Month: April 2023

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Teaching about Caesarean Birth

Teaching about caesarean birth in antenatal classes is more important than ever, with caesarean rates rising worldwide.

Preparing expectant parents for the possibility of a Caesarean birth, sharing information about how to avoid a caesarean birth, educating them about their choices and birth rights are all part of what modern antenatal settings should be covering.

Offering parents-to-be evidence-based and up to date information will help your clients to feel more empowered during their pregnancy and birth.

In your classes, you’ll meet expectant parents for whom a caesarean birth isn’t on their radar at all, parents who already know a caesarean is their preference, and everyone in between.

How to facilitate teaching about Caesarean Birth

One option is that you give each participant in your class a role. Ask for a volunteer to be the person prepped for C-birth. Then hand out some c-birth prep cards with clips and strings on them to be “pinned” onto the volunteer.

C-birth prep card, printed on coloured card, laminated, strings and clips attached.

Discuss/explain each item where needed. It may be worthwhile pointing out that all of the prep items are the same for any operation and that only the foetal monitoring equipment is in addition for a Caesarean birth. Learning outcome here: Participants are aware that a lot of equipment is needed for theatre prep and reassured that this is normal.

Once the person is prepped, you can give everyone else a role play card of a person in the operating theatre. Ask the prepped person to sit or stand in the middle of the room. Then one by one have the medical staff roles step around the person. Again discussing and explaining everyone’s role. It is worthwhile to consider that this kind of role play with real people standing around a real person can feel very daunting and “too much” for some expectant parents.

For the past 10 years or so, I have been using some Playmobil, lego, and wooden characters for the “people in the theatre” role-play part. I deliberately added some non-scrubbed/medical-looking characters to keep it fun. I pass around the cards at random and ask clients to pick a random character out of a bag…

The parent-feedback has been very positive! I’ve received many messages saying how parents were feeling very prepared, remembering all the little people from the antenatal sessions.

I support the activity with epidural and caesarean birth information leaflets from the OAA (Labour Pains), send families a link to a gentle caesarean birth video, and have a caesarean birth photo story available for anyone who’d like to look at it.

We also talk about writing a caesarean birth plan, their caesarean birth options, and other things to consider.

Overall, expectant parents are keen to explore the options, the reasons for a caesarean, and how to make one less likely. They value the time spent on this topic, whether or not they go on to have a caesarean birth. My caesarean birth resources include crosswords, quizzes, a scavenger hunt and step-by-step visuals.

Let me know how you facilitate teaching about caesarean birth in your antenatal classes in the comments or get in touch!

Sources and further reading

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Affirmations for new parents

What are affirmations, and how can they help new parents?

Affirmations (or positive affirmations) are phrases you repeat to yourself again and again to change your mindset. You can say them out loud or in your head, or hear them as part of a session with a hypnotherapist or other therapist. Most commonly, they help you turn negative thoughts into positive ones.

Affirmations can help you feel more in control and empowered as a new parent – including while feeding your baby!

Affirmations can improve your ability to solve problems and make decisions under stress, such as sleep deprivation or pressure from others. Making the right decisions for you and your baby helps you feel empowered as a ‘good enough’ parent.

Here are some videos you can loop while feeding your baby:

Affirmations can really help new parents focus on what they can control and let go of what they can’t.

Your bubble of calm, confidence and control

Set aside a few minutes every day to focus on yourself and your bond with your baby. Imagine that you and your baby are inside a bubble – your safe space. Leave the chores, visitors and everything else outside. It’s just you and your baby. Focus on your breathing, using a calm breathing technique that suits you – you can follow the moving circle in the gif below if you like. For that time, it’s just the two of you, in a safe space, focusing on your bond.

Circle of calm, confidence and control breathing guide
Circle of calm, confidence and control – a technique for new parents

You could also focus on positive parenting affirmations while you’re in your bubble.

Practise your affirmations daily – you’ll feel better for it. Look after yourself and your mental health. Making time for yourself and your baby strengthens your bond, improves your mental wellbeing and may even help your postnatal healing.

Finding a new balance

Having a baby means your time for yourself, for each other as a couple, and with friends and family has to be divided differently. You’ll need to find a new balance that works for your family. Mothers and fathers both benefit from bonding with their baby and taking care of themselves – and the whole family benefits when parents make time and space for themselves, for the family together, and for each other as a couple.

