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Monday, May 1, 2017

Gentle Cesarean: How To Have A More Natural C-Section

For women who wanted a natural childbirth, it can be disheartening – and even traumatic – to end up having a cesarean section. This was surely my experience, especially after my first child (an emergency cesarean) and my third (a planned VBAC birth after two cesareans that ended in another surgery).

What are the repercussions of a cesarean?

C-sections come with plenty of negatives – a longer hospital stay, weeks of recovery time, and lifting and driving restrictions. Emergency cesareans often come with added emotional trauma and increased rates of postpartum depression and anxiety.

A cesarean mama might feel that her birth experience didn’t measure up to what it was “supposed” to be, to what her friends experienced, or to what she heard about in the media. She might have been completely unconscious when her baby was born with her arms strapped down and loved ones out of the room. Baby might have been 10 feet away, surrounded by doctors, or even taken to the NICU.

Mama might not meet her newborn, let alone breastfeed him or her, until hours later.

Does a cesarean have to be a traumatic experience?

No. The answer is simple. You can make your surgical birth experience almost everything you dreamed of when you planned a natural birth. It’s thankfully a new trend we’re seeing in some hospitals and the practice is called Gentle Caesarean.

A gentle cesarean can be part of your birth plan if you know you’ll need a c-section, or it can be part of a back-up plan if your intended natural birth and/or VBAC fails.

The best part about a gentle cesarean is that you can pick and choose which aspects will create your ideal birth atmosphere.

What is a “Gentle Cesarean”?

A gentle cesarean (sometimes called a family-centered birth) includes many features, but its overall purpose is to invoke a peaceful, calm atmosphere that closely mimics what happens during and immediately after a natural childbirth.

  • If you prefer a gentle cesarean to the traditional protocol, you’ll want to add the following to your birth plan
  • Mama should request an epidural or spinal block; general anesthesia should be avoided at all costs, barring any emergencies
  • Mamas should request that anesthesiologists do not automatically give her extra drugs to relax, so that she can be fully present for the experience
  • If mama cannot be conscious, father should be allowed to hold baby skin-to-skin immediately after birth, barring any medical complications with baby
  • If mama has EKG or baby monitoring devices, they can be placed in areas that don’t infringe her ability to see, hold or breastfeed baby.
  • Mama can watch baby lifted from her belly through a clear drape; if this is makes you squeamish, the drape can be lowered and baby can be lifted above it
  • Mama’s gown can be lowered and baby can be placed on mama’s chest while mama is being sutured. To facilitate this, mama must ask that her arms are not strapped down
  • Baby can breastfeed immediately while in the operating room
  • Parents can request cord clamp/cut delay until it stops pulsing
  • Parents can request that the placenta be saved and/or frozen until discharge from the hospital
  • Music of the parent’s choice can play in the operating room
  • Doctors and nurses are asked to refrain from “shop talk” (I distinctly remember hearing doctors converse about my scar tissue and incisions during my second cesarean) or their weekend plans
  • Ask your doctor for a vaginal swab to give your baby the best microbiome possible (see below)
  • Baby can be held by mama while wheeled into recovery, and continue to bond with parents there
  • Any and all usual post-birth procedures such as cleaning the baby and weighing the baby are delayed until parents are ready
  • A doula, grandparent, or friend are permitted to photograph or videotape the birth so that parents can concentrate on bonding


What is a vaginal swab, and how does it help my baby?

When a baby goes through the birth canal during a vaginal birth, he or she is exposed to a plethora of microbes – in baby’s mouth and on the skin. These bacteria help build a healthy microbiome for your baby, which could reduce his or her risk of inflammatory illnesses like Crohn’s disease, heart disease, infections, and much more.

The absence of this bacteria transfer in cesarean babies might explain why some studies have found that cesarean babies have higher rates of asthma, allergies, obesity, and other health concerns.

Does a cesarean mean that your baby has to go without the benefits of these microbes?

Not necessarily. With a gentle caesarean, your doctor or midwife can collect a vaginal swab and wipe it on your baby’s skin and in his or her mouth to contribute toward a positive microbiome. Another option is to take a swab of your vagina and wipe it on your nipples before baby breastfeeds.

While this is a relatively new practice, (indeed, I missed out on it with my three kids – a shame since I suffer from Crohn’s and its related enemy, arthritis), research is currently underway to study the efficacy of the practice.

Here are four steps to prepare for having a gentle cesarean

1. Implement your birth plan
Include your wishes for a gentle cesarean, even if you are planning a natural childbirth, in your birth plan, and keep several copies of it handy – in your hospital bag, your car’s glove compartment, and your purse. Everyone involved in your birth (obstetrician, midwife, doula, neonatologist, pediatrician, anesthesiologist, and operating room nurses) should also have a copy and be willing to abide by it.

2. Find a doctor who is open to the idea
Find a doctor who is open to the idea and ideally familiar with the concept of a gentle cesarean. If you are facing a doctor on-call with whom you are not familiar, make sure you have an advocate with you who is willing to voice any concerns you may have. It is well within your rights to take the extra time prior to surgery (barring any emergencies) to put in place a birth team who is willing to make this work for you.

3. Read up beforehand
Read up on your hospital’s policies and procedures beforehand so that you are aware ahead of time of any obstacles that may get in the way of your gentle cesarean. Hospitals sometimes have regulations in place that are different than your doctor’s practices, and hospital rules override even your doctor’s wishes. Hopefully, you can have every aspect of your birth that you desire, but if everything does not go according to plan, take the time to grieve! Even in the best of circumstances, we all have our “Mama Wound”.

4. Remember, this is your birth experience!
Remember, this might just be another day for them, but this is YOUR birth experience – something that you will remember and reflect upon for the rest of your life. Make your wishes known! This is not the time to be shy.

A gentle cesarean is the best way to get through a surgical birth with compassion, peace, and grace, and it is often extremely healing for mamas who have been through a previous traumatic surgical birth.

This is a guest post from natural mama Abby Deliz. Abby is a mother of three children (Luke, 8; Hannah, 5.5; and Landon, 7 months), and she is also a Master’s student at Claremont Graduate University. Abby has contributed several other wonderful articles on this site on the topic of c-section recovery.

SOURCE: Mamanatural

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