WEBVTT - What To Expect If You Need a C-section 0:00:00.240 --> 0:00:08.400 Who baby, my baby, belof I need you, Oh how 0:00:08.760 --> 0:00:13.000 I need you? What to expect? As a production of 0:00:13.119 --> 0:00:17.119 I Heart Radio, I'm your host Heidi Murkoff and I'm 0:00:17.160 --> 0:00:19.760 a mom on a mission, a mission to help you 0:00:19.800 --> 0:00:26.279 know what to expect every step of the way. It's 0:00:26.320 --> 0:00:30.120 definitely the happiest surgery you could ever dream of having, 0:00:30.480 --> 0:00:34.440 but it's still surgery, whether it's scheduled or last minute, 0:00:34.600 --> 0:00:38.680 a first or repeat. Let's face it, a C section 0:00:38.840 --> 0:00:41.240 is in a box on a birthland you were likely 0:00:41.280 --> 0:00:45.920 hoping to check. But let's face this too. Accessarian delivery 0:00:46.000 --> 0:00:50.400 is something you and every expecting parents should be prepared for. 0:00:50.920 --> 0:00:53.920 That's because c sections are pretty common in the US, 0:00:54.280 --> 0:00:57.480 was close to one in three moms ending up with one. 0:00:58.040 --> 0:01:00.680 The upside to a C section, it's very very safe, 0:01:00.760 --> 0:01:03.240 and in some cases, it's the safest way to deliver 0:01:03.400 --> 0:01:06.800 a baby. The potential downside. If you're a mom to 0:01:06.840 --> 0:01:09.679 be with your heart set on a vaginal birth, the 0:01:09.800 --> 0:01:12.319 news that your baby needs or may need to be 0:01:12.360 --> 0:01:17.200 delivered by C section can definitely be disappointing. Scheduled for 0:01:17.240 --> 0:01:20.520 a C section, hoping to avoid one, hoping to avoid 0:01:20.560 --> 0:01:24.039 a repeat, just plain stress about the possibility you might 0:01:24.160 --> 0:01:28.119 need one, just trying to do your labor and delivery homework. 0:01:28.560 --> 0:01:32.360 No matter what, We've got your back and your belly. 0:01:32.400 --> 0:01:36.920 Today we're delivering everything you need to know about C sections. 0:01:37.400 --> 0:01:41.039 I'm here with my good friend, maternal fetal medicine specialist, 0:01:41.200 --> 0:01:44.600 Dr Sarah Obachon, who is medical director of Mother to 0:01:44.680 --> 0:01:51.760 Baby Florida and Assistant professor at the University of South Florida. Hey, Sarah, Hello, 0:01:51.880 --> 0:01:54.280 thanks for having me. Oh, it's great to have you back. 0:01:54.320 --> 0:01:57.960 We always need you for advice. It's clear how much 0:01:58.000 --> 0:02:02.040 you care about the moms you hair for, and your 0:02:02.080 --> 0:02:05.840 empathy and your reassurance. And you're easy to talk to um, 0:02:05.840 --> 0:02:08.000 which is so important when a mom is stressed out 0:02:08.040 --> 0:02:13.119 about something like having a C section. So let's talk 0:02:13.160 --> 0:02:16.880 about c sections as if I were your patient. Close 0:02:16.960 --> 0:02:19.560 to one in three moms in the US end up 0:02:19.560 --> 0:02:22.840 having a C section. Now, the w h O believes 0:02:22.840 --> 0:02:27.280 that rage should be under percent if c sections were 0:02:27.280 --> 0:02:30.760 only done for medically necessary reasons. Why do you think 0:02:30.840 --> 0:02:34.280 rates are so high in the US. That's a great question. 0:02:34.360 --> 0:02:37.680 There's so much struggle with this that we're working on 0:02:37.800 --> 0:02:41.040 over so many years. I do think they should probably 0:02:41.080 --> 0:02:43.400 be lower. I don't know if it's possible to be 0:02:43.520 --> 0:02:47.320 less than in the country, but they certainly seem like 0:02:47.360 --> 0:02:50.040 they should be lower than they are. And it's always 0:02:50.040 --> 0:02:53.919 a really tough emotional discussion with the with the patients 0:02:54.000 --> 0:02:57.839 because some patients do really need one and it's really 0:02:57.960 --> 0:03:00.960 the safest for them, and they're maybe if you have 0:03:01.000 --> 0:03:04.640 a placenta creta, if you have a placenta previous, so 0:03:04.680 --> 0:03:08.120 it's covering the birth canal, maybe really shouldn't come out 0:03:08.639 --> 0:03:13.120 vaginally under any