StorkNet interview with
Maureen Connolly and Dana Sullivan
Authors of
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

THE ESSENTIAL C-SECTION GUIDE covers everything every expectant mother needs to know-whether she's informed in advance that she will give birth by Cesarean or just delivered a baby by Cesarean. Coauthors Maureen Connolly and Dana Sullivan, accomplished writers on women's health issues who have had five Cesarean deliveries between them, have researched the subject thoroughly. They interviewed respected obstetricians, nurses, anesthesiologists, nutritionists and fitness experts, consulted the leading medical journals for the latest news, and spoke with scores of different women who experienced the miracle of childbirth by C-section. The result is a uniquely informative and reassuring resource for the one million or so women across America who will undergo this procedure this year.

"The purpose of this book is not to debate whether Cesarean deliveries occur too often in this country," Connolly and Sullivan make clear. "Our ultimate goal is simply to help women be better prepared for a Cesarean birth, and to help with their physical and emotional recovery."

Why should a woman choose a Cesarean, or trust her doctor's recommendation? THE ESSENTIAL C-SECTION GUIDE begins by exploring an array of valid reasons for the procedure, from complications with labor or fetal distress to the mother's history of herpes or pain threshold. Then, it's time to go to the hospital for a step-by-step tour through the surgery, starting with the ABCs of anesthesia, including the truth about that dreaded epidural-induced headache and other side effects. Packed with authoritative advice from doctors and nurses in the field, plus practical tips and words of reassurance from women who've been there, other chapters go on to cover the healing process in the hospital and ease common concerns about the ongoing recuperation with baby at home. Along the way, any woman anticipating or fresh from a Cesarean delivery will discover:

  • Simple breathing exercises and safe pain medications to aid post-op recovery
  • The benefits, as well as the risk, of a Cesarean birth for her baby
  • Six really good reasons to commit to breastfeeding-despite the discomfort
  • Ways to stop feeling like "a failure" and overcome postpartum depression
  • Answers to her partner's most frequently asked questions
  • Sensitive, sensible guidelines on weight loss, scar care, and safe, enjoyable sex

To help new moms get back in shape and stay full of energy, THE ESSENTIAL C-SECTION GUIDE delivers a complete workout-from cardio-boosting moves to core strengthening exercises-adaptable to every fitness level. Featuring a Foreword by Dr. Katherine E. Economy, a maternal fetal specialist with Harvard Medical School, this first-of-its-kind resource will be welcomed by all pregnant women-regardless of their age, past birthing experience, or labor plans.

About the Authors
MAUREEN CONNOLLY has served as an editor on the staffs of Parenting, Family Circle, Self, and Woman's Day, and was also a contributing editor to the New York Times Women's Magazines and yourbabytoday.com. Her articles have appeared in numerous publications, including Parenting, Parents, Fit Pregnancy and Redbook. She lives in Montclair, New Jersey with her husband and two sons.

DANA SULLIVAN is a contributing editor at Shape's Fit Pregnancy. She served on the staff of Parenting and has written for numerous national magazines, including Parenting, Parents, Fitness, Shape, Self, and Cooking Light. She lives in Reno, Nevada, with her husband and three children.


The Essential C-Section Guide

By Maureen Connolly and Dana Sullivan

Published by Broadway Books
June 2004

To Purchase:
    Amazon U.S.
    Amazon UK
    Amazon Canada

Childbirth is a life-altering experience for any woman, but a Cesarean delivery can be overwhelming, whether it is unexpected or planned. Very little information about the experience is included in typical pregnancy books, and physicians and childbirth educators often gloss over the details. The Essential C-Section Guide is written by two seasoned health writers who have firsthand knowledge of birth by c-section. (See left panel in blue) This book offers frank discussion, comforting wisdom, and expert advice on pain control, early bonding, breastfeeding, infant care, physical and emotional healing from surgery, postpartum exercise, partner involvement, and much more, in detail not available anywhere else!

StorkNet welcomed both Maureen Connolly and Dana Sullivan as our guests.


Tara: I am 24 years old and married with two children. I have had both children by c-section and I am currently 10 weeks pregnant and will be due to have my third c-section in December 05. I am absolutely TERRIFIED of having a third c-section, I think mainly because I was caught off guard with this pregnancy. But, I also am concerned because my last pregnancy went great and I scheduled my section not thinking twice about the risks or anything. While operating the doctor mentioned that it was taking a long time due to scar tissue. Everything went well and I recovered just fine. At my 6 week check, she mentioned that any more children would have to be delivered via section and that she would be comfortable doing a third. I am having such a hard time with the idea of another surgery. I am so concerned about something happening to me. Please give me your thoughts. Worrying keeps me from being ecstatic about this pregnancy.

Dana and Maureen: I (Dana) have had three c-sections, and I have a friend -- who happens to be an ob-gyn -- who is about to have her fourth. The good news is that you know exactly what you are facing with your next delivery. Recovering from a c-section is a bit more challenging than recovering from a vaginal birth, but you have done it -- and there is no reason to think you won't be able to do it again. I hope you have friends and family who are willing to pitch in during those first few weeks after your baby's birth -- please say "yes" to every offer of help. I hope you can "let go" of your fears and enjoy this pregnancy because it is such an amazing time. On another note, since you write that you were caught "off guard" I can assume that you may be want to make this your last pregnancy -- if that's the case, you can also talk to your doctor about having your tubes tied at the time of your delivery. I tried to do this with my third but because I hadn't made my wishes known prior to the c-section, my doctor couldn't/wouldn't do so.

Doreen: What do I say to my mother-in-law and friends who continually tell me how sorry they are that I had to have a c-section? I'm so tired of the pity, and I'm tired of focusing on something I had no control over. It's making me feel inadequate. I do have regrets, but I also have a baby. I read that you cover this in your book so I'm going to order it through Amazon. Thank you for any words of wisdom!

Dana and Maureen: Oh, we could write a whole different book on this topic! We've been "attacked" by a lot of women who think that by responding to insensitive remarks like your mother-in-law's with comments like "I'm so grateful to have a healthy baby that I don't care how s/he came out" we are denying the issues of failure that many women feel. Now, let me say that we both felt those feelings, of failure, which was one reason we wrote this book. HOWEVER, having delivered your baby by c-section does not make you any less of woman or any less of a mother, than someone who had a vaginal birth. Without knowing what your relationship is with your mother-in-law, this is a tough one. Can you ask your husband to suggest to his mother that she's hurting your feelings and she might want to focus on the positive -- the baby!!! -- instead of dwelling on how he came into the world? You might also just say to your mother-in-law, "You know, in countries where women don't have access to c-sections, the infant AND mortality rates are very high -- I'm so glad I live in a country where my baby and I could both survive childbirth..." and leave it at that. I can only HOPE she will get the hint. Hold your head up -- you have nothing to be "sorry" about! Good luck. And I hope you do read our book, in the "emotional" chapter, we includes lots of strategies suggested by post-partum specialists for dealing with some of the issues you mention.

RSG: I am 4 1/2 months pregnant with my second child. I gave birth to my first child via a planned c-section because of my pelvic structure, and my son's size (8 lbs 9 oz). I have discussed VBAC this time, but I am leaning towards another c-section because I know what to expect. I began my pregnancy about 20 lbs above my ideal weight. I am interested in the option of having a tummy tuck along with a c-section. I plan to discuss this with my doctor at my next appointment. What are your thoughts?

Dana and Maureen: I know this issue is a big one for lots of women, but I don't think there are many reputable doctors who perform "tummy tuck" surgery following c-section delivery. For one thing, cosmetic surgery should be done by a board-certified plastic surgeon -- and not an ob-gyn. If you want advice, ours would be to have this baby, take the time to get yourself back into shape -- as close to your "ideal" weight as you can, and then, when you feel like you've hit a wall, consider the surgery if it is still important to you. We include a great post-partum workout in our book, designed by a fitness instructor who has had two c-sections, that will help you get your body back, and strengthen your core. The bottom line is a tummy tuck should be your "last resort' instead of your first. (Sorry if that's not what you wanted to hear!)

Mary: I have two sons aged 5 and 13. Both pregnancies resulted in a c-section. I have not been able to lose the weight around my stomach area. Should I check with my doctor to see if there is a build-up of scar tissue? I normally work out 3 times a week for about 40 minutes each. It's really frustrating trying to buy clothes that fit loose around my stomach. Is there a lot of scar tissue concentrated near your stomach? If so, what can I do to get rid of it? I am a true size 12 but have to buy clothes a size 14 or 16. Is surgery necessary?

Dana and Maureen: I would be surprised if the tummy bulge is the result of scar tissue, but I suppose it's worth asking about. It's more likely that as you've gotten older, your body composition has changed -- which is normal! -- and fat has migrated to your middle. It has to do with changing hormones...You might consider reading "Fight Fat After 40" by Pamela Peeke, she explains this issue in great detail and has some suggestions for how to combat belly fat. Good luck...

Tara: I have a 13 month old son via c-section and was wondering is it normal to still be so emotional? Anything on tv can set me off, children that are hurt, kids that are sweet and thank people for various reasons. It doesn't have to be children--anything sad or happy can send me to tears. I was never like this before my son. Is it just the fact I've mellowed being a mum or something else?