Have a look at the images below. Each circle represents a person: the larger ones (grey and blue) are the parents, and the smaller lilac one is the baby. Where the circles overlap shows how much time they spend together. There may be very little couple time unless you get some help, such as a postnatal doula or a babysitter, and one parent may spend more time with the baby than the other. The parts that don’t overlap are the time you divide between chores, ‘me time’, work, family and friends, pets, hobbies and so on. Finding a balance that works for you can take a while, so give it time – and use a few minutes each day with positive affirmations to help you rebalance.

Time balance diagram for new parents
Time balance diagram for new parents
Time balance diagram for new parents

See also: The emotional rollercoaster of parenthood and Top 9 Childbirth Affirmations.

Sources and further reading

  • F, H. R., Supriyana, S., & Runjati, R. (2021). Self-Empowerment, Affirmation And Relaxation Training Against Stress Levels And Cortisol Levels In Pregnant Women: Systematic Literature Review. STRADA Jurnal Ilmiah Kesehatan, 10(1), 335–343. https://doi.org/10.30994/sjik.v10i1.636
  • Hill, Z., Spiegel, M. and Gennetian, L. A. (2020). Pride-Based Self-Affirmations and Parenting Programs. Frontiers in Psychology, 11. https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00910/full
  • Sari, R. P., Silawati, V. and Azzahroh, P. (2022). The Effectiveness of Positive Affirmations Combination of Face Acupressure and Aromatherapy Against Anxiety in Preoperative Sectio Cesarean Patients At Sentosa Hospital Bogor. Science Midwifery, 10(3), pp. 2164–2170. doi: 10.35335/midwifery.v10i3.629.
  • Wiesenfeld, B.M., Brockner, J., Petzall, B., Wolf, R., & Bailey, J. (2001). Stress and coping among layoff survivors: A self-affirmation analysis. Anxiety, Stress and Coping: An International Journal, 14, 15–34.
  • Worthman, C.M., Plotsky, P.M., Schechter, D.S., & Cummings, C.A. (eds). (2010). Formative Experiences: The Interaction of Caregiving, Culture, and Developmental Psychobiology. New York: Cambridge University Press.
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Teaching about pregnancy anatomy

Teaching about pregnancy anatomy in an antenatal setting: one of the first topics I always covered in my childbirth preparation classes was “pregnancy vocabulary”.

Pregnancy vocabulary

In an in-person group, I often split the class into two teams. Each team gets an A2 poster – either the pre-pregnancy cross-section or the pregnant cross-section – plus body part labels such as “coccyx”, “uterus/womb”, “sacrum”, “vagina” and “cervix”. I explain that these are words they’re likely to hear on their journey into parenthood, and that we’ll refer to some of them throughout the course. Then I give them 5–10 minutes to add the labels to their poster (I use laminated labels with Blu Tack on my PVC posters).

Cross-section of a pregnant woman poster

You can download the body part labels for free here:

Body Part labelsDownload

Pregnancy anatomy changes

Once the teams have finished, we come back together with the posters to compare the pregnancy anatomy images. Then we discuss common pregnancy discomforts, where they come from, and how to avoid or ease them.

In 1:1 sessions, I use both posters side by side, or my pregnancy anatomy changes posters.

Online, I use an animated pregnancy vocabulary slide like the one in this video:

Pregnancy vocabulary and anatomy slide

The same image is also in my antenatal class journals. I’ve found that parents-to-be like to take home paper handouts again – they especially love worksheets where they can colour in images and take notes. It all helps them focus and remember the information.

Pregnancy vocabulary worksheet
Pregnancy vocabulary worksheet
Pregnancy vocabulary worksheet
Antenatal class journal – booklet for parents-to-be
Antenatal class journal pages
Antenatal class journal pages

Pre-pregnancy vs pregnant body worksheets

My pre-pregnancy vs pregnant body worksheets come in three skin tones plus a colouring-in version, with and without annotations or lines – so they work as handouts too! For a fun warm-up, try my Pregnancy Anatomy Icebreaker or Uterus Anatomy Scavenger Hunt.

Pregnancy anatomy worksheets
Pregnancy anatomy worksheets
Pregnancy anatomy worksheets
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7 ways to personalise your Caesarean birth

7 ways to personalise your Caesarean birth

Are you having a caesarean birth? Here are 7 ways to personalise it and plan the birth you want and deserve!

