Dads and birth partners….you are awesome. By being with mom in the operating room during a c-section you’re taking on a very, very important role, often without even knowing what exactly your role will be. So, what do dads and birth partners do during a c-section? Dads and birth partners do much more than just be there to see the baby be born. They’re there to help support, encourage, and calm mom. They also have the big responsibility of taking baby’s first pictures and video, and they’re usually the first person to hold baby and introduce them to mom. Continue reading to hear a play-by-play of what dads and birth partners can (and can’t) do during a c-section. WHO CAN MOM HAVE WITH THEM DURING A C-SECTION? Before I jump into the details of what you’ll be doing, it’s important to back up for a moment to discuss who exactly can accompany the mother into the operating room. Unfortunately, it’s usually only ONE person. Most commonly that person will be the father of the baby or the mom’s partner, but I’ve also seen one of mom’s parents or grandparents, siblings, or friends be the “birth partner” or “support person”. It’s really whomever the mom wants to be there. Sadly, some moms don’t have anyone they know with them during a c-section. I work at a hospital that is close to a very large military base in San Diego, and the mom’s that don’t have anyone are usually women whose partners are serving in the military and are deployed far away. Many don’t have family or friends in town because they’re only in San Diego because that’s where their partner got assigned to work. I have endless respect for those military families who can’t be together during the birth of their own child. I have watched them watch their babies be born via Skype or FaceTime. How incredibly hard that must be to not physically be there. Another reason why the mom may not have the dad or support person there is because they may have taken themselves to the hospital. Once she arrives she needs an emergency c-section to protect her or her baby’s lives, so there’ll be no time to wait for anyone that the mother knows to get there. Ultimately, the doctors and nurses don’t care who is there with mom during the cesarean section. They’re just happy when someone is there with her because they know it’s a scary time and they want her to have as much support as possible. If a mom doesn’t have a father of the baby or a birth partner there with her during the birth, doctors and nurses take great notice of this and will give extra love and attention for this reason. WHAT WILL YOU DO BEFORE YOU GO INTO THE OPERATING ROOM? YAY! IT’S TIME! Whether it was a scheduled c-section or an unplanned one, it’s time for you to SUIT UP! You will be given a “bunny suit” to put on. I’m not sure why we call it a bunny suit, or what it’s called elsewhere, but in any case it looks like an old gas station attendant’s outfit, or quite simply, a onesie. You’ll be told to put this on over your clothes. You’ll also be given covers for your shoes, a shower cap type of cover over your head/hair, and a face mask to put on. Covering up is very important in the operating room to help prevent the mother or baby from catching an infection during the surgery. It’s ok to have your phone or camera in the operating room during the c-section, so be sure to bring them with you. You won’t be allowed to take pictures or video of the actual c-section being performed, but you’re free to take photos of the baby and mom after the baby is born. While you’re putting on your bunny suit, the mother will be taken back to the operating room. There, the anesthesiologist will sit her on the side of the bed and insert a needle with anesthetic into her lower back (aka- a spinal) and this will make her become numb from the abdomen down. While this is happening, a nurse will stand in front of her to help her stay calm and to help guide her through any fear, anxiety, or pain she may be feeling. Then, they will lay her down, and a nurse will insert a catheter (aka- a Foley) into her bladder. This sterile tube will drain her urine into a bag outside of her body. This is done because she will not be able to get up to pee for at least 12 hours after the c-section. During this time you may be nervously waiting in a room or in the hall, but once those things are done with mom, someone (usually a nurse) will finally take you into the operating room to be with her. WHAT WILL YOU SEE WHEN YOU ENTER THE OPERATING ROOM? When you enter the operating room you’ll see the mother lying down and there will be a lot of medical equipment around her, mostly at the head of her bed. That’s where the anesthesiologist will be throughout the c-section. The anesthesiologist is a doctor who specializes in giving anesthesia. They closely monitor the mother’s vital signs, give pain medication, and they’re also there to assist with any allergic reactions or complications during the operation. There will