Questions to ask your doctor before C-section

Having gone through now two c-sections I feel that I have a pretty good grasp of what questions to ask the doctor prior to your c-section delivery.

I had my first c-section 11 years ago and my second only six days ago! So what has changed in those 11 years?

  • My age. I was 26 when I gave birth to my daughter and my recovery seemed speedier. At 37 I was considered advanced for maternal age and as a result, was at risk for greater pregnancy related complications and my son at risk for greater birth defects.
  • My OB. The doctor who delivered my daughter was not longer seeing OB patients, only GYN patients.

In my opinion there are many advantages to having the same OB manage your prenatal care and, if required, to perform your c-section. Should your doctor change OR if you are considering or must have a c-section here are some questions to ask your doctor:

  1. If you have previously had a c-section inquire about the hospital’s and your doctor’s personal philosophy and comfort level with performing VBAC. Hospitals are required to have certain staffing ratios and a specific composition of care team staff on hand to manage a VBAC. In my case, my doctor personally preferred c-section deliveries and by her own admission elected to have two of them. There were even a few instances where she strongly encouraged me to simplify things by just opting for a second c-section. If your doctor holds these beliefs they may not support your desires/wishes to have a VBAC.
  2. For when will my c-section be scheduled and are the dates flexible? My doctor scheduled mine for me one day prior to the original due date. We did not discuss my preference for dates, but given that my due date was sandwiched between Christmas and New Year’s Eve I figured that the date was a matter of when the OR suite and staff were available.
  3. How many support persons can I have in the OR room with me during delivery? Are photos and/or video recording allowed?
  4. What type of incision will you make? If your c-section is emergency or if your baby is in a transverse position your doctor may use a vertical incision. This may also be required in other instances. The most common approach is a horizontal incision that is slightly below the bikini line. Both of mine were horizontal incisions.
  5. Will you use stitches, staples or dermabond (glue)? I had dermabond with my first and staples with the second.
  6. If you have previously had a c-section ask the doctor if he/she will use the existing scar. During my prenatal visits the OB would jokingly say, you already have a scar, just have another c-section. This led me to erroneously assume that she would use my existing scar. Imagine my surprise when the bandages were removed and I realized that I had a brand new incision! The nurses on the unit and the doctor who made rounds that weekend could not explain to me WHY the doctor had made a new incision, but assured me that the doctor will assess to see if this is the best approach. I have this on my list of questions to ask at my follow-up visit and have done some research just to see if this was standard practice. It seems that in most instances the previous scar is used, but in others a new one is made. I couldn’t find any evidence based practice articles on the subject, but did consistently see that new scars heal faster. Either way, this is something to ask your doctor BEFORE hand to avoid any post-op surprises.
  7. What type of anesthesia will be used? I personally had a spinal block. With my first c-section I could not move my legs for 6 hours following delivery. The nurse anesthetist explained that the amount of time varies depending on the amount of anesthesia that was used. In my case I received duramorph and it made me itch both the first and second time. This is a normal reaction to the drug.
  8. How soon after will I be able to drive? I was told two weeks due to the spinal block anesthesia that was used. Make sure you have someone to help you in those two weeks following delivery as your baby’s first doctor’s visit will usually occur within the first few days after delivery.
  9. What are my weight lifting restrictions? I was told 10 lbs or nothing that weighs more than baby and car seat.

These are the questions that first came to mind. Hope these are helpful and good luck on your c-section delivery!

 

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