Dana and Maureen: Well, I can't speak for all women, but having children certainly make you more attuned to life's difficulties, and bring out a sensitive side that you never saw before. (Then again, I cry at those Johnson & Johnson baby commercials, so I might be the wrong person to ask!). If you are worried that you are suffering from post-partum depression, you should certainly talk with your doctor. There is the possibility that you have a depression that is magnified now that you've had a baby. Good luck.

Nazish: Is it safe to weight train 4 months after a c-section?

Dana and Maureen: Yes! And we wholeheartedly recommend you start with the workout in our book -- it was designed by a trainer who is a pre- and post-partum fitness specialist who has also had two c-sections herself.

Sara: I had an emergency c-section 21 months ago. The scar is low into my pubic hair, and I have a really hard time with ingrown hairs in my scar. They get pretty bad with infected raised up red bumps on my scar. How can I stop this from happening?

Dana and Maureen: Ouch. I haven't heard of this happening before but it sounds very painful. Have you considered electrolysis to have the problem hairs removed? I know it can be expensive but it sounds like this is more than a nuisance for you!

Annette: I am 23 weeks pregnant with my second child. My first is 2 years old. I had a c-section due to labor not progressing and baby's heart rate was up and down. He's very healthy. But my concern is I work in a Nursing Home lifting constantly and bending and walking on the hard floors. A co-worker said she had uterine rupture at 7 1/2 months pregnant while working and I wondered if this would be a concern? I do have a doctor's excuse for no lifting over 20 lbs but it's about impossible to avoid at my job. Just wanted to hear your thoughts on this.

Dana and Maureen: I would certainly follow your doctor's advice and not do any heavy lifting -- uterine rupture is always a possibility in a pregnancy after a c-section (or other uterine surgery). The more strain you put on your body, the higher your risk. Please take care of yourself -- a uterine rupture can be very dangerous for you and your baby!

Angel: I had an emergency c-section with my son back in January 1999. I am diabetic and he came three weeks early. I dilated completely but could not deliver him because he was a 10 lb baby. I lost a lot of blood and had to have a transfusion after my c-section and had a rough recovery. My question is will the recovery be as bad with a planned c-section as it was with my first?

Dana and Maureen: It certainly shouldn't... with a scheduled delivery, you won't go through any labor so you won't be as tired. You doctor should be watching your baby's size closely so that the baby can be delivered at a safe point in your pregnancy, but before you go into labor. I don't know all the risks associated with diabetes, but I'm sure your doctor is very aware of your health challenges. This time there won't be the element of surprise, either, so your recovery should be easier. Good luck.

Jackie: What are the risks at 42 after having three children (first c-section, second vbac, third c-section) as far as the placenta attaching itself to the c-section scars?

Dana and Maureen: Do you mean in the event of a future pregnancy? Unless you become pregnant again, this won't be an issue. But you're right, there is the risk of placental problems with future pregnancies. You should discuss your concerns with your physician -- the circumstances of your delivery, and the types of incisions that you had, will help him/her discuss your potential risks.

Gaby: Hi, Mrs. Connolly and Mrs. Sullivan! I am currently pregnant with #3 and had two previous c-sections. I am a little hesitant with the third, only because the scar still feels numb and in some spots feels uncomfortable. I did not heal well with the last one, but it may be because I was way to active with my toddler and newborn (no outside help). Could you give me any advice on how to encourage healing?

Dana and Maureen: Hi, Gaby. Without knowing how long you waited before pregnancies #2 and #3, it's hard to say how long you can expect to feel numbness. I (Dana) also just had my third cesarean four months ago and my incision site is still quite numb, and even a bit swollen. My second and third pregnancies were nearly four years apart. You already found out what most moms do: it's harder to get fit and recover from a pregnancy and cesarean birth if you already have a child to care for. To encourage healing after your next birth, I would reiterate the advice that the nurses we interviewed for our book gave us: rest, say "yes" to all offers of help--such as meals, play dates, laundry, errands--and so on. For at least six weeks, do virtually nothing but take care of yourself and your newborn. Your other two kids will survive a few months of "house arrest!" We also consulted an exercise expert who created a fantastic workout for our book, she even includes some breathing and stretching exercises that you can do while you're still in the hospital! Then, once you've had your doctor's okay, you can move on to some more challenging aerobic and strength-training work, which you can do from home.

Gaby: Ever since my second c-section, I've had muscle spasms just above my rib cage when I weight lift, or restrain a pet at work. Any suggestions?

Dana: Hmmm, since we're not physicians, we're reluctant to offer a "diagnosis" but you may have some scar tissue from your cesareans that is the source of the irritation. Please tell your doctor about your concerns so he/she can rule out anything serious. And if you're pregnant, you shouldn't be doing any "heavy" lifting, so please be careful. The last thing you need is to injure your back!

Kia: I had an emergency c-section with my first child, born in 2000. I am 75% sure that we'll be scheduling a c-section with this pregnancy. My question is this: I had general anesthesia for the delivery but I have clear and painful memories of having someone laying on my stomach in what I was later told were attempts to force contractions and help my uterus to return to it's normal size. They call it "massaging" but I remember it being incredibly painful and brutal even. The pain of that far surpassed the pain of contractions and even the recovery after delivery. It even woke me up from the anesthesia every time she did it.

No one's ever been able to tell me if that was normal or if I maybe had something going on that required a more hands-on physical intervention. I haven't ever spoken to anyone that had a similar experience and I never see it when watching others have c-sections on TV. Was this a normal part of a c-section and should I expect that again?

Dana: We haven't heard of that, either, Kia! However, both of us can remember the "tugging" sensation that we felt when the doctors were ready to take our babies out. I even felt like I was going to be lifted right off the table when my daughter was being delivered four months ago; that was my third cesarean. However, I don't remember the tugging sensation at all during my first cesarean, which, like yours, was an emergency that required a general anesthesia. Perhaps your anesthesia wasn't quite strong enough and that tugging to get the baby out is what you recall? Finally, after a woman has given birth, whether vaginally or by c-section, the nurses will massage the uterus which does help return it to its normal size (but this is a very gradual process that happens over the course of many weeks) and they will recommend that you do this after you leave the hospital.

Susan Michelle: Hi ladies. I have two children (3 and 19 mos.). I had an emergency c-section with the first and a repeat c-section with the second. We will be starting to try for our third baby this month. I am eating healthy and walking daily but I was wondering if there are specific exercises that I can do to help better prepare by body for my third c-section? Thank you.

Dana: Yes! Strengthen your core. If you have the opportunity to do Pilates, we highly recommend it. Pilates is a very abdominal and lower-back focused type of exercise. I did it during my third pregnancy and it kept my back healthy and I can see that my tummy is getting flatter faster than it did after my other two c-sections. Most gyms now offer some type of Pilates class, and there are lots of videos out there. If you can't do Pilates, or don't care for it, you should concentrate on doing a variety of abdominal and lower back strength-training moves, that will help you strengthen your mid-section. You're very smart to be thinking about getting in shape before your pregnancy because that will make the whole experience so much more pleasant for you. And, of course, it will mean you have less work to do after your baby is born! I would also recommend that you look at the exercise chapter we included in our book, "The ultimate post- c-section workout" is a comprehensive exercise program (you can begin after six weeks, with your doc's approval) that we hired a terrific fitness expert to design for us. She even had two c-sections herself, so she's been there! Good luck, Susan Michelle.

Robbie: I have not been able to get my stomach back to normal after my c-section. What can I do. I seem to have this pudge always sticking out. It is also flabby and nothing seems to make it go away.

Dana: Robbie, we include a post-c-section workout in our book that focuses on core strength. We also know from personal experience that Pilates, which is a very core-intensive form of exercise is a great way to strengthen muscles. If you're eating sensibly and getting regular cardio exercise, you are doing two great things for your body. As for your pudgy stomach, you need to keep your own body type/genetics in mind: some women just seem to store more fat in their mid-sections no matter how much they exercise or how thin they are.

Chris: I don't have any questions myself, but I'm thinking of buying your book as a gift for my sister who will be having a C-Section in October. Tell us more about your book. Thank you for coming to StorkNet.

Dana: Chris, your sister will be so grateful to you. We wrote this book because we found that the typical childbirth education class, and even the most popular pregnancy books, barely cover birth by cesarean. We were both so sure that we'd have vaginal births that we didn't really know what to expect from a cesarean. Our book covers everything from the most common reasons that women have cesareans, to a step by step look at the surgery, to tips on breastfeeding and two chapters on "getting your body back." There is also a chapter on future pregnancies and the vaginal-birth-after-cesarean debate that she will want to read if this is her first pregnancy. You/she can read excerpts on www.csectionguide.com

Jill: What is the earliest I can begin trying to conceive another child after a c-section? I had my first child at 40 and want to have one more child right away, but want to know when it is safe. I had no difficulty whatsoever with my c-section or the healing.

Dana: Hi, Jill. In our book we included a mention of a study that suggests waiting nine months between pregnancies (so conceiving when baby is at least nine months old) is a good idea. It takes at least six months for the surgical scars to heal so you'll reduce your risk of a uterine rupture, which is rare, but very dangerous, if you give yourself adequate time to heal. Good luck!

Rick: My wife is having a c-section on the strong advice of her doctors due to medical reasons. She had planned on a homebirth, with tub, family around, and well, you know. She's very disappointed and depressed. This is the worst news she could have gotten, she said. I don't know how to help her. Help! Rick.

