What is a “Gentle Cesarean”?

April is National Cesarean Awareness Month.* Although a cesarean is often not part of a mother’s ideal birth plan, she may have a Cesarean birth for a variety of reasons. If you decide with your care provider that Cesarean birth is unavoidable and the most appropriate choice for your health and/or your baby’s health, a “gentle” or  “family-centered Cesarean” can actively include the mother and best suit the needs of the newborn. These are 5 elements you can incorporate to make your Cesarean birth as gentle as possible:

1. Request medications that are safe for breastfeeding

Make sure your surgeon, anesthesiologist and nurses know that you plan to breastfeed your baby as soon as possible, so it’s important to use medication that will be safe for your newborn. You can also choose whether or not to have anti-nausea medication or sedatives, depending on your personal preferences. Remember that while sedatives might make the procedure less stressful for you, they may also make your memory foggy and interfere with breastfeeding. Make sure that the doctors and nurses understand that you wish to be informed before given any medication.

2. Lower, remove or use a clear curtain

Having a Cesarean birth doesn’t necessarily mean you won’t be able to see your child enter the world. You can ask for a clear curtain, which are slowly becoming more widely available, or ask for the curtain to be lowered for the moment of birth. When infection control measures allow, you can also ask that the curtain be removed entirely.

3. Delay cord clamping

The benefits of delayed cord clamping and cutting hold true for babies born via Cesarean. When possible, allow the cord to remain attached until it has stopped pulsing so that your baby can take his or her first breaths while still attached to the placenta. You can also request that the cord to be left long enough for the partner to cut again.

4. Immediate skin-to-skin

Just as with a vaginal birth, your baby can be placed immediately on your chest after birth. Have IV tubing and monitoring equipment placed so as to keep your dominant hand free so that you can more easily hold your baby close after birth and better facilitate nursing right away. You can also request that your baby be examined while on your chest. If an exam while on mom isn’t medically best for your baby, the partner  can accompany the newborn and give as much skin-to-skin as possible until baby can be reunited with mom.

5. Preserve the mother-baby microbiome

A relatively new but increasingly popular procedure called “vaginal seeding” exposes the baby to the potentially beneficial bacteria the baby would have encountered in the birth canal during a vaginal birth. A doctor or nurse can use a cultured swab to transfer vaginal fluid onto the baby after birth. While seeding is still being investigated to more fully understand the benefits and risks, it’s an intriguing new option worth discussing with your care provider.

While a Cesarean birth is major surgery, and therefore carries with it certain risks for the mother as well as the baby, it certainly doesn’t require the mother to forfeit any of her rights or dignity in the process. You can be informed and empowered no matter how you welcome your child into to the world.

*The International Cesarean Awareness Network started Cesarean Awareness Month to bring attention to the number of Cesarean births in the United States as well as the need for access to vaginal birth after Cesarean (VBAC). You can learn more about this initiative at their website.

Jennifer Stutzman, Freelance Writer

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