The Gentle Cesarean is The New C-Section. How to Have One.

Currently, one in three babies are born via a Cesarean birth or c-section, the most commonly performed surgery in the U.S. Some of these may be planned or elective c-sections for any number of reasons, but the majority are not. As a result, it’s a good idea to be discussing the potential for a Cesarean birth with your health care provider as well as your support system (midwife, doula, partner, etc.).

What is a Gentle Cesarean?

Also known as a Family-Centered Cesarean, Natural Cesarean or Gentle C-Section, this new approach to the c-section procedure uses practices that place more emphasis on the physical and emotional well-being of both the mother and newborn.

The surgical part of the procedure is still largely the same – anesthesia that numbs the mother from the waist down, and an incision through the abdomen and the uterus to remove the baby. The difference is about the quality of care that is provided to the birthing person and their partner.  

What follows is a list of things to review, consider and potentially discuss with your health care provider that can help make the cesarean a better overall experience. The items on this list can help to form the basis for a gentle c-section birth plan that aligns with your values and wishes.

Support Persons

Having two support people in the Operating Room (OR) is ideal. This allows your partner to stay with the baby when it’s being examined. If your baby needs to leave the OR for special care, they can attend to that while a doula, midwife or other family member stays to support you. This has been especially difficult during COVID as most hospitals only allow one person to enter the facility.

Communication

Consider asking that the OR staff introduce themselves when they arrive. There will likely be more people than you expect, all wearing masks and gowns. That little bit of human connection can go a long way for creating a positive experience.

Ambiance

Playing your own music can be deeply comforting especially if you’ve been planning something special. Ask if the staff allows you to put on your own music.

Nausea

Peppermint Oil can ease symptoms of nausea reported during and after surgery. A little dabbed on a cotton ball by your partner and held under your nose is all it takes. Staff can provide a medication for nausea but it does cause sleepiness, so avoiding it can be helpful.

Surgical Curtain

If you’re interested, you can ask if the curtain can be clear or even lowered at the moment of delivery so you can see your baby enter the world.

Announcing the Sex

If you’ve been waiting to learn the sex, ask if the staff can abstain from announcing it so you can discover it yourself when the baby is brought over to you.

Delaying Chord Clamping

Delaying chord clamping can be beneficial for the baby even if it’s only for 30 seconds or so. Ask if your surgeon can delay this slightly. Here’s more reading on this topic from The American College of Gynecologists & Obstetricians.

Skin-On-Skin

Ask if the baby can be delivered to you immediately after delivery for skin-on-skin contact, bonding, and potentially breastfeeding rather than being handed off to nursing staff for routine procedures. In the U.S. three out of four people who birth via Cesarean are separated from their babies for at least the first hour (Declercq et al. 2013). Research has clearly shown that this has a negative impact on breastfeeding. Here’s a link to some of the best evidence-based research on skin-on-skin time after a Cesarean.

Monitoring Equipment

In hospitals that perform Gentle Cesareans, the IV catheter, oximeter and blood pressure cuff are placed on the mother’s non-dominant arm and the electrocardiographic leads are placed on her back, leaving her chest clear so she can hold her baby.

Routine Procedures

Ask if all newborn procedures (e.g. weighing, Vitamin K shot, dressing, etc.) can be delayed until after you’ve gone back to your room and had the opportunity to bond and breastfeed with your baby.

Exteriorizing Your Uterus

Surgeons often move the uterus out of the body to examine and repair it. However, research shows that this in no more effective than repairing it inside your abdominal cavity. Removing the uterus to repair it is tied to increases in nausea, vomiting, longer time to first bowel movement and postpartum pain. This is a worthwhile thing to inquire about with regards to surgical best practices. Here’s a link to a summary of one of the clinical trials on this topic.

Talk to Your Baby

You and your partner can help ease your baby’s transition into the world by talking to them when they arrive. Hearing the sound of you and/or your partners voice is incredibly comforting for them and begins the next stage of your relationship.

A Cesarean birth is its own form of birth and a triumph for all. It can be challenging to voice your preferences about this process to your healthcare providers, but it is the first step towards creating an empowering birth experience.

For more information on Cesarean birth, check out our post, 7 Simple Tips for Cesarean Recovery for a list of simple but highly effective steps you can take to accelerate and deepen your recovery postpartum.

Also, if you’re planning a Cesarean birth, consider our Repair Down There salve, designed to accelerate and deepen healing of your cesarean incision while minimizing scarring.