Resources and advice

This page gives you suggestions, some of them very simple, to improve your experience of a caesarean section, whether in hospital or at home, and invites you to mobilize your own resources.

Suggestions for hospital stays:

The proposals relate more to the organization of hospital structures to which future parents entrust the smooth running of their baby's birth, without being able to modify the way they operate at the time. But when future parents visit a maternity hospital beforehand, it would be a good idea to ask very concrete questions about aspects such as how the baby is welcomed in the operating room, the place of the father/co-parent during and after the operation, and breastfeeding assistance in particular.

At present, two Caesarean section techniques are commonly performed: the "classic" according to Pfannenstiel and the "gentle" according to Misgav Ladach or Cohen Stark. The latter seems to offer a number of advantages, including less blood loss and shorter operating times. Ask your doctor or the hospital of your choice, and find out about their current C-section rates.

A third surgical technique - the extraperitoneal cesarean section - is very rarely used. Without opening the peritoneal cavity, this technique appears to improve postoperative comfort for women undergoing caesarean section, and avoid certain operative complications. At present, however, there is still a lack of hindsight and sufficiently well-founded scientific studies.

Recent studies have shown that babies are much less likely to suffer, especially respiratory problems, if Caesarean section is performed. beyond 38 weeks gestation. This won't be possible in all cases, of course, but it should become a serious criterion for scheduling this procedure and accepting caesarean sections for convenience.

As standard, you can expect the medical team to involve the woman and the couple as much as possible in the decision-making process, to take the time to explain the necessary procedures and to respect the woman's modesty. Depending on the configuration of the site, the insertion of the urinary catheter, a sometimes unpleasant procedure, can be carried out under good conditions after the anesthesia has been administered. The next step is to supervise the future father/co-parent if he wishes to attend the Caesarean section, which is generally the case. He must change into sterile operating theatre garments, complete with mask and hat, and be seated next to his partner as soon as she is settled in for the procedure. A curtain to block the view of the operating field

A third surgical technique - extra-peritoneal Caesarean section - is starting to be used again. This technique dates back to the early 19th century, and was developed by Baudelocque. Without opening the peritoneal cavity, this technique seems to improve postoperative comfort for women undergoing caesarean section, and avoid certain operative complications. At present, there is still a lack of hindsight and sufficiently well-founded scientific studies.

Recent studies have shown that babies are much less likely to suffer, especially respiratory distress, if Caesarean section is performed beyond 38 weeks' gestation. This won't be possible in all cases, of course, but it should become a serious criterion for scheduling this procedure and accepting caesareans of convenience.

As standard, you can expect the medical team to involve the woman and the couple as much as possible in the decision-making process, to take the time to explain the necessary procedures and to respect the woman's modesty. Depending on the configuration of the site, the insertion of the urinary catheter, a sometimes unpleasant procedure, can be carried out under good conditions after the anesthesia has been administered. Next, the father-to-be needs to be supervised if he wishes to attend the Caesarean section, which is generally the case. He must change into his sterile operating room clothes, complete with mask and chaqeau, and be seated next to his wife as soon as she is settled in for the procedure. A curtain will hide the view of the operating field!

A less medical aspect seems to me to be fundamental, although not always easy to achieve depending on the circumstances: staying in touch with your baby by placing your hands on his belly, in thought, talking to him mentally or "in real life" and explaining to him that he will soon be taken out of your belly, perhaps in a different way than planned, but that you will be there with him. Even with a scheduled Caesarean section, a certain amount of stress is unavoidable, and stress hormones will circulate to your baby, who is even less prepared for what's about to happen to him because he hasn't experienced the beginning of labor.

