Vaginal birth and Caesarean
Vaginal birth or Caesarean?
Preparing for a vaginal or natural birth
St John of God Murdoch Hospital offer antenatal classes with the hospital midwives which cover all aspects of birth such as:
- when to come into the hospital
- when to call (depending also on where you live in the Perth metro area)
- what labour is
- what to expect in hospital
The hospital midwives also cover your choices in feeding and caring for your baby. There are also options of pregnancy physiotherapy, pilates and yoga classes. These classes teach you about positions for labour and relaxation and breathing methods. It depends on what you believe can be helpful, what you feel attracted to, and on the exact circumstances of your pregnancy.
During your pregnancy Anna and our practice midwife Marie will discuss these classes with you so you can make a choice and be well-prepared.
Our mothers tell us that being able to discuss questions as they arise, during one of the antenatal appointments, is very helpful. It means the questions are dealt with long before you are in active labour. Our mothers also tell us they hear lots of ‘horror stories’. This is when we point out all the stories of amazing birth experiences that are out there and that you might not have picked up as a future Mum.
Care after a vaginal birth
Most women will stay in hospital for three to five days after their baby’s birth. The exact time frame depends on how well they are recovering and on how well the baby is feeding.
Whether you have chosen breastfeeding or formula feeding there are lactation consultants on the maternity ward who will help you with your first steps.
After you have given birth, the midwife caring for you will check your blood pressure. She will also gently press on your abdomen to ensure your uterus is contracting back down into your pelvis. Another routine check involves checking your vaginal blood loss and checking any stitches that you may have.
If Anna needs to do any stitching (after either a skin tear or episiotomy), those stitches are dissolvable. It means that they won’t need to be removed at a later stage. In the first few days a series of observations are planned to follow up on your recovery.
Once you are discharged and go home with your newborn you will be offered a follow-up appointment with Anna. It is generally planned between six to eight weeks after the birth. The purpose is to discuss any questions you may have, to ensure all is well, and to obviously show off your new bundle of joy.
In general, you should be able to resume all normal activities by six weeks. If you have any questions during that time, we will always be here and just one phone call away, to help you whenever we can.
Preparing for a Caesarean
How can you prepare for a C-section? If you are planning to have a Caesarean section, or you require it for medical reasons, Anna will go through the reasons with you. She will also go over the risks and complications with you, and ask you to sign a consent form. This happens usually during one of your antenatal appointments at about 36 weeks.
Part of the conversation will be to inform you about the type of anaesthetic that is used. It is usually a spinal anaesthetic +/- epidural and the anaesthetist will discuss this in more detail with you. Anna will let you know the time you need to come into hospital and when you need to start fasting. We will make sure that you are well-informed about where you need to go for your admission to St John of God Murdoch Hospital on the day of your elective C-section.
Our office staff will ensure that your consent form is added to your hospital file, and we will also organise the anaesthetist and the paediatrician. Some mothers request for a specific paediatrician so several children in one family are seen by the same specialist. Where possible, we help you organise all this.
On the day of your Caesarian delivery, the hospital midwife will accompany you to the operating theatre and she will stay with you during the operation to assist the paediatrician.
You might be wondering who can come with you in theatre on the day as you prepare for a C-section. The hospital policy allows for one support person and that means that usually only one person is allowed with you into theatre on the day.
Once your baby is born, Anna will introduce you to your newborn. Then she will hand the baby over to the paediatrician to check that the baby is well. After those routine checks, your baby will be passed to you for a first cuddle as soon as possible. Your baby will be warmly wrapped, if you prefer skin-to-skin, the paediatrician will discuss this with you.
How will they recognise your baby in the hospital? Your baby will have name bands attached to them in theatre to ensure all is clear once you return to the maternity ward.
If all is well, your baby will be tucked up in bed with you and travel with you to the maternity ward. If there are any concerns, the paediatrician will take your baby to the nursery on the maternity ward. If this is the case, your partner can accompany them.
Care after a Caesarean
Whilst you are still in hospital the midwives will do frequent observations to check on your health. You will have a catheter in place to drain urine from your bladder. This will usually be removed the next day. Over the first 24 hours the midwives on the ward will help you get up and shower. Most mothers will stay in hospital a little bit longer after a caesarean than with a vaginal birth, however, the length of your hospital stay after a C-section is still usually based on how long it takes to establish feeding and being comfortable with caring for your new baby.
When you are discharged from the hospital you will get plenty of medication to control any pain. If you have any concerns or questions about this you will also be able to speak to our practice midwife Marie or to the hospital midwives if after hours.
The stitches that are used at a C-section are dissolvable and do not need to be removed manually. Once the wound dressing is removed, you will be able to shower as normal.
Most women are ready to resume their normal activities by six weeks. One of the main concerns is often being able to drive. In some situations you can be allowed and able to drive as soon as two to three weeks after the birth. However, every delivery is different, so we ask that you call the rooms to discuss this in more detail for your individual circumstances.
If you have any questions about the recovery after your Caesarean we are here to help.
You will be offered a postnatal appointment at 6-8 weeks so Anna can review you and discuss your birth and potentially your future births.
Vaginal birth after previous C-section?
In some circumstances you may have required a caesarean for a birth and then wish to achieve a vaginal birth for your subsequent births. If this is the case and Anna looked after you in your previous birth, she will have discussed this with you at your postnatal check.
In some cases she may have asked you to have a CT scan of your pelvis, to check that there was not a pelvic reason that you did not achieve a vaginal birth last time.
Where Anna has looked after you in your last birth and depending on the circumstances, she will support you in any attempt to have a vaginal birth.
However there are potential complications and she will only support an attempt if appropriate. As always her first priority is the health of your baby and yourself and secondarily aiming to achieve the birth experience you desire.