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The Doula Diaries: Emergency C-Section


"What happens if it goes to a c-section?" is a frequently asked question when meeting with potential doula clients. That there's a misconception that a doula is there to only support unmedicated vaginal births, and if the birth ends up going that way, that the investment in a doula was a waste, but there is still so much support that can be done no matter how the birth goes.



This birth story starts off with an overdue baby. At 10 days past the due date my client got the call to come in for an induction. This petite woman was now carrying a baby predicted to be around 10lbs, and they wanted to get things moving.

She went in to get things started on a Saturday afternoon, with a dose of Cervidil to ripen the cervix ,she was sent home to wait for things to kick in. I got a text Sunday morning letting me know she was experiencing back pain all night, but didn't think anything was really happening. It seemed the back pain was coming in waves, and I let her know that it may be contractions! They don't always hit from the front. She was scheduled to head back to the hospital around noon so she went in to get the update and they were indeed contractions, but only maybe a cm of dilation. The contractions were consistent enough to keep her so I got the call to come down and joined them in the delivery room.


Once in the delivery room, artificial oxytocin was used to hopefully get dilation going and get baby on his way out! The goal was to stay unmedicated as much as possible so we used movement and counter pressure to work through the contractions. She was working through them well as they began to intensify, and lots of the good signs of getting there were happening, closer together contractions, feeling of pressure, and a not so pleasant frequent sign of labour transition, puking. Myself and the nursing staff for sure thought she was close and they offered a cerivical check to see if it was almost time to push.


TWO CENTIMETRES.


The feelings of excitement, shifted to disappointment. After hours of labour and very little progress an epidural was requested. It was now almost midnight, and rest was needed. Once the epidural was place we all decided to try and get some rest. I left to give my client and her partner a nap, and caught a few hours of sleep myself. Around 8am I received the text to come back, progression happened and she was at 9cm! Things were looking up again!

It was time to start moving to get baby moving. We moved her in to an upright position resting over an elevated head of the bed, but baby didn't like this. The tracing wasn't good. Baby only seemed happy if Mom was in one position, so that's where she stayed, in a side laying position. Things still were progressing and she made it to 10cm, baby was still pretty high so the medical team was hoping some pushing could help bring him down and out, potentially with some assistance.


First push, heart rate dropped and wasn't improving. Immediately the medical staff began preparing to move her to the operating room. They'd see what the options were and hopefully let her push with assistance in there but be ready to operate if needed.


Myself and her partner followed to the operating room, they got him scrubs so he could join in when ready. We waited.

I gave Dad space to express his concerns while we waited for an update in this space of unknown.


Eventually an update came. A cesarean was needed and the epidural wasn't working well enough to operate so full general anaesthetic was needed, which means dad isn't allowed in surgery. We were told once baby was born they'd bring him out to Dad while Mom was stitched back up. We waited together in recovery for baby, so Dad could do skin to skin.

Mom had prepared food for baby by pumping colostrum which was stored in the fridge so we asked the nursing staff to help prepare it so baby could be fed once out.


I was able to capture the first moments of meeting once baby joined us, photos that mom has said were priceless as she wasn't there to witness it. That first golden hour was spent with Dad instead and once Mom was out she was finally able to meet her baby boy, almost an hour after his time of birth.

It was time for her golden hour, where she got skin to skin and baby latched beautifully.


The scan wasn't too far off with this big boy weighing in just shy of 10lbs.

He was likely putting pressure on the cord and once it got to the pushing stage it was just too much.


During our postpartum visit we talked about how hard Mom worked for this baby and let her process what happened. There was trauma there and she needed to process it. While she said that she was just glad baby was ok, we worked through her feelings as well. It's not just baby that needed to be ok, Mom needs to be ok too. We created space for those emotions and that it was ok to cry, it was ok to feel disappointed even if your baby is healthy.

Creating space to process your birth, no matter how it goes, is so important. If you need someone to talk to, to process a traumatic birth or help you through postpartum depression contact the Postpartum Support International (PSI) Helpline at 1-800-944-4773 (4PPD) to speak with a trained volunteer who can get you in touch with your local PSI volunteer support coordinators.

Call or text the Mood Disorders Association of Manitoba Postpartum Warmline at 204-391-5983 to speak with a volunteer with personal experience. You can also email the Postpartum Warmline at postpartumwarmline@mooddisordersmanitoba.ca.


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