circumstance. But there are sometimes that it 0:03:13.240 --> 0:03:16.359 was casually that maybe really need to have a cesarean, 0:03:16.840 --> 0:03:20.720 And that's a question that's being worked on nationally, uh 0:03:20.880 --> 0:03:24.160 kind of really higher level of work looking at data 0:03:24.320 --> 0:03:28.360 how to decrease that first cesarean in women. And the 0:03:28.400 --> 0:03:31.080 reason for that reason that sometimes it's harder to get 0:03:31.120 --> 0:03:33.520 a b back to have a vaginal delivery after a 0:03:33.560 --> 0:03:37.600 C section because some hospitals won't do it. Some hospitals 0:03:37.600 --> 0:03:40.920 are scared the medical legal aspect of it, or their 0:03:40.960 --> 0:03:44.360 doctors won't perform it, or I don't for multiple reasons. 0:03:44.440 --> 0:03:47.920 But if we can decrease the chances that a woman 0:03:48.040 --> 0:03:50.760 the first time around is going to have a C section. 0:03:50.880 --> 0:03:54.040 This is where we would be probably winning the most. Yeah, 0:03:54.080 --> 0:03:56.760 because if you avoid the first c section, then you're 0:03:56.800 --> 0:04:00.760 going to automatically reduce the rates. That's right, and we're 0:04:00.760 --> 0:04:03.680 gonna have a much better chance of having the second one. 0:04:03.840 --> 0:04:07.160 That generally, do you think they're getting your care from 0:04:07.240 --> 0:04:10.600 a midwife? Assuming that you are low risk makes it 0:04:10.720 --> 0:04:12.880 less likely that you'll end up with a C section 0:04:13.000 --> 0:04:17.000 if all other things are relatively equal. I think that depends. 0:04:17.040 --> 0:04:19.920 Just like any time you think about doctors, good doctors, 0:04:20.000 --> 0:04:23.040 you know somebody don't really click with the same with midwives. 0:04:23.120 --> 0:04:25.919 I have worked with midwife, some wonderful midwife in my 0:04:26.000 --> 0:04:29.839 career here at USF and also at George Washington University, 0:04:29.920 --> 0:04:34.040 and sometimes the criteria to be their patient is rather 0:04:34.200 --> 0:04:38.320 strict because they know if you're a waking during pregnancy 0:04:38.480 --> 0:04:41.679 is not very high. If you are otherwise healthy person, 0:04:42.160 --> 0:04:46.560 if you are a nutritionally doing well, then your chances 0:04:46.600 --> 0:04:49.640 of having a badge of delivery a higher. So it 0:04:49.800 --> 0:04:53.159 depends if you have a midwife who is able to 0:04:53.200 --> 0:04:55.919 guide you in that process and do that with you, 0:04:56.440 --> 0:05:00.400 then that is wonderful. But also it like of the 0:05:00.520 --> 0:05:02.800 way some people from seeing a midwife if they feel 0:05:02.800 --> 0:05:05.240 a little bit marginalized, like they couldn't keep the weight 0:05:05.279 --> 0:05:07.440 down for some reason. So it kind of works a 0:05:07.480 --> 0:05:10.320 little bit both ways. But finding the right fit for you, 0:05:10.480 --> 0:05:13.000 I think it's been most beneficial for each patient, and 0:05:13.080 --> 0:05:17.160 that right person could come in the form of maternal 0:05:17.160 --> 0:05:20.160 fetal medicine specialists, or it could come in the form 0:05:20.240 --> 0:05:23.520 of a midwife that's right, or a combination, which is 0:05:23.520 --> 0:05:27.280 always possible. What are some of the most common reasons 0:05:27.400 --> 0:05:31.679 for medically necessary c section? You mentioned plus center preview, 0:05:31.839 --> 0:05:34.520 and of course placentas can do a lot of moving 0:05:34.680 --> 0:05:37.680 during pregnancy, so you shouldn't assume too early on that 0:05:37.720 --> 0:05:40.400 you're destined to have a C section if you're placenta 0:05:40.480 --> 0:05:43.320 is low lying right, well, what are some other reasons 0:05:43.360 --> 0:05:47.000 why you might have a planned C section? So for 0:05:47.120 --> 0:05:50.520 planned c section, the most common reasons are things like 0:05:50.960 --> 0:05:53.320 fetal mouth presentation, In other words, the baby has just 0:05:53.400 --> 0:05:56.159 turned the wrong way, it is transverse, or its reach. 