What is a GENTLE cesarean section?

By January 1, 2018 August 9th, 2018 Birth
There has been a recent discussion and trend towards gentle cesarean sections. The question is what does this mean?

What happens during a cesarean section?

For those of us who have had cesarean sections (me included, I’ve had three), the experience can be disconnected. Or in other words, a little surgical. I’ll use myself as an example. When the decision was made to have a cesarean section with my first, I was wheeled into the operating room, given a re-bolus of my epidural. They laid me down, tilted me to the left, and then wiped my belly clean with sterile solution. Then the drapes went on, which are blue. The blue drape is strategically placed to keep gory stuff hidden from the mother. This also hides the birth from her as well. Eventually, my husband was called in and he stood by my side at the head of the bed. He couldn’t see anything. I couldn’t see anything. We could hear everyone talking. And then finally, the surgeon warned me about the pressure, and oh what a feeling. It felt like the assistant was standing on my chest. Then the pressure ended and boom, I became a mother with the birth of my baby boy. A minute later, they showed him to us and brought him to the warmer where they cleaned and dried him. My husband went to the warmer and stayed with him the rest of the time. Eventually, I got to hold him after we were in the recovery room, which was about 1 hour later. This little baby is now 16 years old, 6 foot 4 inches tall, and healthy as can be. His size (back then and now) is another blog post for another day.

Sounds a little sterile, and surgical, and distant. I didn’t feel like I was a part of the delivery. But, having a cesarean section is not a simple procedure. It is a major surgery and gets treated like that. Complications can happen within minutes, and for that reason, the people at the head of bed aren’t included in the surgical part of the procedure With a cesarean section, whether it is planned or not, it feels like a surgery instead of a delivery.

Why this matters?

Having a vaginal birth is totally different. Mom is involved every step of the way. In fact, we can’t have the baby without mom being involved the entire time. It’s her body, her input and bodily functions that determine all stages of labor and delivery.

Studies reveal that women who have cesarean sections are less satisfied with their childbirth experience than those who deliver vaginally. There’s also concern about bonding between mom and baby and breastfeeding outcomes after a cesarean section. Being involved in the delivery is very important to many women and this desire has guided the medial field to search for ways to accomplish this request. Obviously, they can’t help with the surgery and dad can’t cut the cord because the area is a sterile field.

What we can offer?

In response, we’ve made some subtle improvements to give parents and family more involvement in the delivery. These changes have proven to help in many ways.

A clear drape instead of a blue drape
We can use a clear drape so that everyone at the head of the bed can witness the birth. At the time of delivery, the blue drape is lowered and mom can witness her baby being born through a clear drape that is under the blue one. Once the delivery is done, the blue drape is rasied up again, so we can shield everyone from the scary side of major surgery.
Immediate skin to skin contact
Once the baby is born and the cord is clamped, if all is well, the baby is brought directly to mom and placed on mom’s chest, which is called skin-to-skin. This dramatically increases mom’s satisfaction with the delivery. It also increases breastfeeding rates, bonding, and sleep behaviors for both mom and baby. The baby is being warmed and dried while on mom’s chest. Skin-to-skin can go on until mom is taken to the post-anesthesia care unit.
This also allows for immediate breast feeding if mom is able.
The bottom line is that we try to have little to no separation between mom and baby.
Anesthesia (the people at the head of the bed) can be make subtle changes as well
Heart-monitoring equipment is positioned more strategically so that it does not interfere with baby going skin-to-skin on the chest or with breast feeding.
The epidural or spinal can be tailored so that the upper body is not affected as much as the lower body, so you can move the upper body to hold baby.
Your hands can be released and not strapped down so you can hold your baby.
Your head and upper body and be lifted so you can see more.
Slow delivery of the baby
This is where the baby is slowly delivered through the incision, instead of us pushing the baby out. This allows time for the chest to be squeezed, as in a vaginal birth, to clear the lungs of fluid.
Most of us do not do this, as we have yet to prove whether it is beneficial.
I mention this because there are a lot of social media posts about this technique. Just know, the verdict is not out regarding this.
The goals are simple. Let mom be a part of the birth experience. Let mom, baby, and family stay together as long as they want. Thanks to the women (moms, midwives, who have guided the medical field to make these changes possible so everyone who walks the path of a cesarean section can have the best experience possible.

Here’s me and my baby boy after delivery. I have that confused and tired look. He looks happy.

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