by Tamara Kelly

Created on: June 28, 2007

When planning a cesarean section, the formation of a birth plan is often overlooked. However, it is important to let your birth team know what you want to have happen, regardless of what kind of birth you are having. Additionally, there may be options available that you had not considered. Even if you are writing a plan for a natural birth, it is important to plan for every possibility - including a c-section.

One of the first options to consider is anesthesia during the operation. Some doctors and hospitals have firm policies in place about what types of anesthetics they will use. Others offer you a choice of epidural or spinal block. There are pros and cons to each type of medication. Epidurals are often seen as the safer choice, but they can leave what are called "hot spots" - areas that have not been numbed sufficiently. Spinal blocks carry slightly more risk, but offer more consistent pain relief. The main anesthetic can also be followed by morphine, which will help the transition from IV medication to the pain relievers you will take later in pill form. Be sure to discuss your options with your doctor, and include your decision on your birth plan.

A requirement of any cesarean section is urinary catheterization. While being catheterized is not itself an option, many hospitals will let you decide when to be catheterized before or after you have received the anesthesia. Having a catheter placed can be very uncomfortable, so do not be afraid to request that the attending nurses wait until the anesthetic has started to take effect.

Another common prep for surgery is to tie down the mother's arms, to prevent the mother from reaching into the surgical area or pulling at an IV line. In many hospitals, restraining the arms is automatically done, but if you are clear that you do not want your arms tied down, your wishes will be respected.

During the birth itself, you will be able to have at least one person of your choice with you. For most women this is their spouse or partner. If you have the option of having a second person with you, consider a Doula. Many women have a Doula for their vaginal deliveries, and it is now becoming more common to see a Doula assisting during cesarean sections as well. If you are restricted to only one support person, and your partner will be accompanying the newborn to the nursery for testing, you may wish to have the Doula come in to be with you at that point.

Perhaps the most exciting option many women are asking for is to have

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