0:05:56.800 --> 0:05:59.400 That is one of the bigger indications for a planned one. 0:05:59.720 --> 0:06:03.680 Some times twins uh will be more likely to be planned. 0:06:04.120 --> 0:06:07.840 Sometimes when the baby is very large. Is whether or 0:06:07.839 --> 0:06:09.520 not it's a good indication for a C section in 0:06:09.600 --> 0:06:13.039 a different discussion, but oftentimes that will be one of 0:06:13.040 --> 0:06:16.440 the reasons that's quoted for the cesarean. And what about 0:06:16.720 --> 0:06:19.160 reasons that come up during labor for a C section? 0:06:20.880 --> 0:06:25.080 The two most common ones tend to be later for dystocia, 0:06:25.120 --> 0:06:27.800 in other words, you've been trying to have a vagine delivery, 0:06:28.000 --> 0:06:31.719 You've dilated a certain amount and you're not dilating anymore, 0:06:31.839 --> 0:06:35.479 You're not dilating quickly, or the other reason is that 0:06:35.720 --> 0:06:38.920 the baby may or may not be tolerating the labor. 0:06:39.040 --> 0:06:42.640 So there's uh what was previously called non reassuring fetal 0:06:42.640 --> 0:06:47.080 heart tracing, so abnormal tracing on the monitor. So in 0:06:47.120 --> 0:06:49.520 other words, if the baby is not doing well, then 0:06:49.680 --> 0:06:52.680 it's time to move straight to a safer birth through 0:06:52.800 --> 0:06:56.120 C section. Yes, one of the things we're looking at 0:06:56.160 --> 0:06:59.400 in terms of how we define whether or not there's 0:06:59.440 --> 0:07:02.159 an abnormal all tracing. And this is the part that 0:07:02.240 --> 0:07:05.640 I think helps a lot on an institutional basis, um 0:07:05.880 --> 0:07:08.640 a large number basis, meaning that I can teach a 0:07:08.680 --> 0:07:13.160 lot of physicians or nurses how to appropriately interpret some 0:07:13.280 --> 0:07:16.320 of this feutal heart rate tracing so that everybody using 0:07:16.360 --> 0:07:19.240 the same language. And really what is considered to be 0:07:19.280 --> 0:07:23.200 a risk is risk versus not having the same kind 0:07:23.200 --> 0:07:28.200 of communication and maybe misinterpreting some of the fetal heart 0:07:28.240 --> 0:07:30.920 rate tracing. And is it sometimes just a matter of 0:07:31.000 --> 0:07:34.720 changing mom's position. Yes, there's a few things that we 0:07:34.720 --> 0:07:37.160 can do in labor that can help the fetal heart 0:07:37.200 --> 0:07:40.960 rate tracing. We can change the mom's position. We can 0:07:40.960 --> 0:07:44.520 actually sometimes infuse fluid if the mom is already ruptured, 0:07:44.520 --> 0:07:46.680 we can put a little bit of an amnio infusion, 0:07:46.720 --> 0:07:49.600 meaning to put a little bit of fluid into the 0:07:49.680 --> 0:07:52.120 uterus in order to buffer a little bit of that 0:07:52.720 --> 0:07:56.600 fetal cord so that there has less of these decelerations 0:07:56.640 --> 0:07:58.880 on the fetal monitor. So the refuse tricks that we 0:07:58.920 --> 0:08:01.760 can do one and for all. Let's clear this up 0:08:01.840 --> 0:08:07.640 to epidurals make a C section more likely. No, epidrows 0:08:07.640 --> 0:08:11.640 are rather safe. It's one of thost commonly performed procedures. 0:08:11.720 --> 0:08:15.600 Because c sections are our most common like performed procedures 0:08:15.640 --> 0:08:18.440 that we don't think it decreases the chance of having 0:08:18.520 --> 0:08:22.800 a vaginal birth um sometimes and this is sometimes that 0:08:22.880 --> 0:08:25.480 I dotal too. It's like, well, sometimes it helps just 0:08:25.600 --> 0:08:28.280 to relax all your muscles to be able to have 0:08:28.400 --> 0:08:31.680 avaginal delivery. Honestly, that is a choice every woman can 0:08:31.720 --> 0:08:34.280 answer for herself whether or not she's interested in something 0:08:34.360 --> 0:08:36.560 like this, and a good discussion with her doctor and 0:08:36.600 --> 0:08:40.080 also with her anesthesia. But it doesn't matter at what 0:08:40.240 --> 0:08:43.960 point in the process you have your epidural. There are 0:08:44.000 --> 0:08:47.120 no rules, but you can't have it too early. No, No, 0:08:47.360 --> 0:08:49.520 