5 reasons to have a birth doula for your caesarean (c-section)

How can a doula help if I’m planning to have a caesarean?

This is a question that comes up often, especially as the rate of caesarean births is swiftly rising in the UK, nearing 50% of births in some areas (with about half of these being planned c-sections, and the other emergency c-sections).

There is indeed this deep assumption that doulas are for ‘physiological’ birth or vaginal birth only; or that their main role and value is the help they can provide during labour itself.

There is also this assumption that making the choice of a caesarean is somehow ‘an easy way out’ that doesn’t warrant or require support, or preparation, or that cesareans are fully led and decided by your hospital/consultant and that therefore there isn’t much to discuss around it.

But that’s not the case. 

Whether your caesarean is planned or unplanned, getting the support of a birth & postpartum doula is a trustworthy and deeply valuable way to secure personalised emotional, physical, and advocacy support for your birth & postpartum, and help you approach and embrace the lead up to, actual birth of you baby and the days and weeks afterwards with more calm, ease and confidence.

Here’s how.

Birth planning & advocacy

• When you are planning for, or strongly considering an elective caesarean for the birth of your baby, it is valuable to spend some time exploring your feelings, motivations and rationale for the cesarean, which a doula can expertly guide you with. This might involve helping you assess whether this path will meet your needs and wishes (where several birth paths ARE an option), or support you processing difficult emotions and reframing you mindset if this wasn’t your initial or preferred option.
  

• A doula should also help you get familiar with the procedure itself, what happens before, during, straight after, the people, timings, sensations, etc and what choices can be made at each and every step (including ‘gentle’ cesarean and maternal assisted cesareans), and help you put together your birth plan / birth preferences, as well as how best to advocate for these preferences with you care team (sometimes attending appointments with you). When I support couples planning for c-section, I always make sure we also discuss plans and best ways to manage the situation in case labour starts before your scheduled c-section date, as this does happen and can create a lot of stress if you’ve never thought about it.

• The part of a cesarean birth that often creates the a lot of apprehension is always the post-surgery and postpartum recovery part. A doula can help you understand what exactly to expect afterwards, physically, emotionally, practically, for you AND for your baby, and put together a supportive postpartum plan for your recovery and early postpartum 

Emotional support before and during your c-section birth

• If you’re having a cesarean due to to complex medical needs or because of a traumatic previous birth, or if you have fears around surgery, the lead up to your birth might be a stressful and anxious time. A doula can share specific and sometimes personalised tools, techniques and ongoing emotional support to help you manage stress and anxiety before birth, and promote calm and grounding on the day as you wait to go to theatre and during the birth itself, so that you can as present as possible for this most precious moment in your life! Of course, this would equally apply if a cesarean wasn’t your initial plan, but turned out to be on the cards or required during your labour - with all the emotional support that this entails.

• Depending on your birth plans and preferences in place at your chosen place of birth, a doula might provide extensive in-person and/or remote support on the day, sometimes for many more hours than a vaginal birth would involve: from waiting with you pre-surgery (which can be a very long wait), being with you in theatre throughout the surgery (as your main birth partner or a second birth partner, when and where allowed) and immediately afterwards in recovery (see below).
  

Post-op support in hospital

Straight after surgery, a doula can offer deeply valuable support while you are in the high-dependency unity/recovery area and/or while you’re staying on the postnatal ward (generally, for at least one night as standard).

At this time when your mobility will still be very limited, and you might suffer temporary after-effects of the surgery, a doula can help facilitate skin-to-skin with your baby, offer hands-on support and guidance with the first feed(s) and help you stay as comfortable as can be.

Doula support can also allow your birth partner to take a break, go attend to any siblings and/or go fetch supplies as needed. It is worth bearing in mind that with the increase of cesarean births in the UK, postnatal wards are not always sufficiently staffed to provide thorough/timely support to post-op mums so a second or knowledgeable helper is often very valuable.

Support with physical postpartum recovery (including c-section scar massage)

One of the women’s most common concerns with caesarean births is the recovery part. Recovery from any surgery always requires time & care, and in the case of c-sections is compounded by the recovery the body requires after any pregnancy and birth.

Frustratingly, despite the ever-rising rate of caesareans in the UK in the past decade, specific guidance and support around post-surgery and physical (and mental) recovery after caesarean is almost non-existent or extremely limited in the NHS. Lot of new mums are barely given a leaflet about how to care for their scars upon discharge from the hospital, or only given unrealistic advice such as not lifting anything but their baby for the first few weeks, without practical tools to manage daily life after surgery. This is in high-contrast with other types of surgery, including abdominal surgery, where extensive post-surgery guidance and physiotherapy is often provided after!

Depending on her specific expertise and training, a doula can provide guidance how to positively support scar healing & appearance (including how to massage your scar & belly), how to return to movement, support your pelvic floor health, digestive comfort, help you explore your feelings around your scar, body or birth experience

A doula can also provide very practical support at a time when your mobility is limited and you want to to prioritise rest as much as possible, including: cooking nourishing meals, looking after your baby while you rest / nap / have a shower, share tips and tricks on how best you set up your living space to facilitate daily life with a baby or help with light tasks around the house.

Support with feeding your baby

Giving birth by cesarean, especially by planned caesarean before labour has started, can lead to more difficulties with feeding your baby. Contrary to popular belief, this doesn’t only apply to breastfeeding - babies can also experience temporary issues with bottle feeding related to their (lack of) readiness to feed - although breastfeeding issues are more common. These are most often due to the relative readiness of newborn babies to suckle effectively and regularly, and for your milk supply to get going and established well, which are issues best addressed from the very early days to avoid derailing your breastfeeding journey.

Regardless of how you’re hoping to feed your baby, experiencing these issues can feel extremely stressful as a new parent, and practical support and emotional reassurance can go a long way making this time a lot less stressful.

All doulas are trained to support with this, including: helping you explore all your feeding options and ways to prepare (antenatally) for potential difficulties in the early days, harvesting colostrum, positioning and latching, pace-feeding using a bottle, checking and supporting effective milk transfer and milk supply, spotting redflags and signposting to further support where needed (some doulas also carry extra qualifications in infant feeding, such as lactaction consultants and IBCLCs, and can offer this further specialist support themselves).

If you’d like to learn more about my elective cesarean support package, or my birth & postpartum doula support in general, please do not hesitate to get in touch or book a free connection call.