elective c-section Melbourne
elective c-section and natural birth
Birth delivery via a Caesarean or c-section
A planned or elective c-section
When you give birth via c-section, it is still your delivery, your moment, and your preferences matter. That is why, when we plan your elective c-section we talk about the type of atmosphere you would prefer when the big moment arrives: who you would like to be with you in the room, light conditions, music you want to play to relax or to give extra meaning to the event. We can also talk about how to get the best photos for you of the birth!
Many women will choose Caesarean as their preferred birthing method. Even should you go into labour before the planned date for your caesarean, you would still have the opportunity to birth via a c-section as we always have a full team available 24 hours per day 7 days a week just in case. Our team includes an anaesthetist, a paediatrician, surgical and nursing staff to look after you and your baby.
You may hear the term repeat section. It means that you have had a c-section before. So when you are preparing to give birth again this would be called a repeat section as opposed to a VBAC (vaginal birth after c-section).
A VBAC, or attempting a natural birth after you had a c-section before, carries certain risks. That is why at Melbourne Mothers we believe in personalised care. We talk about your history (in particular your pregnancy history) to make sure we have a clear understanding of the risks that may exist. One of the important factors is the reason why you had an earlier c-section. That conversation is important because we can then talk about the likelihood of giving birth naturally in your current situation.
In other words, everything depends on the unique circumstances of your pregnancy. In general, there are several factors that impact the decision as to whether we should trial labour after a c-section or book an elective c-section for you:
- The baby’s position. If your baby is positioned so its bottom or feet enter your pelvis – what we call a breech presentation – that in itself may be a reason to discuss a caesarean. In general about one in two babies can be turned, and the chances are a bit lower if this is your first pregnancy. If your baby is positioned sideways in your uterus then an elective c-section is usually the safest possible choice.
- The placenta position is another part of the puzzle. If it is positioned low in your uterus, there is a risk of heavy bleeding when you are in labour. As your obstetric team, we focus on your baby’s health and your own safety, and that is why the position of your placenta may be the starting point of a conversation about elective c-section. Most placentas that lie low at 20 weeks will “move out of the way” by the late third trimester.
- Twins are another reason to discuss an elective caesarean. Obstetricians have different attitudes toward vaginal twin delivery and again, everything depends on your unique babies, your pregnancy and your body. We discuss the pros and cons, and have a regard for the type of twins and their growth. We can then make an informed decision together about how best to have your babies.
- The size of your baby will be another aspect of the conversations we will have as you consider a natural birth or a c-section. When you are told that you have a very large baby, one thing to bear in mind is that pregnancy ultrasounds have a certain error margin. In other words, your baby may be smaller than what you are told. But then again, we focus on your wellbeing and your baby’s safety, and if we know for a fact that you have a big baby, we may talk about doing a c-section or having a baby a little earlier when the baby is that little bit smaller.
- Preference is at play too. Some mums simply prefer a c-section because they feel more in control or feel very stressed at the thought of giving birth vaginally. Our role here at Melbourne Mothers is to genuinely listen to your feelings around delivery methods. Once you have received all the personalised information, you can make an empowered quality decision.
An emergency c-section is unplanned. When your obstetrician identifies an obstacle during labour or before you go into labour, your delivery method could change and an emergency surgical procedure is then the only option.
It means that the emergency itself is the main indicator. If your labour doesn’t progress, or if there is an obstruction, the safest way to deliver your baby might be via c-section. Similarly, if your baby’s health is in danger, immediate delivery can save their life. Our role as obstetricians is always to respect your preferences, but also to make the call and act with your own and your baby’s safety in mind.
If your baby is in distress, our birth suite team will pick up the signals early on. For example, meconium-stained liquor in your amniotic fluid indicates that your baby has done a poo and it is one of the indications that your baby may be stressed. If we see abnormal heart rate patterns, again, as your obstetrics team, we sometimes have to make the call and change the plan into an emergency c-section.
Bleeding before labour is a reason to choose the safest way and abandon the plan for a vaginal birth. It’s called an antepartum haemorrhage and it can happen if your placenta is positioned abnormally or if it starts coming away from the uterine wall.
There are many reasons why an emergency c-section may be needed to ensure the safety of the mother or baby. This is why all our obstetric units have ready access to the operating room and a team of dedicated professionals at the ready for you and your baby.
Maternally assisted c-section
A maternally assisted caesarean section is a beautiful option for mothers who want to be actively involved in the caesarean delivery of their baby. We require you to scrub in and wear sterile gloves. Once I have made the incision and have lifted the baby’s head and shoulders, I’ll ask you to put your hands under the baby’s arms and to pull him or her towards your chest. It’s an amazing opportunity for you as a mum and I’m happy to offer this to you, if you feel this is something you’d love.
“Like everything however, there are pros and cons. Some women may find being involved in their own operation a little unnerving and also may lament that the first time they touch their baby, it is through surgical gloves.”