this is something that every woman should be a part 0:08:49.559 --> 0:09:09.280 of that conversation. Now, does inducing labor lead to a 0:09:09.280 --> 0:09:12.040 greater risk of C section? This is something we were 0:09:12.080 --> 0:09:14.440 taught even when I was a resident, And there is 0:09:14.520 --> 0:09:18.079 now really great evidence that an induction doesn't increase the 0:09:18.200 --> 0:09:21.240 risk of your of your C section And this study 0:09:21.360 --> 0:09:24.920 was done relatively recently. Um, but when is the best 0:09:24.920 --> 0:09:27.960 time to deliver? And an induction itself isn't the culprit 0:09:28.080 --> 0:09:31.080 for the cesarean. I don't think we should really be 0:09:31.200 --> 0:09:35.040 afraid of inductions as we used to be. And what 0:09:35.160 --> 0:09:38.440 about being admitted to the hospital too early in labor? 0:09:38.960 --> 0:09:42.440 Does that increase risk? That's a great question. I think 0:09:42.440 --> 0:09:46.160 that one's harder to answer because sometimes you know, when 0:09:46.160 --> 0:09:48.560 you're looking at so many things, like you're looking at 0:09:48.559 --> 0:09:51.280 if you don't heart retracing, and if you're acting on 0:09:51.320 --> 0:09:53.480 it too quickly, then maybe there would be an increased 0:09:53.559 --> 0:09:56.199 risk for that. But you never want to tell the patient, oh, 0:09:56.280 --> 0:09:58.040 stay at home for as long as you can, because 0:09:58.080 --> 0:10:00.320 you then you really don't know how she is or 0:10:00.320 --> 0:10:03.000 how that baby is doing. There have been some hospitals 0:10:03.040 --> 0:10:05.800 who have been putting restrictions on when a mom can 0:10:05.800 --> 0:10:07.880 come in that you know, I've heard, for instance, ince 0:10:07.920 --> 0:10:11.240 some military hospitals you have to be six centimeters, which 0:10:11.280 --> 0:10:14.880 seems like a lot to me. It seems like a lot, yes, 0:10:15.720 --> 0:10:19.080 because you can go very quickly from six to ten. 0:10:20.800 --> 0:10:23.760 And also you're right, I mean women progress very differently 0:10:24.120 --> 0:10:27.320 if you've had a baby before, and just women themselves. 0:10:27.400 --> 0:10:29.680 I have patients who, even if it's their fourth baby, 0:10:29.720 --> 0:10:31.440 it takes them a long time to have a basin 0:10:31.480 --> 0:10:34.520 of delivery, but they do. And then there's moms who 0:10:34.600 --> 0:10:36.960 you know, there are two centimeters to senates, two senators, 0:10:37.000 --> 0:10:39.520 and then then they're called because I'm running to catch 0:10:39.520 --> 0:10:43.040 the baby. But it's hard, right, It's hard to to 0:10:43.120 --> 0:10:47.080 make a cut off for every single patient. For sure. Now, 0:10:47.120 --> 0:10:50.120 if an opie pushes first C section and Mom's kind 0:10:50.120 --> 0:10:52.199 of like, I wish there's some way out of this. 0:10:52.480 --> 0:10:54.920 What are the right questions for her to ask? That's 0:10:54.960 --> 0:10:57.840 great question. I think one is really important to have 0:10:57.960 --> 0:11:01.280 a good communication with your doctor, right, make sure that 0:11:01.360 --> 0:11:03.839 you obviously trust their judgment, and then you know them 0:11:03.880 --> 0:11:06.600 and they know you. While you're having that discussion, you 0:11:06.640 --> 0:11:08.920 know some things even if you don't maybe understand if 0:11:08.960 --> 0:11:11.400 you trust their judgment, Like my goodness, it's easy to 0:11:11.440 --> 0:11:13.120 say yes because if it's the right thing to do, 0:11:13.120 --> 0:11:15.679 it's the right thing to do. But thanks to ask like, Okay, 0:11:15.760 --> 0:11:18.000 is this really necessary? What do you think the risks 0:11:18.000 --> 0:11:21.240 are to me and my baby? Um? You know, could 0:11:21.320 --> 0:11:23.920 I try a little bit longer? And you can read 0:11:24.000 --> 0:11:26.040 the person too if they're like, look, I'm really worried 0:11:26.040 --> 0:11:28.160 about this for this reason, and they give you really 0:11:28.200 --> 0:11:31.280 good reasons. I mean, you really need to trust the 0:11:31.320 --> 0:11:34.040 doctor that's helping to take care of you, too, especially 0:11:34.160 --> 0:11:36.680 if you've chosen that person you feel most comfortable with. 0:11:36.800 --> 0:11:39.320 That's a great place to start. Yes, what are some 0:11:39.400 --> 0:11:42.320 ways of reducing the chances that you'll have a C section? 