also be several other care team members in the room. Those people will be: The surgeon Their assistant (this can be another obstetrician or a midwife) A surgical tech (the person who hands the tools to the surgeon) Two registered nurses A respiratory therapist to help support your baby with breathing after birth, if needed. Possibly a nurse from the neonatal intensive care unit (aka- neonatal ICU or NICU) or a Neonatal Nurse Practitioner (aka- NNP) if the doctor believes the baby will need extra support after birth. One of the hospital staff (usually a nurse) will take you into the operating room and guide you over to the top of the mother’s bed by the anesthesiologist. You will sit up by the anesthesiologist who’s like the captain at the bow of the ship in control of all of those machines and monitors. A drape will be drawn up between the mother’s head and the rest of her body during the birth. The mom will be awake, and very grateful to see you, I’m sure! But, she may not show it due to her nerves. She will be awake during the entire c-section, and you will sit on a stool up by her head. The only time that the mother would NOT be awake during a c-section is if there’s an emergency and the baby needs to be delivered as soon as possible. Emergency c-sections (aka- “crash” c-sections) are performed when the mother’s or baby’s life is in imminent danger. If this happens, there will not be time to sit the mother at the side of the bed and give her spinal anesthesia in her lower back. Time is of the essence when it comes to mom or baby being in distress. So, instead the anesthesiologist will administer general anesthesia drugs into mom’s IV and have her inhale gases which will put her into a deep sleep almost immediately. General anesthesia drugs will paralyze her muscles, so that’s why she will have to have a breathing tube during this time (aka- intubated), but it will be taken out immediately after the surgery and she will resume breathing on her own again. WHAT DO YOU DO DURING THE SURGERY BEFORE BABY IS BORN? During the surgery you will be sitting up by mom’s head, but you won’t be able to see the procedure because of the drape. If mom is feeling ok and you’re interested in seeing what is going on during the surgery, you can ask the anesthesiologist if it’s ok if you stand up and peak over, or ask if they can lower the drape a little bit. If mom is o.k. with it, you can even ask the surgeon if you can leave her side and stand at the foot of her bed (several feet away of course in order to stay away from the sterile field). From that position you will be able to watch the birth! Please don’t ask to do this if you already know that blood and guts makes you feel queazy or lightheaded! The surgeon may tell you that they’d like you to stay up by mom, but most doctors are fine with it. With that said, it’s totally normal for dads and birth partners to feel very nervous and anxious during a c-section! If at anytime you’re feeling overly anxious or not feeling well in general, never hesitate to tell someone in the room. While their main focus during a c-section is on mom and baby, they’re also there to help you stay calm and safe too! While sitting up by the mother’s head, it’s nice to tell her the usual reassuring things like, “You’re doing so great!” and “It’s not much longer!”. If mom’s really anxious or scared you can remind her that she’s one in 30 MILLION c-sections per year. How’s that for some perspective?! Moms may need to be reminded that c-sections are EXTREMELY common, and while complications can arise, they usually don’t. While sitting up by mom’s head you might engage in some small talk with the anesthesiologist since they’re right there by you, and that can be a nice distraction from any anxiety that you and mom may be feeling. You may smell burning hair or skin, and that is from small blood vessels being cauterized (aka- burnt) to help prevent bleeding. A sign that the birth time is close is usually when the mother begins to complain about pressure. Even though the mother is numb and pain-free during the c-section, they may still feel pressure from the baby being pulled out of the small incision. Sometimes the surgeon will have to apply pressure to the top the the mother’s abdomen to help push the baby out. If mom’s feeling discomfort during this time you can remind her that it’s not much longer, and the baby will be born ANY SECOND! WHAT DO YOU DO AFTER THE BABY IS BORN? Once the baby is born, the birth time will be noted, and the doctor will cut the umbilical cord. Can a dad or birth partner cut the umbilical cord during a c-section? Unfortunately, no. Dads or birth partners are not able to cut the umbilical cord during a c-section because to do so they would have to enter the “sterile field” around the mother’s body. Even though they are covered up with the bunny suit, cap, shoe covers and mask, they are not covered in sterile gowns and gloves like the doctors