Dana: Rick, buy her our book! Seriously, your wife sounds like she had anticipated the kind of birth I did. My husband and I did our labor education class with midwives and the only reason I didn't deliver at the midwife center in my town was that my insurance wouldn't pay for it. So I went to the hospital expecting -- planning! -- on a drug-free birth only to have an emergency cesarean. I had a rare situation occur when my son aspirated meconium during labor. He was born via emergency cesarean and in cardio-respiratory failure. It was a fluke, I know, but had we been laboring anywhere but the hospital, he would have died. (not to be dramatic, but it's the truth.) He ultimately spent a month in the neonatal intensive care unit but is now a healthy seven-year-old. I've since had two more cesareans, though both were scheduled, and the lesson I learned is that the only outcome that is important is a healthy baby.

Still, I know how your wife feels, it's a sense of no control and fear of the unknown. It is usually the healthy and confident woman who desires a completely natural birth so I understand her frustrations. I hope she has a doctor she trusts because from my own experiences, and the experience of writing this book, I feel that most OBs do have a woman's and baby's best interests at heart. And, because of the recovery involved, and risk of surgical infection, the doctors won't recommend a cesarean unless there is a compelling reason.

In our book you will find explanations for some of the reasons cesareans are recommended, plus very helpful info on breastfeeding, healing at the hospital and at home, and the emotional healing some woman face. There is also a chapter devoted to you -- dad -- that addresses concerns you might have. For now, your job is to encourage her and make sure she knows that by putting your baby's health first you are both doing the "right" thing. Good luck!

Amanda: I delivered triplets at almost 31 weeks (by c-section, of course) 11 1/2 years ago at age 31 and years of infertility treatment. Finally, the second round of Pergonal was a success. (We had been married 12 years.) They had complications at first, but are all fine and healthy now. We never expected to get pregnant on our own especially at almost 43 and 45!! We are excited and go for an ultrasound today to find out how far along I am. I had the vertical kind of c-section (thought one triplet might be in distress and that was fastest way). What extra complications can I expect with my age and the fact it is a second section? Also, I hate the way my stomach dips in in the middle now. Is there anything that can be done differently this time to minimize that? I am assuming I will get another vertical - or should the second one be a horizontal, if possible?? We are not telling anyone until risk of miscarriage is past due to my age and the fact we own a business in a small town and would be hard to tell people about a miscarriage for months until everyone knew. I plan to buy your book as soon as the risk is past. I wish I had had it the first time!! You are SO right about there not being any in-depth info on the subject (even from the doctor)! I almost jumped for joy when I found out about your book!! Hopefully all will go well and I will be pouring over your book soon!

Dana: Congratulations! You will be one busy lady! First, we want to remind StorkNet readers that we are not medical professionals, we are journalists who have had five c-sections between us. The reason we wrote this book was because we were frustrated by the lack of resources out there for women like us -- and you! So, we are reluctant to "dispense" medical advice, and urge you all to write down any questions/concerns you have and bring that list to your physician so you can get all the information that is due to you. During a rushed OB visit, it can be very difficult to remember to bring up any concerns you have, but your doctor owes you that time, so don't feel uncomfortable asking! That said, your physician will determine whether or not you will have a repeat vertical incision or a low transverse incision (because of your vertical incision a vaginal birth is very unlikely). S/he may be reluctant to do a low transverse incision this time since you already have had the other type of incision; a new incision site would increase the amount of scar tissue on your uterus and abdomen. But again, you will have to discuss your options with your doctor. As for your age, your recovery shouldn't be that much more difficult from this delivery than it was for your first. In fact, now that you'll only have one baby to care for, we suspect it will be a breeze in comparison. Just remember to give your body ample time to heal, that means taking it very slow for at least six weeks. We also wish we had a magic answer for that post-Cesarean "dip" but a lot of how your body heals is simply the result of genetics, and your general health. Do you exercise regularly, eat nutritiously? Those things will help reduce your body fat which will in turn help keep you slim. You can also take a look at the core-strengthening workout we include in our book. The woman who designed the workout for us has had two c-sections herself, so she knew exactly what kinds of exercises would be most effective for reducing that annoying pooch. Best of luck with your pregnancy.

Sheryl: Hi, I had a c-section with my first child and was wondering if I should attempt to have a natural birth with my second pregnancy. Is it safe?

Dana: Without knowing exactly why you had that first c-section, it's hard to say. The trend lately has been for repeat c-sections more often than not. There are a number of reasons for this trend. One reason is malpractice. Even though the risk of uterine rupture is low, when it happens it can be life-threatening for both the mother and the baby. Be sure to discuss the reasons that you desire a vaginal birth with your physician, she may be willing to work with you, depending on where your hospital is and what that hospital's policies are. Finally, there has been a move lately for women who wish to have a vaginal birth after Cesarean (VBAC), but whose doctors won't deliver this way, to attempt to have their babies at home. We would never, ever, recommend this! The risk is simply to great for you and your baby, should something go wrong.

Susan Michelle: If I get pregnant, this will be my third child, third c-section. I was under the impression that my husband and I were lucky to even be able to try for a third child but I recently met someone who has had four c-sections. I was curious if there was a general limit to how many c-sections you can have? Why?

Dana: I have a neighbor who has had five c-sections . . . and I've had three myself, so, I know it's possible. My neighbor happens to be a very fit and healthy woman and seems to have recovered quite well from each one (though after number five she took measures to prevent future pregnancies). Still, there may be medical reasons that some woman shouldn't have repeated c-sections. You should discuss your medical history and your desires with your physician. I'm sure s/he will help you decide if you should go forward with your plans. Good luck!

Jessica: I had an emergency C-section due to placenta previa with my daughter. I was told my by OB that I could deliver vaginally with my next child. I have heard horror stories about uterine rupture, etc. with VBAC. What exactly are the statistics on this? Which do you feel is more safe... a VBAC or a repeat C-Section? (FYI... I have a bikini line horizontal incision.)

Dana: As we mentioned earlier, there is a slight risk of uterine rupture for women who attempt a "trial of labor" after a c-section. And if the uterus does rupture it can be catastrophic for mother and baby. That is one reason that more and more doctors are opting for scheduled c-sections instead of allowing women to attempt a vaginal birth after Cesarean (VBAC). You will need to discuss the pros and cons of VBAC with your doctor. In the final chapter of our book we include the criteria that the American College of Obstetricians and Gynecologists currently recommend for women wishing to deliver vaginally after a c-section. Reading that list might help you decide which way to go.

Kynda: I had my first child in the USA at the age of 31. It was a vaginal birth. Labor lasted just five hours 13 minutes after my water broke. Although I had an epidural, I thoroughly enjoyed the experience. I had my second child in México at the age of 33. It was also a vaginal birth. Labor lasted just 6 hours 20 minutes. I had no epidural this time, and absolutely loved the experience!

I had my third child in México at the age of 35 vía C-Section (with an extremely low horizontal cut) as he was breech with the umbilical cord wrapped around his neck. This was a very disappointing birthing experience for me. Unfortunately, my son was born with several congenital organ defects and passed away just 18 days after he was born.

My husband and I are now thinking about baby #4. Besides the obvious and psychological healing that must take place before we will be ready to start trying to get pregnant again, we need to consider the physical healing that needs to happen so that I can try for a VBAC.

My OBGYN says it would be way too dangerous to try before two years, but I'm concerned about my age ... that would basically make me 37 conceiving and 38 giving birth ~ definitely older than what I would like. So what I'm wondering is if I continue to lose weight (I'm down 35 pounds from my last pre-conception weight already) and start to exercise regularly, wouldn't it be possible to hope for a VBAC in a shorter time frame? PLEASE give me any ideas or recommendations that you might have.

Dana: We are so sorry for your loss . . .losing a baby must surely be one of the most difficult things to deal with. As for future pregnancies and your desire for a VBAC, listen to your doctor. S/he knows the details of your medical history best. Your doctor's concerns probably relate to the length of time required for your uterus to heal sufficiently to endure another pregnancy, rather than what your weight is. During the course of researching our book, we did find a study that concluded women who have deliveries less than 18 months apart are at greater risk for uterine rupture. The uterus takes time -- at least six months -- to heal so you certainly don't want to increase your risk of something going wrong by getting pregnant too soon. And just FYI, the details of the study mentioned and other information about VBAC are included in the last chapter of our book, "Future Pregnancies."

Lulu: Because of my small frame and a prior surgery I had to an artery in my neck, my doctor has mentioned a C-section. He is highly regarded in high-risk pregnancies and I chose him after suffering two losses. (6 and 12 weeks.) However, I know of two cases where he has knicked the baby during the procedure. Does this qualify me to be alarmed?

Dana: We're not sure what you mean by "knicked" the baby, do you mean during a c-section delivery? Or with forceps prior to a c-section? Also, were you given this information firsthand, or is it hearsay? You should definitely state your concerns to the doctor; you have every right to know about his past performance. Also, you can find out from your state medical board what your doctor's past record is, e.g. if there have been any lawsuits against him, or if his license has ever been suspended. But, if you feel at all uncomfortable with this practitioner, we also urge you to listen to your instincts. Your health and your baby's health are paramount.