0:11:42.440 --> 0:11:45.400 Things that you can do during your pregnancy or even 0:11:45.440 --> 0:11:49.559 before so being an optimal health is really important. That 0:11:49.920 --> 0:11:52.840 is just for good pregnancy outcomes in general. Taking care 0:11:52.840 --> 0:11:56.640 of yourself, making sure that you are managing your diabetes 0:11:56.760 --> 0:11:59.160 or your high blood pressure, to make sure that you're 0:11:59.200 --> 0:12:03.160 managing your eight It's important that you have an appropriate 0:12:03.160 --> 0:12:05.600 weaking and talk to your doctor what that appropriate weight 0:12:05.640 --> 0:12:08.440 gain is. We know gaining too much weight during the 0:12:08.480 --> 0:12:12.160 pregnancy may increase the rest for our ces areanum. Being 0:12:12.240 --> 0:12:15.360 obese may increase the risk for cesarian So those are 0:12:15.400 --> 0:12:18.720 the things that we may have some power to help 0:12:18.760 --> 0:12:23.640 ourselves in our pregnancy outcomes. Douels research has shown that 0:12:23.760 --> 0:12:27.760 having a duel at your birth may reduce the risk 0:12:28.000 --> 0:12:30.719 of a C section. Why do you think that is? 0:12:31.640 --> 0:12:33.959 It's so interesting. I think it's wonderful to have a 0:12:34.080 --> 0:12:37.920 continuous labor support right, somebody who's really in your corner, 0:12:38.240 --> 0:12:41.720 who had some training, is really there to be your 0:12:41.800 --> 0:12:45.040 helping your voice through the process. And just like with anything, 0:12:45.080 --> 0:12:47.440 you know, good doctors, bad doctors, good miitherwise bad. You know, 0:12:47.640 --> 0:12:49.560 it's not good or bad. It's just that you have 0:12:49.679 --> 0:12:52.360 to click with somebody well right, And if you do 0:12:52.600 --> 0:12:55.520 and you have the right support person, I think that's wonderful. 0:12:55.720 --> 0:12:58.520 To be a part of that that labor process, and 0:12:58.559 --> 0:13:01.480 I think that well, clear the doctors and nurses aren't 0:13:01.520 --> 0:13:05.840 there with you, but just having someone there by your 0:13:05.880 --> 0:13:09.200 side the entire time can reduce your stress level and 0:13:09.280 --> 0:13:11.880 hopefully that makes a difference. But also, you know, just 0:13:12.400 --> 0:13:17.920 positive affirmations getting you into a position that's perhaps going 0:13:17.960 --> 0:13:23.040 to help the baby move down. Massage doesn't hurt right, right, right, 0:13:23.200 --> 0:13:28.600 Absolutely positive affirmations, you know, even imagery and position they 0:13:28.679 --> 0:13:31.240 like you said, massage, all those things are really positive. 0:13:31.760 --> 0:13:35.920 Do you think that it's important to have childbirth education class? 0:13:36.240 --> 0:13:38.760 Take a class even if you know you're having a 0:13:38.800 --> 0:13:42.320 scheduled C section? Yes, I think that is a good idea, 0:13:42.520 --> 0:13:45.480 especially if they cover c sections right. C sections can 0:13:45.520 --> 0:13:48.880 be scary. I think some of the some of the 0:13:48.920 --> 0:13:52.160 concern my patients have is that obviously they haven't had one, 0:13:52.600 --> 0:13:55.280 and they don't know a lot about people that have. 0:13:55.600 --> 0:13:58.360 Maybe they don't have positive stories about people having c 0:13:58.520 --> 0:14:01.040 sections and there really are mean someone men tell me 0:14:01.080 --> 0:14:03.280 when they have done both that they prefer the season. Actually, 0:14:03.360 --> 0:14:06.920 I mean, who would have known, right, But just understanding 0:14:06.960 --> 0:14:10.000 and knowing what to expect really does kind of change 0:14:10.040 --> 0:14:13.320 your outlook. On what's to come. Definitely, knowledge is power. 