foetal distress (through foetal lactate sample, for example) if CTG readings suggest this is a concern.
It is also important to plan not only for the birth itself, but also for the time surrounding the birth. If you know that you will be birthing by Caesarean, do not forget that you are about to have major abdominal sugery and prepare yourself in the days leading up to the birth accordingly – take things easy and be kind to your body to give yourself the best chances at a quicker recovery. The post-partum period also needs attention; recovering from a Caesarean takes some time (months, usually!) and it is important to have adequate support and help available around home so that you do not hinder the healing process.
The following Caesarean birth plan is a sample only and is intended as a starting point for you as you plan your birth. Please amend this document to suit your individual wishes, needs and context.