I didn’t know anything about gentle cesarean birth until I was in the thick of my first pregnancy complicated by placenta previa. Was a scheduled c-section at 39 weeks my dream birth? Definitely not! But it is possible to have a more birth-like cesarean if you know what to look for.
When I was told I had a complete placenta previa, which makes safe vaginal delivery impossible, I was devastated. For months I had been preparing my unmedicated natural birth. I researched the best labor and pain control techniques, attended childbirth classes, drank all the raspberry leaf tea, got my birth ball ready and diligently did prenatal yoga and walked daily.
All of this, to end up having the most unnatural birth possible.
When I discussed my disappointment with my provider, he informed me that c-sections no longer have to be the cut-and-go type of procedures they used to be. They are – with the right attitude – just another way of giving birth to your baby!
Nowadays, so-called gentle or family-centered c-sections try to mimic some of the key elements of natural birth as closely as possible. They also try to give some autonomy over the process back to the mother. This includes, for example, delayed cord clamping, not separating the baby from the mother after birth and allowing for lots of skin to skin following delivery. Not only will this benefit a newborn but it can also make mom more accepting of a delivery method that was possibly not her first choice.
Continue reading if you want to know my tips to schedule a gentle cesarean birth.
How to plan a gentle cesarean?
1. Find a provider who supports gentle cesarean birth
If you are having a planned cesarean, you usually have plenty of time to feel out your medical team. You are dependent on your obstetrician in this case, so you better make sure you get the best care possible. Below I am listing some of the things that indicate your provider is supportive of a gentle cesarean.
Some OB/provider green flags to look out for:
- They give you a good medical reason for why a c-section will ensure the best birth outcome for you and baby. A “big baby” or “small pelvis”, for example, are not great medical reasons to force a c-section. If your provider’s reasoning is along those lines, you might want to consider looking for someone else.
- They take a lot of time to explain the whole process from preparation, through delivery to post-op care.
- They explain to you what will happen in the preparation room and who will be present in the OR.
- They explain to you what type of incision they will make and how it will be closed.
- They explain to you how long the birth usually takes and at what point your baby will be delivered (which is usually after 5-10 mins!)
- They listen to your birth wishes regarding delayed cord clamping, skin-to-skin, vaccines, etc. (see below) and respect them as much as possible.
- They will readily answer any of your questions and will not rush you through your appointment.
If during any of your appointments, you spot too many red flags (aka a lack of green flags), remember it is never too late to switch providers.
2. Schedule your gentle cesarean as late as possible
If you plan a c-section, you likely have a medical reason for it. In many cases, there will be little wiggle room as to the delivery window. If you can, however, schedule your c-section as early as necessary but as late as possible. Why? To give your body and your baby as much time as possible to prepare for birth. Even though a baby is considered “full-term” after 37 weeks’ gestation, this may not necessarily be true for your baby. If your baby would have naturally come at 42 weeks, delivering them 5 weeks early will mean it’s very premature to give birth! Not premature in the medical sense but premature for your baby.
So try discussing a later delivery date with your provider. For example, with a complete placenta previa, many OBs will push to deliver the baby as early as 36-37 weeks to avoid any complications. While this may make sense in some cases, it is always best to look at each case individually. In my previa case, I had no bleeding throughout my whole pregnancy and both baby and I were in great health. This convinced my provider to schedule me at 39 weeks instead.
3. Insist on Delayed Cord Clamping
First things first, what exactly is delayed cord clamping? During childbirth, when a baby is born, the umbilical cord connects them to the placenta. Delayed cord clamping means waiting for a little while before clamping and cutting this cord, instead of doing it immediately after baby is earthside.
When the cord is left intact for a few extra moments, or until it is white and limp, more blood can flow from the placenta to the baby. This extra blood – which is the baby’s blood! – contains important nutrients and oxygen that the baby can benefit from. Studies suggest that this increased blood volume can lead to higher iron levels in babies, which is essential for their overall development and reduces the risk of anemia.