Vonda: I have had two c-sections, with my last being eight months ago. My doctor said if I decide to have another baby, I am fine as far as scar tissue goes. How long do I need to wait in between babies after a c-section?

Maureen: After delivering by c-section, most doctors recommend waiting 9 months before becoming pregnant. That's because the incisions that were made on your uterus and abdomen need time to heal and strengthen before getting stretched out again! A stronger scar means you reduce your chances of uterine rupture. While this is a rare occurrence, it's a very serious and potentially fatal condition for mother and baby.

Shelly: After having two cesarean births, I have a skin fold at my Incision sight. It's kind of like my belly skin just flops right over at the incision. Is there any way to get rid of this unpleasant side-effect? I am overweight and have been losing weight, but I'm afraid that losing the weight just won't get it done. Is plastic surgery the only alternative to a firm tummy after a cesarean?

Maureen: Welcome to the club, Shelly! While researching the book, we spoke to lots and lots of women who were bothered by the very same thing. One of the moms we interviewed for the book said people will ask her if she's bothered by her scar-but she says she tells them she can't even notice the scar thanks to the pouch of fat that hangs over it! Losing weight, especially in the abdominal area, will most definitely help lessen the appearance of the pouch. So keep at it.

In the meantime, it's also really important that you find time to exercise. The best way to tone this area is a two-part approach: First it's essential to do some form of cardiovascular exercise at least 4 to 5 times per week for 30 minutes. This will increase your metabolism and help burn away some of the bulge. Secondly, you need to focus on some core-strengthening exercises (We devote an entire chapter in the book to a core fitness routine, so be sure to check it out) which include abdominal curls, lunges, and squats. The good news is that spending 5 or 10 minutes on this area four or five times per week is all it takes to see a noticeable difference. As for plastic surgery, a tummy tuck is most certainly an option. (Though not directly following the surgery.) But you can save yourself some serious cash and pain by giving the diet and exercise approach a real shot, first.

As for whether you can combine a tummy tuck with a c-section surgery, one of the obstetricians we interviewed for the book said that it just isn't done because they're two separate surgeries that require an obstetrician and a plastic surgeon.

Jeanne: Hello, and thank you for coming to StorkNet. I'm scheduled to have a c-section in September and just saw this interview. I'm relieved to find someone who can talk to me about what's going to happen. I will run out and get your book and in the meantime, could you tell me if the book explains what to expect when I get to the hospital, and then from there on out? I'm a bit uncertain and I guess, even scared. What happens first? Thank you.

Maureen: Hi, Jeanne. Actually, one of the main reasons for us writing this book is so that women like you would have a resource to look to upon discovering that a c-section birth was necessary. Checking in to the hospital on the day of your scheduled surgery can be kind of a surreal experience since you're not in labor, but you know that in a matter of hours you'll have a brand-new baby! After an admission's nurse checks you in and makes sure all your paperwork is filled out, you change into a gown and meet with an anesthesiologist who'll ask you a few questions and go what to expect from the surgery. You're then taken by wheelchair to the surgical operating area.

With my second c-section, which was scheduled, I was dropped off with my husband at the door leading into the OR area. I was then told I could walk the rest of the way. Physically, I was fine to walk since I hadn't received the spinal/epidural, but I can't tell you how weird it was walking down the hallway looking for the operating room that I'd deliver my baby in!

To help allay some of your fears and concerns, there's a whole chapter that walks you step-by-step through the entire c-section procedure. The book goes into detail about the anesthesia and what to expect, plus we cover everything to expect with healing both in the hospital and with your home recovery. Good luck with your delivery and be sure to let us know how everything goes!

Judy: Hi, Ladies. Could you tell me how many days the normal hospital stay is? And what is this based on? Also, what should I bring to the hospital other than what's normally on a suggested list for vaginal birth? Thank you ahead of time.

Maureen: Hello, Judy. Thanks to the Newborns' and Mothers' Health Protection Act, a law enacted in 1998, insurance companies must now cover at least 96 hours of in-patient care following a Cesarean delivery. However, most women don't stay this long, opting instead for just 2 to 3 days of in-hospital recovery. But Dana and I agree that you should really take the time that you're entitled to. Getting the extra rest and 'round-the-clock nursing care can really make a difference in your recovery. Like we say in the book, once you're home, it can be hard to find someone-even a devoted partner or loving mom-who will be there at all hours to change the sheets, bring your pain meds, serve your three meals a day!

Rachelle: Hi Ladies, I am 32 years old with four children - a six-year-old, four-year-old twins, and an eight-month-old baby, all born buy c-section. After having my third c-section my doctor told me that the lower section of my uterus was a little thin and if I wanted to have any more children I should wait as least three years. I had to use the fertility drug clomid to conceive my babies as I have PCOS and don't ovulate on my own, so my fertility is low and I am worried if I leave it too long to try for another baby I wont be able to fall pregnant. I would like to try for another baby sometime next year, but do you think I could risk rupturing my uterus if I don't wait three years?

Dana and Maureen: During the research for our book, we discovered a study that suggests that women who had a c-section and then got pregnant within nine months of that Cesarean birth had an increased risk of uterine rupture. That means the pregnancies should be spaced at least nine months apart. You may have some health concerns that make it safer for you to wait even longer. Please discuss your concerns with your physician.

Alaison: I had an emergency caesarian with my first child in 2002. I had no side affects and when I recommend C-section people think I'm crazy. I'm now expecting my second baby due date December 19, 2004. My gynea has scheduled the c-section for December 12. My mum is set against this as she says when the baby is ready to come and I go into labour then I should have the C section done. Is having the c-section planned for two weeks before due date a good thing for the baby?

Dana and Maureen: Alaison, please discuss your concerns, and your mother's, with your doctor. We learned during our research that there are some benefits to waiting for labor to begin--namely it can help the baby's lungs to experience the onset of labor--but because of current liability issues, some physicians are reluctant to wait for labor to begin naturally. If you do wait to go into labor and something goes wrong, you may end up having another emergency cesarean which is something you definitely don't want to do if you have a scheduled one instead. (We've both had both experiences and trust us, the scheduled Cesarean is SO much easier, in every way, than the emergency!)

Ann: I am curious whether, in your research, you found it was a common experience for women who, for whatever reason, went through induced labor, ended up delivering by c-section? That was my experience. I was induced and although I experienced strong contractions, did not progress adequately. After 12 hours, my baby was delivered by c-section. I simply cannot help but wonder however if, had labor begun on its own (without medical induction) I would have been able to deliver vaginally? I know everyone's circumstances are going to be different, however I just wondered if there was any link between induced labor and probably c-section birth?

Dana and Maureen: Hi, Ann. You will never know for sure. Yes, there does appear to be a link (we cover this issue extensively in our book). There is a theory that the drugs used to stimulate labor "hyperstimulate" the uterus and can lead to a cascade of events that ultimately make Cesarean necessary. Of course there is also the possibility that your circumstances would have been exactly the same if you had gone into labor naturally.

Monique: Hello. I just had my first child by unplanned c-section three weeks ago. The c-section happened due to 22 hours of very unsuccessful labor, plus I had developed pre-eclampsia during the labor and had to be on magnesium sulfate. Plus my baby was nearly 10 pounds despite being only three days past her due date. So my first question is this: With these circumstances, are they likely to want to schedule a c-section for any future pregnancies to avoid the pre-eclampsia and difficult labor? Also, this recovery has been pretty rough. Are future c-sections usually easier to recover from than the first? If I'm able to avoid going on the magnesium next time, would that make recovery easier? Thank you!

Dana and Maureen: Hi, Monique! You did it though and your baby is healthy! Remember, we are not medical professionals and so it is impossible to know what may be ahead for you. Some women experience preeclampsia with one pregnancy but not with the next. Some have it every time. One issue that you would not have to face if you have a scheduled repeat c-section is the utter exhaustion you surely felt after laboring for so long and then having to have a Cesarean. You experienced the double-whammy. If you do have another c-section and it's scheduled the whole experience will be so much easier.

Nicola: I am considering having a third child. My first two were delivered by c-section. I don't feel physically ready to have another c-section as I had lower back problems for some time after our first child was born, and I am still suffering now, and our second child is two. I have started pilates and body balance classes. What else do you suggest?

Dana and Maureen: We love Pilates! I did it through my third pregnancy and afterward, and I am certain (this is Dana speaking) that it saved my back and helped me get back into shape after my third c-section. I would encourage you to continue with Pilates, but don't forget to add some aerobic activity into your program. I also found that while Pilates was a great workout for my core, I still needed to do some strength-training for my arms and legs. Good luck, Nicola.

Miranda: I had a C-Section with my first child and I have a horizontal incision. I want to have another C-Section with my current pregnancy. The reason that I had one in the first place was because there was hardly any fluid left in the sac and it was getting way too dangerous for the baby. I went through 26 hours of labor before they performed it. Do you think my doctor will let me have another C-Section? I don't want to go through that ever again!

Dana and Maureen: Miranda, in the current medical climate, it is likely that if you wish to have a repeat, your doctor will agree. That's the trend these days.

Rita: Hi Maureen and Dana. Thank you for your replies so far. I'm enjoying your interview. I wanted to know if you have anything to share about bonding. Do you discuss this in your book? If so, I'm on my way to the bookstore. This was my biggest concern and problem after my birth last year. I wasn't able to hold my baby right away and everything I had learned ahead of time was the importance of holding and feeding my baby immediately after birth. I was very disappointed. Thanks ahead of time. Rita L.

