Should antenatal education be answering basic caesarean questions?

YES!

On a daily basis I have emails from women with questions and worries. Many of which originate in stories and myths they have been told by friends, health practitioners or read in the media.

A classic one:

‘Will my arms be strapped down?’

The simple answer: NO

However, many women have heard that this is a possibility and some link it to the truth that the table will be on a slight tilt giving it seemingly more credibility. The table is on a tilt but the tilt so slight it is not necessary to restrain you in any.

The list of  myths is huge and the fear they generate considerable. Is it any wonder that some women are terribly afraid of this mode of birth and fight the thought of it even when it might be the safest means of delivery in their specific circumstances?

It is essential to cover caesarean related questions in a balanced, respectful manner and all women should have access to such an approach from those responsible for their antenatal care.

Other examples of typical myths I have been repeatedly contacted about are:

  • I will have to wait till I am back on the ward before I can see my baby (IT DEPENDS – Your baby can be delivered straight onto your chest for skin to skin contact if there are no medical complications. Where there are complications your baby may indeed be elsewhere, but then she is in the best place given her physical condition and you can be wheeled to her immediately if you too are well enough)
  • I will be able to see my insides (UNLIKELY – You will have to look very hard to see anything at all in the blur of the lights above you and there is a large screen between you and your abdomen in any case. Women who want to see their baby lifted from them need to ask to have the screen lowered in order to view anywhere close to the surgical area)
  • I’ll be cut right down the middle (UNLIKELY – Most caesarean scars are horizontal and in your bikini line, it is only in very specific circumstances where this might be necessary and you will be told in advance)
  • I won’t be able to breastfeed my baby (MYTH – Breastfeeding can be tricky however you give birth but a caesarean delivery does not make this more so unless you have needed a General anaesthetic in which case you may be drowsy for up to 24 hours after delivery)
  • I won’t be able to pick her up for days (MYTH – She is NOT too heavy for you to pick up it is more an issue of how quickly you can move in the first 24 hours. You may benefit from having her passed to you initially but you can now request basinets which attach to the side of your bed so even this is becoming a problem of the past)

Then there are more detailed questions:

  • Will I be awake?
  • What is the difference between a spinal and an epidural?
  • Can my partner be with me?
  • Will I have a vertical scar?

I am often asked such things by women who have already been told they need a caesarean and therefore should also have been told the answers in their case. I find it staggering that women are having to ask such things AFTER their appointments.

Educators should not wait to be asked, the information should be presented fairly and accurately. It is not respectful to assume that women do not want to know (many do) nor should it ever be assumed that women know what questions they should be asking in the first place.

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