A friend messaged me recently to ask if I was aware of any practitioners invested in Family Centered Cesarean where she lives, on the east coast, far away from where I am currently located. I wished in that moment I had a list I could hand to her to make her life and journey easier. But I don’t. Truth is, I don’t even have a list of more than one hospital and a handful of practitioners in my home town of Denver. Family Centered Cesarean practices are in flux right now, really catching on in some locales, and never even heard of in others. In addition, the factors that influence them are complicated. So instead of handing over a list, I am writing this to help my dear friend and all the moms out there wondering how they can access Family Centered Cesarean. How do you know if your hospital, practice, midwife, or obstetrician incorporate family centered practices into Cesarean birth?
First, ask your care provider if they are familiar with the concept of Family Centered Cesarean. Sit back, watch, and listen. Does your care provider seem excited, accepting, or put off by your question? Do they seem to have a good grasp of what you expect from a Family Centered Cesarean experience? Can they list out family centered practices specifically that they have and do support in the surgical births that they attend?
Second, ask your care provider specifically about skin to skin in the operating room if they don’t address it in their answer to your first question. Skin to skin contact for mothers and babies is an evidence based practice. We have multitudes of research that shows the amazing benefits of skin to skin. If your care provider balks at this or doesn’t have a grasp of this evidence, this is a red flag.
Third, contact your birthing location and ask to speak with the Clinical Nurse Specialist or Nurse Manager for Labor and Delivery. Let them know you are a potential client and you have some questions as you are working on choosing a birthing location. Ask them the same two questions you asked of your care provider. Many hospitals don’t yet have true policies for Family Centered Cesarean and skin to skin in the operating room. If you hear phrases like, “we can try” or “it’s up to the anesthesiologist” push for more direct answers and if you can’t get a clear picture, consider that a red flag.
I have heard of situations where a care provider told a client they could have a Family Centered Cesarean and then once the client was in the hospital they heard that several of the things their care provider had approved in their birth plan were actually against hospital policy. I’ve also heard of skin to skin being completely dependent on who the anesthesiologist on call is, because the hospital doesn’t have a policy on skin to skin. This is why you need to make sure that you get the same answers from your care provider and your hospital to be sure what you want is really available.
Once you have the information you need, develop your Birth Preferences (I prefer the term “preferences” to “plan” when talking about birth). There are several good samples of Family Centered Cesarean birth plans out there, and they can be found on our Facebook page at www.facebook.com/familycenteredcesarean. Take your written preferences to your care provider and have them sign. Then make multiple copies for your care provider, birthing location, and to keep in your birth bag. When you go for a hospital tour (which I recommend every family do, even if they are not planning to birth there) carry a copy and have the tour guide take a look. Sometimes family educators in the hospital can offer additional tips based on their experiences there.
Family Centered Cesarean is a consumer driven initiative, and you will have the most success being proactive and asking for what you desire. And always feel free to send a message to us on our Facebook page if you have specific questions! Love and luck to you in your journey. Remember, all birth is sacred, and the way we experience birth matters.