Delayed cord clamping may decrease the risk of certain health issues in newborns. It may lower the chances of developing respiratory distress syndrome, a condition where the baby’s lungs have trouble functioning properly. Delayed cord clamping may also reduce the risk of bleeding in the brain and lower the likelihood of needing blood transfusions.
Now, let’s not forget about the moms! Delayed cord clamping has some potential benefits for the mother as well. By allowing more blood to flow from the placenta to the baby, it can help reduce the risk of postpartum hemorrhage in the mother.
Of course, it’s important to note that every birth is unique, and there may be situations where immediate cord clamping is necessary for medical reasons. But for the numerous benefits, many OBs have adopted the practice as part of a gentle cesarean birth. So make sure you have an open conversation with your healthcare provider to make the best decision for you and your little one.
4. Initiate Skin-to-Skin in the OR
Similar to delayed cord clamping, the benefits of immediate skin-to-skin following birth are widely known now. Regulating baby’s temperature and heart rate, the release of oxytocin in mother and baby, increased bonding postpartum and the opportunity for baby to do the breast crawl to initiate breastfeeding are just some reasons why skin-to-skin is so important. This is why most hospitals have adopted a skin-to-skin policy by now.
Unless baby needs to go to the NICU, there is no reason why c-section mamas and babies should not benefit from immediate skin-to-skin. Ask the attending nurse to bring the baby as soon as possible so you can initiate skin-to-skin in the OR. You may need your birth partner to help you hold the baby, as the anesthesia can make you quite weak and dizzy. Due to the cool temperature in the OR, your baby will likely remain swaddled until you reach the recovery room where you or your partner can unswaddle them for increased skin contact.
5. Breastfeed as soon as possible
This one goes a little beyond just the birth itself but birth experience and breastfeeding are intricately linked. A traumatic or over-medicalized birth can make breastfeeding harder. Surgical birth is very medicalized, so by making it gentler you can increase your chances of having a successful start to breastfeeding.
Apart from the numerous benefits of breastfeeding for your baby’s development, breastfeeding after a c-section can be particularly beneficial and gentle on your body and aid in a speedy recovery. Early breastfeeding helps release oxytocin which not only creates a strong mother-baby bond but also helps the uterus contract after birth. This can reduce the risk of postpartum hemorrhage, which can be higher after a c-section.
Even if you do not plan on breastfeeding long-term, it can be useful to take advantage of nipple stimulation by either a suckling baby or pumping. It will make the transition from surgical birth to a healthy postpartum much gentler.
6. Highlight birth preferences
It is important to have an open discussion with your healthcare provider to highlight your preferences for a gentle cesarean. This way, you can feel out their response and whether they expect any pushback stemming from hospital policies. Hospital policies vary widely and it is good to do some research beforehand on how friendly they may be toward a gentle C-section.
Think about what you want your birth to look like and talk about it as much as possible. Make sure to also write down a checklist that you can bring to the hospital and share with the attending nurse and other medical staff. This list can include your wishes for delayed cord clamping and immediate skin-to-skin. It could also include other aspects, such as whether or not you want them to administer eye ointment or Vitamin K (which they will automatically do unless you opt out).
I have also seen cases of gentle cesareans where mamas could see their babies emerge through clear drapes. Or some even had no drapes at all and were handed the baby right after birth, cord attached. The world is your oyster! It truly amazes me how you can make surgical birth as individual as possible.
My gentle cesarean birth experience
I never thought I would have a c-section. I was fully committed to having an intervention-free and magical natural birth. But as with many things in life, we can’t predict everything. Since I had to have a surgical birth, I wanted it to be as close to the “real deal” as possible. In retrospect, my cesarean birth experience was a positive one. I was able to hold my baby within minutes of delivery, and I am glad when I see that the cord was still attached when white and no longer pulsating.
Gentle cesarean birth is something we do not talk about enough, especially with a c-section rate of over 30%! I wish more mamas would know that they have options when it comes to cesarean delivery. If you are one of those mamas, I hope my post inspired you to get the cesarean birth you want.