0:14:13.760 --> 0:14:17.800 Have you ever had a patient use hypno birthing? Yes, 0:14:18.000 --> 0:14:20.640 I've been part of that too. Um. I think anything 0:14:20.680 --> 0:14:25.239 that helps a patient in in terms of relaxation is important. 0:14:25.560 --> 0:14:27.840 I don't know that hypno birthing will take care of 0:14:27.880 --> 0:14:30.160 all that pain. It's kind of really hard. I think 0:14:30.160 --> 0:14:32.200 the best thing that works is an ever dural if 0:14:32.240 --> 0:14:36.400 pain and pain management is your main concern. But something 0:14:36.520 --> 0:14:41.240 for anything that positively affects you. Imagery, meditation, massage I 0:14:41.280 --> 0:14:44.320 think are all helpful during labor. Yeah, we definitely don't 0:14:44.360 --> 0:14:47.920 want to rely on hypno birthing to deliver during a 0:14:47.960 --> 0:14:53.920 C section, right, correct, You don't want me to do that? No, no, no, Um, 0:14:54.040 --> 0:14:56.640 let's talk about v back a little more. Tell us 0:14:56.680 --> 0:14:59.280 who might be a good candidate for v back and 0:14:59.360 --> 0:15:03.120 who might not. B three candidates for a feedback are 0:15:03.200 --> 0:15:06.160 those women who have had a vaginal deliberate or we've 0:15:06.200 --> 0:15:10.320 had a C section and then had a second vaginal birth. 0:15:10.840 --> 0:15:13.960 Um that makes things a lot easier, b am. I 0:15:14.560 --> 0:15:18.360 um comes into that equation, our age comes into that equation. 0:15:18.760 --> 0:15:21.520 So there's a few parameters that are really important, and 0:15:21.800 --> 0:15:25.080 these things can be calculated by their healthcare provider. And 0:15:25.360 --> 0:15:28.560 you had mentioned that some hospitals are not big fans 0:15:28.840 --> 0:15:32.040 of feedbacks or perhaps won't allow one. So this is 0:15:32.080 --> 0:15:36.160 the conversation you need to have with your doctor well 0:15:36.200 --> 0:15:39.560 ahead of time. Absolutely, this is a conversation early in 0:15:39.560 --> 0:15:42.880 your pregnancy that you should discuss. Do you, guys offer 0:15:42.920 --> 0:15:45.840 a vaginal birth? Actors is are and how is that done? 0:15:45.920 --> 0:15:49.400 Do you have anesthesia at your hospital? Two seven? Am 0:15:49.440 --> 0:15:52.160 I good candidate? How can you help me understand that? 0:15:52.560 --> 0:15:55.080 And if that's not the right pctory, then trying to 0:15:55.120 --> 0:15:57.760 find somebody in your community that would be able to 0:15:57.760 --> 0:16:00.760 do that safely and an option if your baby is 0:16:01.240 --> 0:16:04.520 your mentioned transverse, which is side to side or in 0:16:04.520 --> 0:16:08.600 a breach position that wouldn't be favorable for a vaginal birth, 0:16:08.840 --> 0:16:13.640 having using procedure like external cephalic version, which is turning 0:16:13.680 --> 0:16:19.480 the baby, or possibly other spinning baby techniques. I don't 0:16:19.520 --> 0:16:22.240 know how you feel about those, but the idea that 0:16:22.680 --> 0:16:25.440 maybe you can get the baby to move into position 0:16:25.800 --> 0:16:28.360 so that a v back or just a vaginal birth 0:16:28.360 --> 0:16:31.880 in general is more likely. Yes, agree, I think that 0:16:32.080 --> 0:16:35.120 all those things are an option. Um, definitely speaking to 0:16:35.200 --> 0:16:38.200 your doctor about doing an ECB and explaining to you 0:16:38.280 --> 0:16:41.000 what it is, what are the risks and benefits of that, 0:16:41.320 --> 0:16:44.920 how that is done in their institution, and do you 0:16:44.960 --> 0:16:47.680 feel safe about that being done in the hospital setting? 0:16:47.760 --> 0:16:50.120 And if it was an emergency, what would be done next? 0:16:50.160 --> 0:16:53.080 All those are a good questions to ask for the 0:16:53.080 --> 0:16:57.240 external symphalic version, which are usually done before term, like 0:16:57.280 --> 0:17:01.200 thirty six thirty seven weeks. Great. I feel like every 0:17:01.240 --> 0:17:04.600 mom should be prepared for the possibility of a C section. 