Dana and Maureen: Oh, yes, we have something to say about bonding in our book! We both felt so utterly let down after the emergency c-section births of our first babies because we felt like we missed out on those crucial early "bonding" minutes and hours. We didn't get to breast feed right away, we didn't get to hold our babies for many hours (actually, in Dana's case, it was several days!) after their births. However, we have since come to believe that some childbirth educators put such a heavy emphasis on immediate bonding that those of us who are unable to do so feel a deep sense of failure that ultimately affects the early weeks of mothering. Rest assured that we are both STILL bonding with our children, and the oldest is now seven years! We feel that we will be bonding with our children until the day they leave home. Please, please, don't beat yourself about this. You will have plenty of opportunity to make up for lost time. Good luck, Rita.

Kelly: Hi there, I am so pleased I checked this site today. I am scheduled for a C in 11 days and I am very scared. My first son was born by C in the UK almost six years ago. It was very traumatic and distressing. I understand the level of care is higher here and the hospital here is far nicer but still I am scared. I kind of remember what to expect but wondered if you could recommend a way to keep me from freaking out. I intend to buy your book this weekend also! Thank you for your time.

Dana and Maureen: It sounds like your first c-section might have happened under "emergency" circumstances, which is, as you learned, very distressing. You don't know what's happening, you are worried about your baby, and you probably didn't plan for this scenario! However, since your second cesarean is scheduled, you will almost certainly find the whole experience much less stressful. While we certainly can't promise that it will be pain-free or pleasant, neither should it be scary as your first one. For one thing, you won't go into labor which means you won't be as exhausted as you were following your first delivery. For another, you will walk into the hospital and climb onto that delivery table on your own. And you shouldn't require general anesthesia, so you will be alert for the whole procedure. You probably will not get to hold your baby for a couple of hours following delivery, but you will get to see him/her right away and, if you request, you should be able to try to breast feed him/her as well (this sometimes depends on hospital policy, though, so if it's important to you be sure to talk with your doctor). Good luck to you! If you have the chance to read the book before your delivery read the surgery chapter first since we walk you step by step through the whole procedure so at least you have a good idea of what to expect!

Christina: How big is the scar going to be? Where? Is there anything I can do before or after to help the scar heal properly without problems? Thank you.

Dana and Maureen: The scar is usually about four to six inches long. We had a physical therapist recommend doing massage with vitamin oil once you can stand the pressure. She swears it helps the scar fade. The scar does fade even if you do nothing; we like to think of our scars as badges of honor!

Dawn: I had an emergency c-section six months ago. I was 31 weeks pregnant with my first baby. She was breech and heart rate was slowing down. My question is: How soon after the c-section can you start to exercise the area is still tender and the incision is still sort of bubble? I had the bikini cut incision.

Dana and Maureen: Check out our workout! Even though you had your c-section a few months ago, you will find the program we include very helpful for getting your core strength back, and helping you prepare for future pregnancies. Every woman's body heals differently;some women find that little bubble disappears completely, some find (like we do!) that they can always feel the bump of scar tissue under the kin.

Kim: I had my second c-section five years ago and am still struggling with the flabby belly. Is it too late to start abdominal exercises? Also, we're toying with the idea of number three. Should I wait until after the third C-section (due to the reasons for the first two, a third is almost a certainty) to get my tummy in shape? Thanks.

Dana and Maureen: It's never to late! We have a great workout in our book--we hired a trainer who has had two c-sections herself to design it for us--and the more you do now, the better you'll recover from the next one. Like we told Dawn, some women find they always have that little pouch -- it's partly genetic. Still, you can do plenty to tighten up that part of your body, doing the workout we include, plus core-intensive exercises like those found in Pilates workouts. Another key, of course, is losing fat. The less fat you have, the smaller the tummy!

Nikki: I am so happy to have someone besides my doctor to ask about whether or not a VBAC is appropriate for my situation. Almost three years ago, I had the utter joy of seeing my first son being propped up over the surgical curtain with a look of complete bewilderment on his face. Despite the drugs from the C-section, I can remember this as clearly as day. Anyway, I had been diagnosed with possible pre-eclampsia the previous day while at a checkup at my OB-GYN. She sent me to the hospital to be induced. I had normal, strong labor for twenty hours, was dilated to ten and pushing for four hours. The nurses and my husband could see my son's head, about a half inch diameter maybe, and everybody said I was pushing really well, and in no time at all I would push him out. Never happened. My doctor, who is a saint, came in on her day off to see why I was not progressing anymore, and when she tried to see if she could get forceps in to help, she couldn't even get a finger past his head. She took me down to surgery and performed the C-section all within five minutes of walking in the door. I have no idea how long I would have lain there if she had not come in to "assist" the doctor who was on duty that night. She said she thought I had an inward curve in my tailbone, and that was why she thought he wouldn't fit. Unfortunately, because of insurance reasons, I have had to since switch doctors. I am now in the sixth month of my second pregnancy, and have asked him about a VBAC. He is non-committal about it. He says it is my decision, and he is "discouraged" from recommending a single course of action. My husband thinks a C-section would be safer, I am on the fence. I would like to have the experience of a vaginal delivery, but in the end, I agree that the end result is what is most important. I also think that maybe if I had not been in labor for twenty four hours and exhausted right before the surgery, I may have had a better experience and a shorter recovery time. What is your advice? Thank you very much, Nicki

Dana and Maureen: You should insist that your doctor have a very frank discussion with you about why you had your first c-section and what the options are for you this time. You may be a perfect candidate for VBAC, or your doctor may decide it's safer for you to have a repeat. One of us really, really wanted VBAC with pregnancy #2 but when the baby wasn't thriving in utero and needed to be born at 36 weeks, it wasn't even an option. I (Dana) was disappointed at first, but totally agree with you that "the end result" -- meaning a healthy mom and a health baby -- is the most important.

Michelle: I have had 3 prior c-sections and am pregnant with #4 and planning a VBAC. I am concerned about my previous uterus scars and wonder if pregnancy/maternity belts are used often to prevent those scars from being pulled and stressed? I, like Kia, have also had my stomach repeatedly "massaged" just after a c-section. It is incredibly painful and I actually have fought the nurses every time they attempt it. They say they are trying to make sure your uterus is contracting and going back into its proper place.

Dana and Maureen: Hi Michelle. It is highly unlikely that your physician will let you try a VBAC after having had three c-sections. Your uterus just isn't strong enough due to the scar tissue from your previous deliveries and the risk of rupture -- which could be life threatening to you and your baby -- just isn't worth it. Also, don't fight the nurses. They will do that uterine massage whether your baby is born vaginally or by c-section. They're just doing what they're supposed to do.

Elena: Hello. I had my first c-section in 1999 and remember the rather painful and uncomfortable six to eight week recovery. Since then, I have been wanting to try for a VBAC for my second pregnancy. I also want to have my tubes tied. My doctor suggests a second c-section. Can you please tell me if it would just be easier to go ahead with a second c-section, and have a tubal ligation done at the same time? Thanks!

Dana and Maureen: Yes, that is one benefit to a repeat. As long as you sign a consent form ahead of time, your doctor can perform the tubal ligation right after your baby is born.

Norah: I am pregnant and am thinking of having a c-section. How long does it take to heal, and are there medical complications after the operation?

and...

Dana: I'm 18 and this is my first baby. I would really like to have a c-section. I just feel more comfortable. Do I have to have a medical reason to have one, or is it all up to me.

Dana and Maureen: Norah and Dana, unless you have some medical conditions that necessitate a c-section, it's unlikely you will be able to choose. If you're wondering what the procedure involves, you should read "The Surgery" chapter in our book. Remember that a Cesarean is major surgery and it's not something we would ever recommend for the sake of convenience or because you just don't want to have labor. Recovery from a vaginal birth is typically much easier!

Melissa: I am currently pregnant with my fourth child and I am a little scared about his baby. I have a nine year old whose delivery was normal. Then I have a five year old who was a c-section, then I have a one year old also done with a c-section. I am worried about having this baby so soon after my one year old due to the c-section and because I'm over weight. I am also worried that my other c-section has not healed all the way.

Dana and Maureen: Your doctor should be aware of your history and will take whatever precautions are necessary. Since your pregnancies are so close together, your doctor may opt to schedule your c-section a week or two before your delivery so that you don't risk going into labor, which in turn can increase your risk of uterine rupture.

Bette: How will breastfeeding be different with a C-section? I'm concerned about this. Have any breastfeeding tips in your book? Thank you.

Dana and Maureen: We devote a whole chapter to breastfeeding because, yes, you do face some different challenges with breastfeeding after a c-section. But you can do it! During the first few days you might find it hard to get comfortable because you will be hurting, but you will get comfortable and your milk will come in and you'll do it. You will find the breastfeeding information so helpful that you'll be glad you bought the book for that chapter alone. We worked with some wonderful lactation consultants who gave terrific advice! Good luck to you!

Parvin: I had a c-section nine months ago. My stomach isn't really saggy, but right in the middle/lower area, above the bikini line it dips in. I'm doing massage and exercise, but don't see any results. Some people say it is fat and will go away - it just takes time. Is that right?