As soon as your baby is born, you should make it as easy as possible to welcome from new-born baby. If the baby is well, there's no reason why he shouldn't be left with his parents, covered with warm blankets, while the operation continues. Otherwise, skin-to-skin contact with the father in a warm, protected place should be encouraged until the mother comes out of the operating room, and with the mother as soon as possible after the operation. You can also make a preoperative request for the baby to be the first to hear your parental voices as he or she emerges from the womb. Post-operative recovery rooms for women undergoing caesarean section should be specially designed for them, allowing the baby and father to be present after the operation, as well as first breast-feeding so important for the continuation of breastfeeding, supervised by competent and available staff.

But as these arrangements are not at all widespread, visit first moments with baby can be sorely missed by the mother. The father can compensate a little for this by taking photos of the baby's "firsts" (caregiver, first care, first bath, first diaper, weight readings etc. etc.). A short film would obviously be wonderful, and can be made quite easily with modern digital cameras. The first few days after the operation require effective pain relief and help from the medical team in caring for both mother and baby. Restoring mobility to the mother is an important factor in her recovery, but also in enabling her to care for and breastfeed her baby in the greatest comfort.

But as these facilities are not at all widespread, the first moments with baby can be sorely missed by the mother. The father can compensate for this by taking photos of all the baby's "firsts" (caregiver, first care, first bath, first diaper, weight readings, etc.). A short film would obviously be wonderful, and can be made quite easily with modern digital cameras. The first few days after the operation require effective pain relief and help from the medical team in caring for both mother and baby. Restoring mobility to the mother is an important factor in her recovery, but also in enabling her to care for and breastfeed her baby in the greatest comfort.

For parents, taking stock after caesarean section with the doctor(s) (obstetrician, paediatrician, anaesthetist, midwife) can be very useful, especially if the caesarean section was performed in a highly urgent situation. Ideally, such a discussion should take place during the discharge visit, but it can also take place after discharge from hospital. You may need time to realize what has happened and what your needs are.

Your gynecologist will receive the medical report on the operation, and you can ask for a copy. Hospitals and clinics are required to keep medical records for a certain number of years, and it is possible to consult them at a later date. Find out more about the procedure you need to follow, as it may be important for you to clarify certain points. Other specialists like myself can also be a valuable resource.

Suggestions for getting home:

For the baby :

It's never too late to realize the skin-to-skin contact between mother and baby. The longer the separation between mother and child, the more important it is to "make up" for lost time, wherever possible. The future of the relationship between mother and child may be at stake. Afterwards, this carnal contact can be extended with the baby carrying. Special scarves are available on the market, enabling even a newborn baby to wear them without putting too much strain on the spine, and there are even workshops where you can learn to wear them.

For newborn babies, you can prepare a enriched bath with Bach flowers (e.g. "rescue" drops) or an appropriate essential oil (e.g. rose or lavender for one drop), allowing the baby to return to the still-familiar liquid environment. This can be very beneficial in soothing the shock of birth, especially if the baby is gently lifted out of the bath to find himself snuggled up skin-to-skin with his mom, snug and warm.

For babies who are difficult to calm, restless and have trouble falling into a deep sleep, swaddling can be an interesting tool to discover.

Another way is theeffleurage of the skin during the first days of life, and gradually the baby massage after a few weeks. Both contribute to the carnal relationship and are a real balm for mother and child. All you need to do is create a calm, well-tempered atmosphere for this tender moment. If you don't feel confident enough to do this spontaneously, you can get help from the home midwife or take advantage of baby massage course to learn it.

A consultation with a osteopath in the first few weeks can be helpful in gently mobilizing the bones of the skull and neck, particularly in the case of a scheduled Caesarean section without contractions. Your midwife can show you how to mobilize your baby using and flat on the stomach.

Another method is gentle effleurage of the skin during the first days of life, followed by baby massage after a few weeks. Both contribute to the carnal relationship and are a real balm for mother and child. All you need to do is create a calm, well-tempered atmosphere for this tender moment. If you don't feel confident enough to do this spontaneously, you can get help from home midwifery or take advantage of baby massage course to learn it.

