Related topics: •  Will You Need a C-Section?

The Essential C-Section Guide: Pain Control, Healing at Home, Getting Your Body Back, and Everything Else You Need to Know About a Cesarean Birth
By Maureen Connolly and Dana Sullivan
Broadway
Paperback 240 pp $14

At first I was squeamish, but I can finally look down at the scraggly, pink surgical scar on my belly and see it as a marvelous thing. It's a reminder that my body has nurtured and delivered into the world two special little people. But if you're currently an expectant mother, the notion of a cesarean may not be quite so romantic.

Still, with more than one out of four babies in the United States born via cesarean, or "c-section," it's good to learn something about the procedure. Reading up on the topic can help allay any fears and take some of the mystery out of it. In their book The Essential C-Section Guide, authors Maureen Connolly and Dana Sullivan (who has written extensively on pregnancy for Consumer Health Interactive) present a welcome step-by-step manual that takes you through the days before, during, and after the surgery.

Whether you're a seasoned pro with a previous c-section under your belt, or a first-time mom just preparing yourself for the possibility, this book offers a wealth of practical, comprehensive, and easy-to-understand advice. Most pregnancy guides offer some information on cesareans, but it's often relegated to just a chapter or two. Connolly and Sullivan, however, delve into the details of topics ranging from how to breastfeed without straining the incision to dealing with the difficult postpartum emotions common among c-section moms. The book relies on research from medical journals, textbooks, and interviews with experts -- and on personal experience, too.

With five cesareans between them, Connolly and Sullivan write in a straightforward, warm tone. This is one of the most inviting features of the book -- reading it is like talking about c-sections over coffee with a girlfriend who has "been there."

This book doesn't discuss the controversy over the necessity of c-sections. Wisely, the authors chose to leave the debate to medical experts. But it may prove especially valuable to those who have never had surgery. For many expectant moms, this trip to the operating room will be their first.

Before my first c-section, which was planned, I felt pretty anxious about the anesthesia. I wanted to know exactly how it would be chosen and administered, and I reallywanted to know how that big needle would feel going in. The authors discuss all of those questions and use an objective pros-and-cons format to lay out the anesthesia options. As for how it feels, readers will be comforted to learn about the numbing effects of the lidocaine injection, which is given right before the epidural or spinal block needle is inserted.

In describing the surgery, the authors explain not just the procedure itself, but also the finer points that are often left out of pregnancy resource books. They take special care to address both mothers undergoing planned c-sections and those having emergency c-sections. For instance, if the surgery is planned, women learn whether it's necessary to shave pubic hair beforehand and how to prepare themselves for the surprisingly light mood they might encounter in the operating room. (Connolly likens it to people chatting around a water cooler.)

Emergency c-section moms will find out why the particular type of uterine incision is important: Vertical incisions, though rare, -- can be used when the surgeon needs quicker access to the uterus. But they can put future pregnancies at higher risk. The four-page description of the operation -- from first cut to closing the incision -- goes into exactly the right level of detail without overwhelming the reader. The morbidly inquisitive among us may especially enjoy this section. Consider, for instance, that many doctors will pull the uterus out of the body and lay it on the belly to stitch it up before tucking it back in. Who knew?

Connolly and Sullivan are also strong in the area of post-op self-care -- which some pregnancy books skim over. I wish someone had warned me about some of the problems I would experience during the post-op period, such as the teeth-clattering shakes and that intense, morphine-induced itch. Sure enough, Connolly and Sullivan address both topics in this chapter. The "Top Patient Mistakes" section is also a gem, based on a poll of the nursing staff at one of the busiest maternity wards in the country. According to the nurses, some of the most common mistakes that c-section moms make during their recovery include having too many visitors and phone calls and neglecting to ask for help with breastfeeding. The authors advise how to avoid these missteps by suggesting tactful ways to hold off visitors, for example, and encouraging moms to go ahead and buzz for breastfeeding help at 2 a.m. if they need it. Wisely, the authors also encourage new mothers to pay attention to pain relief as well as signs of infection.

On the topic of breastfeeding, Connolly and Sullivan don't mince words. They acknowledge up front that it can be especially challenging for exhausted c-section moms. Although most of the chapter consists of fairly standard breastfeeding advice, they also offer some cesarean-specific information, such as diagrams of breastfeeding positions that will minimize pressure on your incision.

C-section moms often worry that they may not be able to bond skin-to-skin with a baby immediately after birth, as is so often recommended by midwives and other child experts. I had the same concerns before I had my children, and I really like the way the authors address this: "Bonding is a process that takes weeks and months and years. It is most certainly not a now-or-never situation." The authors also offer a great suggestion: Dad can follow the baby to the nursery and be the first to do what mom sometimes can't -- to cuddle, sing, or talk softly with the newborn.

The authors also do an outstanding job of exploring the mixed emotions felt by many c-section moms. These feelings can range from guilt to sadness, particularly for mothers who had emergency c-sections. Some may even feel a sense of failure -- of having "cheated" their baby of a natural delivery. The authors offer great tips for coping, including telling yourself that there's no right or wrong way to deliver a baby and giving yourself permission to truly feel instead of suppressing those emotions.

Connolly and Sullivan also do an excellent job of promoting the health benefits of exercise for c-section moms. Getting in a workout may not be at the top of the new mother’s to-do list, but the authors advise starting small, with gentle steps to help get digestion and circulation moving on day 1 postpartum, such as deep breathing exercises and changing your position in bed every hour or two. And for those who have been given the go-ahead to work out at the six-week postpartum checkup, the book provides a special routine complete with sample workout calendars and illustrations tailored just for c-section moms. Better yet, they can be done at home with basic equipment such as hand weights and an exercise ball.

This book isn't just for expectant moms, however: Connolly and Sullivan also provide a wonderful chapter just for partners. In Q&A format, the authors answer the burning questions men often have. Some of these include "Can I still cut the umbilical cord?"; "How much pain will she be in?"; and "How soon until we can have sex?" Moms will appreciate the section on how her partner can help at home, especially the instructions for the "Ultimate Foot Massage."

This guide is impressively thorough, but I can think of a few topics that could have been better developed. For example, catheterization -- how does it work, and will it hurt? It's not every day that a woman undergoes catheterization, and its delicate nature invites more explanation. And although the authors have a great section on "Getting Out of Bed for the First Time," they don't provide suggestions for the actual mechanics of getting out of bed. This is trickier than one would think. It also would have been useful to learn about the best ways to laugh, sneeze, or cough without straining a new incision.

The authors note that hearing other women's stories can be as eye-opening as receiving a doctor's advice. Personal anecdotes are scattered throughout -- many of them quite funny. But as fun to read as the book may be, the authors are never cavalier. They stress that while the cesarean has become common and is generally considered safe, it is still major surgery and should not be taken lightly.

The message for pregnant moms: Even if you don't think a c-section is in your future, keep in mind that parenthood is often about preparing yourself to the fullest extent possible. Add this guide to your reading list and you'll find yourself ready for just about anything on baby's birthday.

-- Karisa Ding is director of research for Consumer Health Interactive. She has previously worked in neuropsychological research at the University of California, San Francisco.

First published February 22, 2007
Last updated June 26, 2008
Copyright © 2007 Consumer Health Interactive