Dana and Maureen: Since you describe the belly dip as sitting just above your bikini cut incision, chances are it's pulling in because of the stitches and the way the skin in that area has healed. There's not much you can do to get rid of the dip, but getting rid of excess abdominal fat by cutting calories and exercising may help to make this less noticeable. Our book features an excellent core-strengthening workout that is tailor-made for women who've delivered by c-section. Check it out and let us know what you think! Good luck.

Kerry: I had my first child five months ago by c-section and have just found out that I am pregnant again. I can't believe it, it took us 3 years to get pregnant for our daughter and this time it has rather shocked me a bit. Mainly because I am very concerned by the fact there is only 4.5 months between the c-section and getting pregnant. I have read your comments to other peoples questions about when it is safe to get pregnant but as I am now pregnant what sort of things should I not be doing to decrease the risk of a uterine rupture? How frequently does this occur?

Dana and Maureen: Kerry... first of all, you shouldn't stress about your pregnancy spacing. It sounds like this pregnancy is well underway and worrying about "what ifs" will only make your pregnancy less enjoyable and cause you stress about something that you can't control. Your physician is undoubtedly aware of your situation -- and will take the necessary precautions. There is nothing you can do to prevent uterine rupture -- and it is a rare occurrence -- with the exception of NOT attempting to "labor at home" in the event that you hope for a VBAC. Your physician may even decide to schedule your repeat c-section a little bit earlier (as in a week or so) before your due date to reduce the chances that you go into labor. As with any pregnancy, you need to listen to your body, and communicate with your health care provider, so that you can have the best possible outcome. Good luck!

Stephanie: I'm expecting my third child, and this will be my third c-section. I am 27 years old. I only waited 8 months to get pregnant last time (accident - oops). I want to know how long I'll have to wait to get back to the gym again.

Dana and Maureen: As soon as your physician gives you approval (which is generally around the six-weeks post delivery mark) you should be able to get back to your normal routine -- but take it slow. Remember that it took nine months to grow that baby, you need to be easy on yourself and not stress too much about getting RIGHT back into shape. You can, however, start doing breathing exercises and some easy stretches right after you deliver. We had a fantastic pre- and post-natal fitness instructor design a post c/s workout that you can begin the very day you give birth (with breathing exercises). If you can, check out that chapter, you will love it.

Shantelle: Hi! I have had two vaginal deliveries, neither of which I was able to push out successfully on my own so they were both suctioned out. Also during my second delivery I tore all the muscles in my stomach that run straight down in the middle. These muscles are now useless and, as I was told by a specialist, will never regain their use. In talking to my doctor she suggested almost immediately for me to have a planned c-section. I am extremely nervous about this and wonder if it is truly necessary. I do also have a small hernia beside my belly button and a muscle in my right side, close to the middle of my stomach generally aches on a regular basis. Could you help me to answer these questions, I would really appreciate it!
P.S. I will be at the book store tomorrow to buy your book as I have been searching endlessly for info on this subject on the net, and it is almost impossible to find.

Dana and Maureen: I have never heard of permanently damaging muscles the way you describe -- what kind of specialist told you you'd never regain use? That sounds very strange to me. Have you consulted with a physical therapist? You might find that by doing the right kinds of abdominal exercises you can regain some muscle strength. Maybe your doctor plans to repair the hernia when she does the c-section? It's very hard for me to know what to advise since I don't know your whole story! Is the hernia the reason for your c-section?
(Shantelle, if you reply to this please identify this question and let us know you are providing added information so that we can direct our guests. Thanks - StorkNet)

Heather: What is a healthier way to deliver for mom and baby -- vaginal birth or c-section?

Dana and Maureen: Heather, the risks for both baby and mother are lower with a vaginal birth. If you have a c-section you have had major surgery which requires significant recovery (while you're caring for a newborn!).

Sherry: Love the book! I was very excited to find something devoted totally to c-sections. Here's my question: After I had an emergency c-section, I had terrible pains, which I found out later to be just gas pains. I was excited when you mentioned some remedies in your book (liquid diet before a scheduled c-section, gas-x, etc.). I mentioned this to my doctor (I'm 33 weeks pregnant with my second baby - a c-section is scheduled for February 16), and he said that he hadn't found the liquid diet beforehand to make a difference. I may still try it along with your other suggestions (why not?), but I was wondering if you could share some anecdotes about the "gas thing"?

Maureen: Hi, Sherry. Following my first c-section, I also had awful gas pains; they were so bad that I was compelled to get out of bed only 6 or 7 hours after the surgery in the hopes that movement and walking would relieve some of the pressure. (It wasn't until the next morning that I actually started feeling some relief.) When I became pregnant again I told my doctor that the biggest fear I had about my c-section was experiencing those awful gas pains! He recommended I try a semi-liquid diet one to two days before the surgery and said that a lot of his other patients noticed much less gas build-up afterwards. The advice is based on anecdotal evidence and therefore the outcome may vary from woman to woman. I tried it with my second surgery and had a lot of success. We've had a lot of other women tell us the same thing. Unless your doctor thinks there's any reason that you shouldn't give it a go, I say why not try it and see what happens? You should also read up on what to eat--and not to eat--following the surgery. What you choose to eat for the next few days afterwards can also impact how much gas gets built up in the intestines. Good luck to you and please let us know how it goes!

M: Hello. I had c-section almost seven weeks now. I'd like to know how long I should wait before having intercourse, also the regular bleeding (period) had stopped four days prior my sixth week, but after my exam until now I noticed little leak similar with period end, sometimes just little spotting is this normal or should I see my OBGYN? Thanks for your assistance.

Dana and Maureen: Your bleeding should stop any day now. As long it's getting lighter in volume, rather than heavier, and doesn't have a foul odor, it is normal post-partum bleeding. Most doctors will say it's okay to have sex when the bleeding stops. If you're bleeding, it means there is still some healing to be done in the uterus (at the place where the placenta was attached) and you don't want to introduce -- potentially -- bacteria into that area while it's still healing.

Jenn: I am seven weeks pregnant, and very concerned. Eleven years ago I was in a car accident, six months pregnant. I ruptured my uterus and needless to say, the baby did not survive. I had a beautiful daughter six years ago, without any problems. My doctor did a c-section at 36 weeks to prevent me going into labor (as to not cause my uterus to possibly rupture again) What are my odds of this pregnancy going just as good?

Dana and Maureen: That is a terrible story. I am so, so sorry for your loss. It sounds like your doctor is taking a defensive position (not letting you go into labor) for very good reason. I can only assume s/he will do the same thing this time. Remember, we are not medical professionals, we are journalists, but my advice would be to make sure that when you have ANY contractions to check in with your doctor. Obviously uterine rupture is a catastrophic event that you don't want to experience ever again. Best of luck to you!

Jessica: I am 38 weeks and my doctor says that I might have to have a c-section because he said that my pelvis is narrow and the baby hasn't dropped yet. Will there be a chance that I can have it vaginally or should I take the option of scheduling the c-section? What would be a good idea to do? Also, how long will it take for a c-section to heal? Thank you.

Dana and Maureen: If I were you, I would try for the vaginal birth. I know that sounds crazy since we have a book about c-sections, but the bottom line is that the risks for both baby and mother are lower with a vaginal birth and the recovery from a vaginal birth is SO much easier than with a c-section. First of all, if you do have a c-section you will probably be in the hospital for at least three or four days. With a vaginal birth, you'll be home after one day. Try to not let your knowledge about the size of your baby and your pelvis freak you out -- there are LOTS of small women who deliver big babies vaginally. Good luck.

Antoinette: I had a c-section March 2003. Currently I am taking a pilates course to try and strengthen but am concerned that it seems to be taking so long to get back into physical shape and strength. I still get little spasms in the area and numbness - how long before everything is back to normal?

Dana and Maureen: The reality is that you may never return to your pre-pregnancy "normal" because pregnancy changes your body. I'm not sure why you are having spasms. I'd ask your doctor about that, but the numbness may persist for years (or forever) because you did have some nerves cut when your baby was delivered. Stick with the pilates! Even if your tummy is never "normal" looking again, it will be strong, and so will your back.

Susan Michelle: Hi, ladies. I don't have any questions for you. I just wanted to let you know that I bought your book even though I've already had two c/s, and it's fantastic! I never thought in a million years that I would have been one of the ladies out of my birthing class that I would end up with an emergency c/s. I wished I would have known about your book back then because it would have helped me be better prepared. No one wants to think about having a c/s but anyone working on a birthing plan should read your book so that they have all the bases covered. Besides, it's worth it just for the chapter on exercises.

Dana and Maureen: Thank you for your kind words. We wrote the book (and it just came out in summer 2004), because we had the same experience you did -- I was the one who was sure she'd have a drug-free birth and ended up with an emergency c-section. I'm a health writer and was sure there must be some resource out there that would help me figure out what this c-section thing was all about -- but there wasn't. That lack of information about what to expect and how to recover is what inspired us to write this book. Regarding exercise, we love Debi, the lady we hired to do that exercise chapter -- she is a pre and post natal fitness instructor who has had two c-sections herself so we couldn't ask for anything better than what she planned for us. Thanks again and good luck! (We'd love it if you'd post a review on Amazon or Barnes & Noble!)

