After you have done your research and have decided to consciously plan a cesarean birth, here are some suggestions for preparation:
Ideally, you will begin with preparing a plan for your birth that may include various options (see here and here) many may not have considered, such as laboring before cesarean and preparing for a mindful cesarean birth.
This resource from Penny Simkin provides guidance about questions to discuss with your provider as you create your birth preferences.
Laboring Before Cesarean
Very few providers offer the option of going into labor before a cesarean, because they don’t want to have to do a vaginal breech delivery in case the baby comes quickly. However, some mothers decide that they want to wait until they go into labor when they go for a cesarean birth for many reasons. This might be an option to discuss with your provider.
Going into labor has benefits for the uterus as studies show 1,2 there is a decreased chance of rupture with subsequent births. Also, some mothers believe that as we know the baby signals the body to go into labor, that they want to wait until the baby would naturally go into labor 3,4,5,6,7,8 so that the lungs and baby are fully developed. Endorphins are produced by both mom’s body and by the baby as a natural chemical release to the contractions of labor9. Many want to provide baby with these endorphins. Some of the chemicals produced by baby during contractions have also been linked to lowering respiratory distress.
Some moms want to go into labor so that they can value the process of labor, feeling contractions and doing some of the work as it heightens the connection to baby10. They want to feel labor. Finally, some mothers decide to wait because they know that the baby could potentially turn all the way up to labor and rarely in labor.
1 Labor Before a Primary Cesarean Delivery: Reduced Risk of Uterine Rupture in a Subsequent Trial of Labor for Vaginal Birth After Cesarean.
Algert, Charles S. MPH; Morris, Jonathan M. MBChB, PhD; Simpson, Judy M. PhD; Ford, Jane B. PhD; Roberts, Christine L. MBBS, DrPH
Obstetrics & Gynecology 2008;112(5).
3 Respiratory morbidity benefit of awaiting onset of labor after elective cesarean section.
Cohen M, et al.
Obstetrics & Gynecology 1985;65(6):818-24.
4 Neonatal Morbidity After Elective Repeat Cesarean Section and Trial of Labor.
Brenda Hook, MD, Robert Kiwi, MB, ChB, Saeid B. Amini, PhD, Avroy Fanaroff, MB, BCh, Maureen Hack, MB, ChB
PEDIATRICS 1997;100(3):348 -353.
5 The harmful consequences of prelabour caesarean section on the baby.
Anjita Sinha, Susan Bewley
Obstetrics, Gynaecology & Reproductive Medicine 2012;22(2): 54–56.
6 Steroid receptor coactivators 1 and 2 mediate fetal-to-maternal signaling that initiates parturition.
Lu Gao, Elizabeth H. Rabbitt, Jennifer C. Condon, Nora E. Renthal, John M. Johnston, Matthew A. Mitsche, Pierre Chambon, Jianming Xu, Bert W. O’Malley, Carole R. Mendelson.
Journal of Clinical Investigation, 2015; DOI: 10.1172/JCI78544.
7 Does performing cesarean section after onset of labor has positive effect on neonatal respiratory disorders?
Senturk MB, Cakmak, Y. Gundogdu, M., Polat, M., Atac, H.
Journal of Maternal Fetal Neonatal Medicine, 2015.
8Stress deprivation and cesarean birth.
The Hippocratic Post, 2017.