1. Hypnobirthing

Yes, you can use hypnobirthing, meditation, mindfulness and relaxation to your advantage before and during a caesarean birth. Practise calm breathing techniques, positive affirmations and bonding with your baby. The calmer you are, the more oxygen reaches your baby (or babies), and the better your recovery is likely to be. Hypnosis also has a positive effect on your mental wellbeing in pregnancy and after the birth.

2. Skin-to-skin

Immediate skin-to-skin with a parent helps your baby regulate their temperature, spreads good bacteria and much more – it’s beneficial all round! The good news is that most UK hospitals support immediate skin-to-skin between birthing parent and baby after any type of birth, as long as it’s safe. So if you and your baby are well (and the cord is long enough – it usually is!), you can have immediate skin-to-skin.

3. Optimal (delayed) cord clamping

Optimal or delayed cord clamping allows your baby’s blood to flow from the placenta back to them. This can improve their Apgar scores and their immediate and longer-term health. Most UK hospitals support optimal cord clamping for all types of birth, including caesareans.

4. Adapt the environment

Have your partner or doula with you (some hospitals allow two birth partners in theatre) and choose your music. Some birthing parents wear headphones to block out the sounds of surgery, listen to their hypnobirthing tracks, or have their partner repeat their affirmations with them.

5. Stay calm

Use whatever helps you stay calm – your partner, your doula, your relaxations, your music, or a photo of a loved one or pet. Being calm may help reduce blood loss, means more oxygen for your baby, and can improve your recovery.

6. Vaginal seeding and your baby’s microbiome

Vaginal seeding means transferring vaginal fluids – using a sterile gauze or swab placed in the vagina about an hour before the caesarean – to the newborn’s mouth, nose or skin, to pass on the mother’s vaginal flora. Some parents ask about it, but the evidence is still limited and it isn’t routinely recommended in the UK, so discuss it with your care provider. Other ways to support your baby’s microbiome are lots of skin-to-skin and breastfeeding.

7. Ask about a gentle (family-centred) caesarean

Many UK hospitals offer gentle or family-centred caesareans. Rather than the obstetrician pulling the baby out, the baby is born more slowly, helped by the uterus contracting (aided by synthetic oxytocin). It’s usually accompanied by immediate skin-to-skin and optimal cord clamping. Read more in What is a gentle caesarean birth?

Here is an article about a gentle caesarean birth story: The Guardian

And here is a video of a gentle caesarean at one of my local hospitals in Nottinghamshire:

Knowledge is power

Knowing your options and what happens during a caesarean helps you plan the right experience for you. Discuss skin-to-skin, optimal cord clamping and adapting the birth environment with your healthcare provider, and write them into your birth plan.

The video below shows how many people are usually present during a caesarean birth.

These are just 7 ways to personalise your caesarean birth – I’m sure you can think of more! Please share your ideas and experiences in the comments. You might also find Recovery after Caesarean Birth helpful.

Online Birth Preparation Course only £35!

Please also check out my online course! No videos, just text and images to learn in your own time. Includes hypnobirthing mp3s, scripts, workbook, handouts, infographics and much more! Lots and lots of information at your fingertips! Includes:

  • hypnobirthing mp3s
  • hypnobirthing scripts
  • written information
  • infographics and other imagery
  • printable handouts
  • printable workbook/journal
Enrol now

Sources and further reading:

Caesarean Birth and VBAC Information

Ginandes C, Brooks P, Sando W, Jones C, Aker J. Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. Am J Clin Hypn. 2003 Apr;45(4):333-51. doi: 10.1080/00029157.2003.10403546. PMID: 12722936.

Hourigan SK, Dominguez-Bello MG, Mueller NT. Can maternal-child microbial seeding interventions improve the health of infants delivered by Cesarean section? Cell Host Microbe. 2022 May 11;30(5):607-611. doi: 10.1016/j.chom.2022.02.014. PMID: 35550663; PMCID: PMC9237654.

Smith J, Plaat F, Fisk NM. The natural caesarean: a woman-centred technique. BJOG. 2008 Jul;115(8):1037-42; discussion 1042. doi: 10.1111/j.1471-0528.2008.01777.x. PMID: 18651885; PMCID: PMC2613254.

Wilson, Brooke C. et al. (2021) Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial. eBioMedicine, Volume 69, 103443. Available at: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(21)00236-X/fulltext [accessed 3 April 2023]