Homeopathy also offers interesting remedies, and parents who have benefited from haptonomic birth preparation will find it comforting after the caesarean section. Baby care and breastfeeding are ideal times to talk to the baby about what happened around the birth. The mother can tell him of her distress and sadness. She can acknowledge and put into words that it wasn't easy for the baby either. Even if the baby doesn't understand the meaning of these words, he will intuitively understand the intention in his mom's voice and may calm down and relax, sometimes dramatically.

According to the latest knowledge on microbiota (known as the intestinal flora, a collection of micro-organisms that reside in the body), we know that the intestinal flora of a baby born by Caesarean section will not be made up in the same way as that of a baby born by vaginal delivery. It will have other bacteria and fewer varieties of bacteria. This difference could explain why children born by caesarean section develop more illnesses, such as type I diabetes and asthma. For promote a rich variety of microbiotaIn addition, it may be useful to supplement your baby's diet with lactobacilli from the very first days of life (e.g. Lactobiane, BiGaia etc.). Your midwife and pediatrician will be happy to provide you with further information.

In addition, thehomeopathy also offers interesting remedies, and parents who have benefited from birth preparation by thehaptonomy will find it comforting after the cesarean section. Baby care and breastfeeding are very favourable times for talking to the baby about what happened around his birth. The mother can tell him of her confusion and sadness. She can recognize and put into words that it wasn't easy for the baby either. Even if the baby doesn't understand the meaning of these words, he will intuitively understand the intention in his mom's voice and may calm down and relax, sometimes dramatically.

For the mother

The journey home begins with a painful movement: get in, and later, get out of the car. Instead of twisting your body to do it, you can place a plastic bag on the seat to allow you to turn-slide with your legs together in a seated position.

We recommend no driving, no heavy lifting, no abdominal exercises, no upper-body/lower-body twisting and no exaggerated stretching of the body. No bathing or swimming for the first 6 weeks post-operatively either.

Paying attention to and caring for recovery postoperative care in the first month (at least) will help you recover more quickly. Don't forget that you already have your newborn to look after, care for and breastfeed 24/7.

Visit lying flat helps the scar to grow harmoniously into the skin. the full range of your body's extension. Remember to lie flat 2-3 times a day, ideally to sleep at the same time as your baby.

Start walking with short, flat strolls of around 20 minutes and gradually increase the time and effort involved. The most important thing is to listen to your body. A sensation of heaviness weighing on the vagina indicates a weakness in your perineum, and it's a good idea to consider postnatal gym and/or perineal reeducation. Your midwife and gynecologist will be able to give you more information.

Women's backs and necks often ache after spending several days in bed in hospital. Why not offer the mother a moment of massage too? Massaging the shoulders and nape of the neck, or the lower back, with massage oil can relieve a great deal of physical - and sometimes psychological - tension. Massage oil (e.g. arnica) can be enriched with an essential oil, to be chosen according to need and mood. Lavender is often appreciated for its soothing and harmonizing qualities.

Providing the mother with a sense of well-being (e.g. rest, meals, housework, errands), listening to her, accepting her tears, supporting her in her role as a mother and surrounding her with kindness, without feeling sorry for herself, are attentions that are within the reach of those around her.

Probably the most important thing for a woman is to be heard and listened to when she expresses her experiences and (re)feelings.

For mother and baby care, as well as breastfeeding, the visits of a home midwife can be a great help. The midwife will have a global view of the situation and can advise you individually, in the protected setting of your home. Her listening skills, empathy and professional experience can provide real support in the postnatal period, whatever the circumstances.

She can also guide you in your choice of alternative methods, while respecting your individual sensitivity. There is a whole range of alternative methods for ease post-operative recoveryScar healing, lactation, emotional state and sleep, among many other possibilities. In SwitzerlandThe basic health insurance scheme provides for home visits by the midwife up to the 56th day (8 weeks) after the birth, as well as three breastfeeding consultations. No medical prescription is required, and services are reimbursed in full, with no co-payments or deductibles.