are. Sterility around the mother is extremely important in order to reduce the risk of transmitting bacteria and causing an infection. After the cord is cut, a nurse will be waiting beside the surgeon with their arms held out with a sterile drape, and the surgeon will hand the baby to the nurse and the nurse will take the baby a few short steps to a radiant warmer (aka- a warmer). The doctor and their assistant will continue focusing on mom to remove the placenta, and begin sewing her up. A c-section from start to finish usually takes about 45 minutes. Getting the baby out happens pretty quickly. Sewing up mom is typically the longest part of the c-section. It usually takes about 20 minutes. Before you get up to walk over to the warmer to see the baby, make sure with the nurse, doctor, or the anesthesiologist that’s it’s ok. However, they’ll probably tell you to get up before you even have to ask. Walk over to the baby on the warmer, but be sure to stay far away from mom’s bed and the sterile field. You don’t have to go over to baby though if you don’t want to. You can just stay by mom’s side during this time. The baby will be in great hands, and as soon as the care team is done making sure the baby is healthy they will bring them over to you swaddled up in a blanket. If you do choose to walk over to the baby on the warmer, know that the warmer isn’t just keeping them warm with an overhead heating unit. A warmer can also: assess the baby’s heart rate assess the baby’s respiratory rate assess the baby’s blood oxygen level suction their mouth or nose give oxygen, if needed weigh baby A radiant warmer is like a baby hospital on wheels. Two to four hospital staff will be standing around the warmer caring for and assessing baby. Those people most likely are a mix of: Registered nurses Respiratory Therapists NICU (aka- Newborn Intensive Care Unit) nurse Neonatal Nurse Practitioner Immediately after baby is placed on the warmer, the care team will be rubbing the baby with towels or blankets. This is known as “drying and stimulating”. If the baby is born not breathing the simple act of “stimulating” the baby usually causes them to begin breathing on their own. Many things are usually happening when baby is on the warmer: Baby will be dried and stimulated. Amniotic fluid from the baby’s mouth and nose may be suctioned out with a bulb syringe to help clear their airway. Baby’s heartbeat and lung sounds will be assessed. A pulse oximeter may be placed around the baby’s right hand or wrist to see how much oxygen is in their blood. If the baby needs help with breathing, increasing their heart rate or oxygen levels, they will have a mask placed around their nose and mouth. This mask will give them oxygen and it will help open up their airway to help them to breathe. This is known as positive pressure ventilation (aka- PPV). One in ten newborns need PPV, so this extra support is actually quite common. Babies usually respond very quickly and well to PPV. You’ll be on the sidelines while the baby is being assessed on the warmer, and obviously you won’t want to get in the way, so it’s a great time to take out your camera and start taking photos or video. After the care team has deemed the baby to be healthy and stable, they may weigh baby, take measurements, and give them their newborn medications. However, most of those things may be held off until the mom and baby have been moved to the recovery room. A diaper will be placed on baby and they will be swaddled in a blanket. You may then walk the baby over to mom so they can finally meet each other after waiting all of that time! A nurse may actually place the baby on mom’s chest while her incision continues to be sewn up. If this happens, you can ensure that baby will not fall off by keeping one hand on them. However, if placing baby on mom’s chest while she’s being sewn up is not a standard of practice at your hospital, then you’ll simply just hold the baby while you sit up by mom’s head. Don’t forget to ask the anesthesiologist or nurse to take a photo of you, baby and mom while you’re in the operating room! After the surgeon is done sewing up mom, she will be moved from the operating room bed to a recovery bed. Then, you will all be taken out of the operating room and into a normal hospital room where mom will recover. DADS & BIRTH PARTNERS, Thank You. During the c-section you will help calm the mother, take baby’s first photos and/or video, and introduce mom to baby. Every mother who has a c-section needs someone like you there with them. I assure you that being there during a c-section is truly an experience you’ll never forget, and you’ll hold the memory dear to your heart forever. * * * Disclaimer:The content that I share on Purely Postpartum is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. I encourage you to always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.
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