Elizabeth: Hi, Dana and Maureen! I gave birth to my second child in October 2003. I had 35 hours of back labor due to an overdue and overlarge (9+lbs) posterior positioned baby. My epidural did not work and I stalled at 5 cm for more than 6 hours. My hospital wouldn't allow me to ask for and get a c-section, even despite all of that, because we hadn't done two rounds of Pitocin, which they required. After the second round of Pitocin, I did dilate fully and give birth vaginally, but the psychological trauma of that delivery haunts me. I am currently in treatment for Post-Traumatic Stress Disorder. My husband and I would like to have another child, but I absolutely refuse to have another vaginal delivery after all of that. How can I bring up the topic of a planned c-section with my doctor in such a way that she will understand that I am not just "afraid of labor," but rather that I have real reasons for wanting a c-section this time? Thanks.

Dana and Maureen: I think you should have a very frank discussion with your doctor. S/he will either help you understand why you are a good candidate for another VBAC, or agree that you are a candidate for a repeat c-section. I know this sounds harsh but if you don't feel like you can have a very honest discussion with your doctor, then you might consider looking for another one. Pregnancy is such a vulnerable time and you really need the support of the person who is caring for you. You were obviously exhausted by the delivery since you are still dealing with it. I hope you are able to process that experience so that it doesn't affect your future pregnancies. Best of luck to you.

lamia: After my second c-section, it has been 18 months and I still have pain at the site, some numbing and where my undies meet the scar, it is very irritating. Is that normal?

Dana and Maureen: You may always feel some numbness since there was some nerve "damage"
as a result of the surgery. But pain shouldn't be an issue at this point. I would mention it to your doctor -- it may be that the scar tissue is causing a problem.

Tara: Hi, I'm currently trying to decide whether or not to have a VBAC or repeat c-section and I'm having a tough time. Two years ago I had my son by emergency c-section due to his heart rate not getting back up easily after contractions. I was about 10 days late and had been induced, first by gel, then oxytocin. I laboured at home for about 14 hours with just the gel then went into the hospital for the oxytocin, which is when they discovered the decelerating heart rate (I never got past 2 cm dilated!). My doctor gives me stats and facts, but won't give me an opinion on the best way for this baby. She's open to either. I would prefer a VBAC, but am scared I'd have to be induced again, in which case I think I'd rather have a c-section. I can't help thinking that I'd end up with another emerg c-section anyway. I'm very torn over what to do.

Dana and Maureen: Is there any way she'll let you go into labor and try for a VBAC without the induction drugs? That's what I (personally) would want to do. Only because the risk of a c-section does go up slightly with use of these drugs. If your doctor is supportive of VBAC then that would be my choice (again, personal preference) only because the recovery will be easier, especially with a toddler at home. When you say emergency, do you mean you had to have a general anesthesia? If you have had one c-section, I would certainly ask for the epidural -- don't labor at home if you can help it -- to be in place as you labor so that if a c-section does become necessary, it can be done quickly, but without the need for a general anesthesia? Hope that helps!

Amy: Dear Dana and Maureen, Thank you so much for your research. I can't wait to buy your book. I am pregnant, due in September, and will be having a 5th c-section. It is so reassuring to not be alone and to read about other women who have had similar experiences. My question for you is are there increased risks, other than a long recovery, for multiple c-sections. Any extra precautions I should take? Thanks for your time! Amy.

Dana and Maureen: Hi, Amy. Because the uterus is being cut open with each c-section, it also weakens with each successive surgery. Scar tissue is simply not as strong as the original uterine tissue. So the more c-sections you have the greater your chance of having your uterus rupture during pregnancy. Uterine rupture is a serious, life-threatening emergency that requires immediate medical intervention to preserve the life of the mother and baby. For women who've had one prior c-section with a low transverse incision (also called the bikini cut), their risk is about 1 percent. But after two or more c-sections, that number goes up to about 3.9 percent, according to the American College of Obstetricians and Gynecologists. While it is an increase, it's also important to keep in mind that the overall risk is still relatively low. Our best to you!

Sandra: Hello, Maureen and Dana. Thank you for writing a book on such an important topic. I think there is such a stigma about c-sections, probably because so little is understood. As someone else wrote, I also had no idea I'd end up with a c-section with the birth of my son. I was all planned out for a wonderful, natural birth with no intervention. I think the wisest thing any of us can do is prepare for anything and that includes reading the latest and greatest information we can find on c-sections. I highly recommend reading your book. (I bought it last week.) I just wanted to tell you thanks for following through on a project like this that is so needed. I'm 13 weeks now and I am reading your book cover to cover because I feel that I will be less stressed and more positive the better prepared I am this time around. I love the chapter on exercise, by the way. Sandy

Dana and Maureen: Thanks for your kind words, Sandra! I (Dana) also hoped for completely natural birth and ended up with an emergency c-section, the first time. I was utterly unprepared for ANY of it. Part of the reason for that is arrogance-- I thought I could control my birth experience (ha!) but also because in my birth class the instructor sort of glossed over the whole c-section scenario. Anyway, that's why we wrote this book, and
we are so gratified that women like you are finding it helpful. Good luck!

Wendy: Will my c-section baby seem any different than a vaginally-delivered baby when I see him?

Dana and Maureen: Wendy, we devote a whole chapter to this issue in our book! (and you can see a photo of my (Dana's) newborn immediately post c-section on www.csectionguide.com in the excerpt labeled "Your c-section baby"). Depending on the type of anesthesia used during delivery, your baby may be a bit sleepier than a baby delivered vaginally. Her/his head will have a more round shape than the head of a vaginally born baby. But other than that, your baby should look just like any other newborn -- beautiful!

Chris: Do most c-section scars fade in time? Do they ever fade completely?

Dana and Maureen: The scars definitely fade with time, but whether or not yours fades completely depends on your skin type and how other scars heal. You might always have a little reminder of your baby's delivery -- we like to think of ours as badges of honor!

Cindy L: Thank you both for writing this book. I just finished reading it and can't express how much it helped me. I was told three weeks ago that I'd need a C-section and I panicked. I didn't sleep the first three nights and wondered how I'd get through this. Now I feel armed and ready, and full of power! I know what to look for, what to ask, and what to insist on. It's even making my hubby feel more secure (knowing I'm informed). If you have any further words of wisdom, please respond with them. I will soak it up. Thanks again.
Cynthia

Dana and Maureen: Thanks for your very kind words. It's so gratifying to know that we are helping people! It sounds like you are relieved and ready. Just be good to yourself, be patient with your body while you heal and love that baby. Good luck!

Chandra: Hi Maureen and Dana. I'm wondering if either of you had pressure from friends to not have another C-section. Two of my friends are urging me to try to have a VBAC and I'm scared to do it. I hear pros and cons and good stories and bad stories and I don't know what to believe. I'd love to have a vaginal birth this next time. But I need to know what risks I'm taking. Will your book help? Thank you for listening.

Dana and Maureen: Yes, our book will help you evaluate the pros and cons of both options. It's funny - and frustrating - because of the reasons we wrote the book was that we felt, after the fact, like we had to justify having had our C-sections, even though the situations that necessitated them were beyond our control. The bottom line is that you have to do what is best for you and your baby, and not worry what anybody else says. Don't be afraid to discuss your fears with your doctor, either. S/he should be willing to help you decide which route is best for you.

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Lorna: 12 years ago I had a emergency C-Section with my first child, due to him being 9.76lb, he was stuck and turned the wrong way. Ten years later I had an elective C-Section for I was told the baby looked very large once again, also my tail bone appeared turned inwards. When my second child was born I was very disappointed for he was only 7lbs and still to this day very tiny in size. I am now pregnant with my third child, due to my second child being so small, I am now hoping there could be chance that I could give natural birth this time round, what are my chances?

Dana and Maureen: There is certainly a possibility that you can have a VBAC if you have a physician who is willing to work with you. Please, please, please do not attempt to give birth at home if you can't find a doctor to help you have a vaginal birth. We know women who have done this and the risk is simply not worth it. Because you have had two C-sections, you are at an increase risk for a rupture, though the risk is small. Wishing you the best for you and your baby.

Tim J: My wife thinks she can do it all when she gets home. I'm thinking that we will need some help because I will only have a week off. My cooking stinks, and I turned laundry pink last time around. We can easily get family (her sister and cousin offered) help and I'm all for it.

Dana and Maureen: Get help!! Seriously, say a grateful "yes" to every offer that comes your way. (We have a chapter in our book about healing at home, in which we make several suggestions for how to make best use of offers of help.) If she is unwilling to have people in the house, then ask your kind family and friends to help you with cooking. Get out a calendar and any time someone volunteers, say, "If you could bring dinner on Tuesday, that would be great! Thank you." Maybe your Mom or sister, or whoever, would be willing to come over and do a couple loads of laundry in the afternoon while your wife and baby nap? You are so lucky to have people offering to help, and your wife might not realize just how much she'll appreciate that once she's home. The only thing she should be doing for those first few weeks are feeding the baby and resting. That will speed her healing, and make her less grumpy and tired! Good luck.

Tiffany: I had a c-section about eight months ago and I'm in the military (National Guard) and I wanted to know when it would be safe to take a physical fitness test. There's a part where I need to do 54 situps in 2 minutes. I just don't know when my stomach muscles will be strong enough again.