It may also be useful to call on the services of a domestic help for the first few weeks after the caesarean section, to avoid putting too much strain on the scar through inappropriate movements. Your doctor will draw up a medical voucher for this, and in Geneva, IMAD (home help and care centers) will provide you with this assistance.

In a more symbolic approach After the care, the couple could imagine a special moment to experience the baby's arrival as they had imagined it before the Caesarean section: subdued lighting and soft music, taking the naked baby, perhaps coming out of the bath described above, from between the legs as if just born to place him gently on the mother's belly, enveloping him in warmth, tenderness and intimacy...

... and many other things that your imagination inspires. For some, writing or another artistic approach such as painting or sculpture can be a very powerful and healing means of expression.

As a general rule, walks in nature, contact with water, natural light, sunshine and warmth are beneficial for centering yourself, getting back in touch with yourself and finding some beneficial distance from events. And if you've learned relaxation and/or meditation techniques, or even hypnosis, you have some very useful tools to reactivate for yourself.

For the father/co-parent

The father/co-parent also needs to recover from this more difficult birth. For all his pride, he's well aware of his partner's physical and moral pain, and of the separation from the baby. His lack of sleep won't be partly compensated by hormones, as it is for his wife, so letting him get a good night's sleep will be very beneficial.

The new father/co-parent will inevitably have to deal personally with the paperwork surrounding the birth declaration, but why not spare him other chores (e.g. pharmacy, shopping) and allow him to spend some cuddly time with mom and baby. A family member or friend will probably be delighted to help.

This is all the more true as the father/co-parent can play a genuine intermediary role between his wife and baby in the early post-operative days. On the other hand, getting involved in care from the outset will help him to create your own early relationship with the baby and find your place in it. Caring for a baby is something you learn "on the job", and it's only through practical experience that you get the hang of it. With longer parental leave starting to be introduced, it's easier to realize and experience those very special first weeks with a newborn - with all the moments of happiness and tenderness, and also the moments of disarray and great fatigue.

But what a reward when the baby surrenders to sleep in your arms with that total trust of which only children are capable.

For the couple

When a baby arrives, the whole family may be couple communication concentrates on the imperatives of the moment, which are numerous and almost 24/7. We put aside what we've experienced around birth, and deal with what's most urgent. However, several of the testimonials we received spoke of the benefits of writing down one's own experience of the birth, and then sharing these stories with others. Redrawing the chronology of the birth, (ex)putting emotions into words and onto paper is a good way to heal oneself, relaunch dialogue within the couple, better understand each other and fill in "gaps" and oversights.

A Caesarean section is an experience in three stories, not to mention the medical team: that of the mother, that of the father/co-parent and that of the child. Obviously, babies can't express themselves in words, but they have many other ways of doing so.

It's also good to know that couple's sexuality may change. As a general rule, it is advisable to wait until bleeding has stopped (approx. 1 month). This is already true during pregnancy and after vaginal delivery, but you'd think it would be easier after a Caesarean section, as the woman's genital intimacy generally remains intact. But pain around the scar, and particularly deeper scars, can occur and cause discomfort. Often, too, the still slightly rounded belly and the lower abdomen with the scar are a very delicate area for the woman, which she cannot easily allow to be touched. And sometimes, the hormones of breast-feeding can cause slight vaginal dryness, so it's a good idea to have a tube of lubricant on hand. After the first month, it's time to think about a means of effective contraception. especially after a Caesarean section, a close pregnancy is not desirable. Ideally, births should be 2 years apart.

Not to mention the psychological aspect of having failed, of the feeling of not being a real woman and of being as if cut off from her body. And with the very real unpleasant manifestations of the scar: sometimes a great deal of sleepiness around it, itching as the hair heals and grows back, tingling, various aches and pains .... Most of these discomforts are temporary, lasting from a few days to a few months, but this explains why women tend to ignore this area. With a gentle, tender approach, it may become acceptable for the woman to have her partner apply cream or oil and massage the area. Tenderness is so important and rewarding at this key moment when the woman is rediscovering her modified body.