0:17:04.880 --> 0:17:07.560 Even if all systems seem to be a go for 0:17:07.640 --> 0:17:10.800 vaginal birth, you never know how labor is going to 0:17:10.920 --> 0:17:15.160 progress or not progress, And even if you're being scheduled 0:17:15.160 --> 0:17:17.960 to deliver at a birthing center by a midwife, it's 0:17:17.960 --> 0:17:21.000 always a possibility. So knowledge is power. We're going to 0:17:21.080 --> 0:17:24.040 get empowered about c sections. First of all, what kind 0:17:24.080 --> 0:17:26.840 of anesthesia well you probably have if you have a 0:17:26.840 --> 0:17:29.639 C section, If you're come to have a C section, 0:17:29.760 --> 0:17:31.840 there's a few ways to do this to make sure 0:17:31.880 --> 0:17:35.280 you have appropriate pain control. The usual is something we 0:17:35.400 --> 0:17:40.760 call spinal anesthesia or an epidural anesthesia. UM. Spinal is 0:17:40.800 --> 0:17:43.200 just something that happens go at one time, needle goes 0:17:43.400 --> 0:17:45.520 the medicine goes in and it's good for a couple 0:17:45.560 --> 0:17:48.440 of hours, which should be sufficient time for a cesarean. 0:17:48.920 --> 0:17:51.399 An epidural will give you a little bit more of 0:17:51.400 --> 0:17:55.520 pain control afterwards, uh with maybe like a pump that 0:17:55.600 --> 0:17:57.760 you can do yourself, so you have a little bit 0:17:57.800 --> 0:18:01.080 more control there. And then in some cases, depending on 0:18:01.160 --> 0:18:04.159 the high risk cases of the pregnancy, that may have 0:18:04.280 --> 0:18:06.480 to do general honest esure where the woman has to 0:18:06.520 --> 0:18:09.080 go to sleep, but those are less common. Will you 0:18:09.119 --> 0:18:11.320 be allowed to have your partner with you during a 0:18:11.400 --> 0:18:15.359 land sea section? In our institution, we are allowing a 0:18:15.400 --> 0:18:17.840 partner to be there during the time of delivery, either 0:18:18.080 --> 0:18:20.760 a vagin deility or cesarian, to have that support for 0:18:20.840 --> 0:18:24.160 us present. And you should always check with your specific 0:18:24.200 --> 0:18:29.080 hospital and your specific guian group to discuss who is available, 0:18:29.119 --> 0:18:33.240 who's able to come to your delivery. How many hospitals 0:18:33.240 --> 0:18:38.639 are making cesareans more mom breastfeeding friendly. Some hospitals call 0:18:38.720 --> 0:18:42.879 them gentle cesareans, so you have immediate skin to skin 0:18:43.080 --> 0:18:46.879 and breastfeeding if it's possible. Yeah, that's a really good, 0:18:47.119 --> 0:18:49.920 big trend that's happening, and I think it's a positive one. 0:18:50.320 --> 0:18:53.760 The idea of just even though this is surgery and 0:18:54.480 --> 0:18:56.520 you know it's very technical and we're all trained to 0:18:56.560 --> 0:18:59.080 do this, to make this more of this loving environment 0:18:59.200 --> 0:19:01.320 of this is actually the birth of a child. And 0:19:01.359 --> 0:19:04.159 in our institution we do things like a clear drape 0:19:04.200 --> 0:19:07.000 where the there's a clear drape that is put up 0:19:07.440 --> 0:19:09.800 and the blue one comes down when your baby is 0:19:09.840 --> 0:19:11.919 being born, so you are able to see part of 0:19:11.960 --> 0:19:15.359 that process. Your see your baby immediately as I am 0:19:15.359 --> 0:19:17.240 cleaning up the baby for you and the baby is 0:19:17.280 --> 0:19:20.560 being necessitated, the baby is there with you. And then 0:19:20.560 --> 0:19:22.560 as soon as the baby is given off to be 0:19:22.680 --> 0:19:25.880 checked quickly, but it's put on your your chest and 0:19:25.920 --> 0:19:29.000 we encourage breastfeeding early. Um. There are a lot of 0:19:29.040 --> 0:19:31.639 these different mechanisms that are happening in different hospitals that 0:19:31.680 --> 0:19:35.440 are helping moms feeling more connected more quickly with their scaria. 0:19:36.080 --> 0:19:39.040 I think that's so great. I've even seen a drape 0:19:39.040 --> 0:19:42.119 with a portal in it that a couple of nurses invented. 