Dana and Maureen: Technically, you can do it now. But if you haven't been exercising, you will want to start slowly. Your incisions should be healed by this point. How it's just a matter of getting back into shape! If you have a chance, read the workout chapters in our book. We have a fantastic core-strengthening segment that was designed by a fitness expert who has had two C-sections herself. I (Dana) had a C-section almost a year ago - my third - and I can finally do 50 crunches at a time, although I've never done them with a stopwatch! Good luck.

Cheryl B.: I had a c-section nine months ago, but here is the weird thing - the day after surgery I was walking around and doing laps around the nursery floor! Two-three easy. The week after, I could go upstairs! Everyone was yelling at me to take it easy, that I should rest. I wanted to move around because I had just gotten off of bed rest (for three months!) But I recovered extremely quick. By the time my husband went to work two weeks later, I did not need anyone to help me. I also had my gallbladder removed one month later after my son was born, and the same scenario happened. Why did this happen to me? Why did I recover so fast? I was not able to exercise during the pregnancy. But today I can get up out of bed using my abs! Will it happen again? I plan to try to get pregnant within the next six months. I do not look great - I have the classic flabby tummy, and am still trying to lose it. If you have any exercises that will work for where I am at please let me know! I already plan on getting your book!

Dana and Maureen: Your recovery doesn't sound exactly typical! You must be very strong and healthy... It's much more usual for women to feel a considerable amount of pain for at least the first couple of days post-delivery. And there are a number of reasons that physicians recommend taking it easy for a couple of weeks afterward - namely that the last thing you want to do is open your incision. But, you made it past that, obviously. As for what's ahead, I would certainly advise you to at least try to take it easy after your next delivery. Who knows you might not even have a c/s next time around. And you will be caring for a toddler (which adds a whole new element to recovery!). You will find a great workout in our book. And it's certainly not too late. The exercises are designed to start *gradually* right after delivery, but the exercises can be done both to help you regain strength in your core and to prepare for future pregnancies.

Liz: Hi ladies, I have had two c-sections (the first was an emergency and the second a repeat). The doctor told me that because of my first c-section, my bladder is high. He said that to avoid a cut in the bladder, I should have a vertical incision instead of another bikini cut. I have read conflicting information on the recovery and safety of both. Have you ever heard of this problem, and what advice could you give me? Thanks, Liz

Dana and Maureen: We haven't, but as you already know, the potential problems with a vertical (or classical) incision are greater, so most physicians prefer the bikini cut for that reason, unless there are situations in which they must choose the vertical. In some cases, the vertical is done in an emergency situation. Be sure to discuss your concerns with your doctor. He/she should be willing to discuss the pros and cons with you so that you know what you are facing. Good luck.

Stephanie: I had a very successful c-section 12 weeks ago (my first child). I was up and walking a day after the c-section. Four weeks later, with my doctor's approval, I started walking on my treadmill. Six weeks later, I started lightly jogging on it. I recently read somewhere that you should wait 8 weeks before starting an exercise routine. Do you think I started too soon? Could I have caused any harm to my incision or uterus? I felt no pain during or after exercising.

Dana and Maureen: If you had your doctor's approval, then we can't argue. Presumably he was pleased with your progress and felt that your incision was healed enough for you to start exercising again. The danger would have been for you to open your incision, but obviously that didn't happen.

Tanya: Hello Maureen and Dana. Thank you for visiting us at StorkNet. I want to share with you that my husband picked up your book last week for me and surprised me with it. He knows how worried I am about my upcoming C-section planned for June. I highly suggest this book to anyone who is concerned in any way about this procedure. I feel so better having only read a third of the book so far. I feel like I will be sliding into a familiar place when I go to the hospital. Thank you.

Dana and Maureen: Thank you for your kind words. We hope that our book is helpful for women in your situation and for those who have already had a C-section but want to learn more about their birth experience and how to best recover from it. Good luck!

Lori: Hi, I am 24 and am almost four months pregnant with my third child and third C-section. I'm really scared about having a third C-section. What are my chances of survival? I love my two children with all my heart and they are attached to me and if anything should happen to me they would be devastated. I have nightmares about this at least three nights a week. Do I have a good chance of being ok?

Dana and Maureen: Yes! Please do not torment yourself by worrying like this. I (Dana) have had three C/S also and while it was a bit more challenging to get back to my normal routine after #3, I healed just fine. It's just harder to take care of yourself and your newborn when you have two other kids at home.

Shawnna: Hello Dana and Maureen, I am now 28 weeks pregnant with my third child and he has been diagnosed with having a two vessel cord. My doctor has already informed me that we will deliver at 36 weeks to avoid the rapid weight gain at the end of the pregnancy where his 1 artery may not be able to sustain the heavier weight. He will be performing a series of stress tests to determine whether we will deliver vaginally or by c-section. After my studies and research I really want to have the c-section. Is that something that I have the right to tell my doctor I want? And would the insurance company find that a valid reason to have the c-section?

Dana and Maureen: Of course you have every right to voice your concerns and your preferences to your doctor. As for whether he will suggest a vaginal birth or a C-section, we can't say. He may have valid reasons for preferring one over the other. It's always a good idea to keep the lines of communication open. You should understand why he is making his decisions. That is your right. Good luck, Shawnna.

Annie: Dear Maureen and Dana, I'm wondering what most women are afraid of or worried about the most when they are told that they will be having a planned, non-emergency C-section.
What is the biggest worry that you see? Does your book address it? Thank you. Annie.

Dana and Maureen: Yes, we do discuss issues like the one you mention. Many woman are just not informed about C-sections so they are fearful of the unknown. Our childbirth education system doesn't cover in enough detail (we think) what happens during a C-section, so many women are just not prepared for it if/when it happens. Since C-sections do happen in about 25% of births, it is important that we all know what the possibilities are, and understand that by having a C-section birth, we have not failed in any way. Best of luck with your delivery.

Kwanzaa Jean-Baptiste: I gave birth to my daughter in November 2004. She is four months now, I just found out 2 weeks ago that I am pregnant again - maybe 6 weeks along now. I gave birth to my daughter via C- Section. And my doctor tells me that this baby too will have to be delivered via C-Section. I am really concerned because I feel as though my body has not had ample time to heal. Should I be concerned? And how long does it takes your body to fully recover from a C-section?

Dana and Maureen: The research we read suggests that waiting about nine months between pregnancies is ideal and enough time to let your body heal -- but there is no point in worrying about that now. Please do follow your doctor's advice, especially about exercise and weight gain, so that your pregnancy proceeds without additional complications. Good luck.

Tania: I just wanted to say I love your site. I have been looking and looking for anything about repeated c-section (3 or more) and found nothing. I was happy to see your site and read that many of people have had more than two c-sections and did fine. I have two girls - just had one a little less than 3 weeks ago so still recovering at the moment. Hubby and I wanted 3 kids but due to c-section I cut it down to 2 but since this last one was a girl I don't no if I could live without trying one more time for a boy. Of course I will give it a year or more before attempting this again. Thanks again. Tania

Dana and Maureen: Thanks for your kind words. We were in your situation... which is why we wrote this book! We hope it provides you and other women facing our situation, the information they need to get through this experience and enjoy motherhood!

Gemma: I had my first child in November 2005. I always hoped to have my children close together. Some people have told me that it can take longer to get pregnant after a c-section. Is this true?

Dana and Maureen: We learned from our research that the IDEAL amount of time to wait to become pregnancy again is nine months...but sometimes that doesn't happen. The reason for the suggested length of time is that it gives your uterus ample time to heal before another pregnancy.

Liz: Will getting my tubal ligation done right after my c-section affect my plans of losing tummy fat?

Dana and Maureen: I don't know why it would because the amount of fat you carry in your middle depends on genetics, diet and exercise. Your tubes have nothing to do with it! Regarding that tubal, though, I learned that you should request the tubal before your delivery because your doctor might not be willing to do it following delivery if you haven't already signed the consent.

Hannah: Do people generally tell you that they feel disappointed at first that they did not have a vaginal delivery? Does your book cover this problem?

Dana and Maureen: Oh yes it does! In fact, that was one huge reason for the book -- we felt like we had failed ourselves and our babies and the midwives who trained us to have natural childbirths. This is a huge emotional issue for many woman and we cover it in depth and include a number of resources for women who are struggling with this issue (and we include several strategies for "emotional healing" in our book. Good luck!

Rose: If I have already had a C-section and will have another, will the incision be in the same place? If so, why? And if not, why? Thank you!

Dana and Maureen: It should be, unless for some reason your doctor decides you need a different type of incision. If your repeat is scheduled (vs. an emergency) then your doctor should be able to cut along the same scar.

Sandy: I have a fear of being numb and it creeping up my body to my chest and neck and breathing area. How numb will I be? Will this be a problem? Is it possible to be numb from the waist down and awake during the C-section? How does it all work? I'll be purchasing your book soon. My due date is in October. Thank you.

Dana and Maureen: That is a feeling that many women experience -- to be honest -- but you should discuss your fears with your doctor and, if possible, your anesthesiologist. My anesthesiologist told me to concentrate on my breathing -- to listen to every breath coming in and out -- which helped my brain understand that I was in fact breathing even though I was numb. It worked! And yes, you should read our book because we cover both the anesthesia options and the surgery -- step by step -- which will help you know exactly what to expect. Good luck (you'll be fine!).

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