C-sections and scarring
natural birth Melbourne
For most women, the default birthing route is vaginal. Some term vaginal birth as natural birth simply because that is how they feel nature intended things to be. For many women, vaginal delivery is an absolute preference. If that is the case for you, we will work towards it, which may involve birthing classes, education on methods to maximise your chances of vaginal birth and instrumental delivery.. But remember: our focus is always to deliver your baby safely.
Many women will have heard or read stories about other women’s experiences. From short and flawless, to painful, long and challenging birthing processes. At Melbourne Mothers we believe that knowledge is key here, and understanding the stages of labour is a good starting point.
Three stages of labour
Literature may differ but in general, these are the three stages:
- First stage: from when you go into labour until you have 10cm of dilation (this is about the opening of your cervix).
- Second stage: from when you are fully dilated until the big moment when your baby is born.
- Third stage: From the delivery of your baby until you deliver your placenta and membranes.
Melbourne-based mums look back at working with Melbourne Mothers and appreciate the time we take to talk things through. You can count on our experience to inform you properly about what is involved, also what we call plan-B. And you can also count on us to really listen to your preferences, your questions and your concerns. There is always a big focus on the safety of your baby and your own wellbeing. So we keep the option open to have a conversation about what if scenarios and plan-B. Your pregnancy is unique, and time will tell us if and when we need to have that conversation.
“I am very aware of my role, to help you achieve a birth experience that you remember as positive. Preparation is key. When we plan your antenatal care consultations, I am here to listen and to give you the best summary of our expertise, so you can make quality choices.”
We know for a fact that you will have dozens of questions. And as you prepare to give birth, for every question we answer there might be new ones appearing. We will make sure you get unbiased information when you need it, so you are confident when you have to make a decision.
What are the risks of a vaginal birth?
Expecting mums will often discuss the risks of giving birth naturally. Even if nature has set us up to give birth vaginally, there is a risk of things not going as planned. There are a number of situations that we will flag as risks:
- Your baby gets stuck or distressed
- Risks of pelvic floor injury, caused by the way your body is built and the pressure your pelvic floor has been under during your entire pregnancy. When forceps are used, there is a higher risk of pelvic floor injuries.
As your obstetrician we will also go over any other health conditions that may cause additional risks
Risk monitoring is one of the key pillars of modern obstetrics, also on the big day. At the hospital, trained and experienced midwives keep an eye on your baby’s heart rate. The big benefit of a hospital birth is that decisions can be made quickly. If there is any sign of distress, you can be moved to theatre to perform a c-section and safely deliver your baby.
How about vaginal birth if I had challenges before?
Working with expecting mums in Melbourne, a common question I get is about the safety of planning a natural birth, even if you have had a c-section before. Our role is to give you a fresh and new experience, no matter what experience you had in the past.
Even if you have gone through trauma – even if you have lost a baby…We have work to do, so we can manage your fears and anxiety together. I believe clear information helps, our experience and hard work is another big part of the story. And simply being available for you when you need us, is also something we strongly believe in.
Can I have a VBAC: Vaginal Delivery after (previous) Caesarean Section?
VBAC is a popular topic when you talk to other mums and if you browse social media and the web you can spend weeks going through all the pros and cons. It is a big question: Can you still deliver vaginally, even if you delivered a previous baby with a c-section?
We do talk about the risks, and we take a positive attitude. If this is your strong preference, we go over the exact circumstances of your current pregnancy. This is why it is so important to choose an obstetrician who brings experience to the table. It starts when we carefully discuss your health history, your pregnancy history and all the information we get from your routine tests and pregnancy ultrasounds.
Then, we have an open conversation. There is your preference and choice, and there are details about your pregnancy, your baby, and your body. What happens in the end is always a well-informed and quality decision. It’s your baby, your delivery, and your decision, that is always the starting point.
vaccination and pregnancy
What about vaccination during my pregnancy?
When the word vaccination is used nowadays, the first thing that comes to mind is COVID-19. The latest guidelines state that pregnant women are a priority group for COVID-19 vaccination.
A few things to remember here is that:
- Australian health advice states that Pfizer or Moderna should be offered at any stage of pregnancy
- If you are trying to fall pregnant there is no need to delay vaccination
- There is also no need to delay becoming pregnant after COVID-19 vaccination
- Scientific evidence has shown that Pfizer and Moderna are safe for pregnant women
- When you are pregnant you have a higher risk of severe illness from COVID-19.
- When you get infected and you are pregnant there is a higher risk of a premature birth.
- Vaccination may provide indirect protection to your baby because antibodies are transferred through your placenta.
Other than COVID-19, vaccines for newborns are already a sensitive, often emotional topic for expecting mums.
All babies are born with a lack of Vitamin K. It is important for blood clotting and 3 in 1,000 babies could have a bleed inside their brain right after birth, because of this deficiency. This is why Vitamin K injections are administered right after birth.
The hepatitis B vaccine is another conversation you will have. As a mum you can transmit this to your baby and babies are more likely to develop serious complications. You will be checked for hepatitis B and the general recommendation is to give your baby a hepatitis B vaccination at birth.
During your pregnancy, you will also be offered an influenza vaccine, Whooping cough vaccination and a Rubella booster vaccination if you are not immune to Rubella.