0:19:42.119 --> 0:19:45.040 Have you ever seen that? I have not actually seen them, 0:19:45.040 --> 0:19:47.640 so curious. That would be so wonderful. I think it'd 0:19:47.640 --> 0:19:51.520 be an interesting um thing too, just to watch. I 0:19:51.520 --> 0:19:53.600 would be fascinating. But I have not seen that yet 0:19:53.600 --> 0:20:14.720 in our hospital. What happens during necessarian your baby is born. 0:20:14.800 --> 0:20:17.359 Hopefully you're not going to feel anything in terms of pain, 0:20:17.440 --> 0:20:22.360 but what will you feel and here and possibly see? Yes. 0:20:22.480 --> 0:20:24.080 So one of the things I try to explain to 0:20:24.200 --> 0:20:26.280 patients is that, look, you're gonna be on this table. 0:20:26.280 --> 0:20:28.840 There's gonna be a lot of people on you, uh, 0:20:28.880 --> 0:20:30.720 And I trying to empower them. And I was saying, 0:20:30.760 --> 0:20:32.800 look even at your instigia team right next to you, 0:20:32.840 --> 0:20:35.160 and I am literally a blue drape away like it's 0:20:35.200 --> 0:20:37.800 so thin, and you and I can actually talk during 0:20:37.840 --> 0:20:39.800 it if everything is going safely, and I can have 0:20:39.840 --> 0:20:42.159 a conversation and as I talk to your baby, and 0:20:42.160 --> 0:20:44.040 when your baby is ready to come out, I'll let 0:20:44.040 --> 0:20:46.640 you know. And so they don't have pain, for say, 0:20:46.680 --> 0:20:49.320 but they may still experience some pressure because I still 0:20:49.359 --> 0:20:50.960 need to push on their belly a little bit to 0:20:51.040 --> 0:20:53.879 get that baby to come out of that decision and 0:20:53.960 --> 0:20:56.960 show the mom obviously, but um, there might feel some 0:20:57.080 --> 0:20:59.919 pressure that kind of feels odd because there are paints. 0:21:00.000 --> 0:21:04.720 Sensation is very different with that type of anesthesia. Um. 0:21:04.760 --> 0:21:07.560 I tell them about the stark lights sometimes that people 0:21:07.600 --> 0:21:09.399 are like wow, just so bright. And here it is 0:21:09.440 --> 0:21:11.640 because we're doing surgery, so it's a little bit tough. 0:21:11.680 --> 0:21:13.199 But we try if they make things a little bit 0:21:13.240 --> 0:21:15.720 more calm by picking the music that they like to hear, 0:21:16.520 --> 0:21:18.640 what they want their babies to be born too. So 0:21:19.040 --> 0:21:22.040 we have these little tricks that are being implemented, but 0:21:22.359 --> 0:21:24.040 I try to warn them of all the things are 0:21:24.040 --> 0:21:27.240 going to be experiencing. Well, I'm sure you are so reassuring. 0:21:27.280 --> 0:21:30.080 That makes a huge difference. Oh, I hope. So I 0:21:30.080 --> 0:21:32.639 think any birth is really a positive one. Getting a 0:21:32.640 --> 0:21:35.080 healthy amount and healthy babies really what we can all 0:21:35.119 --> 0:21:38.639 hope for. About how long does the C section take 0:21:38.680 --> 0:21:41.800 from start to finish? That's the great question. So if 0:21:41.800 --> 0:21:43.560 we're doing it for the first time, in other words, 0:21:43.560 --> 0:21:46.320 we've never had abdominal surgery, that means we are not 0:21:46.400 --> 0:21:50.679 really going to anticipate having scarring during necessary And the 0:21:50.760 --> 0:21:55.160 c sections are relatively easy to do. I mean, even 0:21:55.160 --> 0:21:57.440 though it's a lot of training goes into that, it's 0:21:57.480 --> 0:22:00.880 not a very difficult surgery if we've been trained well, 0:22:00.960 --> 0:22:03.480 and so it can take only like thirty minutes to 0:22:03.600 --> 0:22:06.280 forty five minutes um. And a woman who has not 0:22:06.320 --> 0:22:09.399 done that before and women have had priority sections. There 0:22:09.480 --> 0:22:11.720 might be a lot of scoring and which basically be 0:22:11.920 --> 0:22:14.360 very damtic about how we do things and make sure 0:22:14.440 --> 0:22:17.120 we put back things the way exactly what we were 0:22:17.760 --> 0:22:20.639 um and delivering the baby safely. But in that case 0:22:20.640 --> 0:22:23.639 it might take longer an hour and a half two hours, 0:22:23.920 --> 0:22:26.720 depending on how much trouble we may liked. He could 0:22:26.760 --> 0:22:30.080