With nearly a third of all U.S. deliveries occurring via cesarean section, it’s no surprise that healthcare providers and families alike are working to improve outcomes and the overall birth experience associated with surgical delivery. While the risks and health impacts of cesarean sections have long been studied, the emotional and psychological impacts have often been overlooked. Gentle cesarean sections (sometimes called family-centered cesarean sections) offer a solution that serves to improve both psychological and physical outcomes for parents and newborns.
Tradition vs Gentle C-Section
Many mothers who have delivered via cesarean birth (or c-section) describe the experience as “clinical,” “cold,” “shocking,” and even “traumatic.” Traditionally, babies have been delivered, whisked aside for lengthy medical assessments, then passed to dad or mother’s partner during the conclusion of surgery. With a gentle cesarean, the focus is on getting baby skin-to-skin on mom as soon as possible after delivery, much the same as with a vaginal birth.
Skin to Skin in the Operating Room
Many parents are surprised and excited to learn that baby can safely be placed on the mother’s chest and can even begin breastfeeding while the surgical incision is being closed. Families report a sense of peace knowing their infant won’t automatically be carried out of sight or to a separate area for assessments. These tasks can either be delayed or completed while baby is skin-to-skin with mom. In hospitals where a gentle cesarean is available, there is a designated nurse who assists parents with positioning the newborn for early breastfeeding while mom may still be unable to fully support the infant on her own.
A large study from Lowson, Offer, Watson, McGuire, and Renfrew (2015) reveals that mothers who have early skin-to-skin contact with their babies experience less anxiety by the third postpartum day and are more confident in their parenting abilities at discharge. Bringing baby skin-to-skin allows for quicker bonding, enhanced mood, and maternal stress reduction.
In addition to its emotional and psychological benefits, immediate skin-to-skin when babies are eager, alert, and awake has been shown to improve neonatal temperature, heart rate regulations, and blood sugar regulation, all leading to improved initiation of breastfeeding. In turn, early breastfeeding initiation aids in rapid uterine involution, decreased postpartum blood loss, and correlates to long-term breastfeeding success.
Options for Your Baby's Birth
If you are planning to have a cesarean delivery, discuss the potential for a gentle approach with your obstetrician or obstetrics team (which may include an ob/gyn, anesthesiologist, pediatrician or pediatric staff, certified nurse midwives, labor and delivery nurses, and medical team members).
Find out what options are currently available to you and consider which aspects of a gentle or family-centered request. Ideas you may want to include are:
- Warming the operating room and dimming the lights not directly involved in the surgical procedure, creating a cozier, less clinical feel.
- Playing the your choice of music throughout the process
having more than one support person present during birth (this can be family members or other support). - Minimizing conversation among operating room staff during delivery
placing IV lines, blood pressure cuffs, etc. on your non-dominant side so you have greater ease and freedom to hold your baby with an unencumbered arm skin-to-skin post-delivery. - Using a clear drape so that you and your support people can view the emerging of your baby from your abdomen.
- Monitors facing away from you if watching them will cause stress.
- Delayed cord clamping for better long-term iron reserves in baby.
- Uninterrupted skin-to-skin for the first hour or until the first breastfeeding is accomplished.
Additionally, asking for an operating room and recovery room tour prior to your c-section date and introducing yourself to staff who will be assisting with surgery may help you feel more prepared. Having a health care provider and place of birth that are aligned with your goals and preferences is the most important factor in having your preferences respected. Have the “what if…” discussions at your prenatal visits and ask specific questions about policy and procedure on the hospital tour so you can be assured that the provider and birth place you are choosing will provide the birth experience you want.
What if I Have Questions?
If you are interested in learning more about planning a gentle c-section, our dual-certified lactation consultant/doulas are happy to meet with you to discuss. Write to birthplan@aeroflowbreastpumps.com to schedule.
References
A Gentler C-Section. (n.d.). Www.muhealth.org. https://www.muhealth.org/our-stories/gentler-c-section
FamilyCentered CSection | Labor and Delivery. (n.d.). Www.vcuhealth.org. Retrieved August 20, 2021, from https://www.vcuhealth.org/services/womens-health/our-services/pregnancy-and-birth/team-and-capabilities/family-centered-c-section
FastStats – Births – Method of Delivery. (2017, January 20). Retrieved March 31, 2020, from https://www.cdc.gov/nchs/fastats/delivery.htm
Heaton, M. (2020, June 29). How to Plan for a Natural Family Centered Cesarean. The VBAC Link. https://www.thevbaclink.com/family-centered-cesarean/
Neczypor, J. L., & Holley, S. L. (2017). Providing Evidence-Based Care During the Golden Hour. Nursing for Women’s Health, 21(6), 462–472. https://doi.org/10.1016/j.nwh.2017.10.011
Sostek, A. (n.d.). Making The Case For A Gentler C-Section | Journal of Advanced Practice Nursing. Nursing Journals : American Society of Registered Nurses. Www.asrn.org. Retrieved August 20, 2021, from https://www.asrn.org/journal-advanced-practice-nursing/1320-making-the-case-for-a-gentler-c-section.html
Vaginal & Cesarean (C-Section) Birthing Options. (n.d.). Prod.uchicagomedicine.org. Retrieved August 20, 2021, from https://prod.uchicagomedicine.org/conditions-services/pregnancy-childbirth/labor-delivery/vaginal-cesarean-c-section-birthing-options
Wisner MS, RNC, CNS, K. (2016). Gentle Cesarean Birth. Www.nursingcenter.com. https://www.nursingcenter.com/journalarticle?Article_ID=3483680&Journal_ID=54021&Issue_ID=3483293
Yan, Y., Gao, X., & Xiang, S. (2020). Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study. Journal of Human Lactation, 34(11). doi: 10.1177/0890334417741434
