What are the repercussions of an unplanned cesarean?

C-sections (when unplanned) 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 mother who has a cesarean 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. The mother 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 Los angeles 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. 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 :

  • The mother should request an epidural or spinal block; general anesthesia should be avoided at all costs, barring any emergencies
  • The mother should request that anesthesiologists do not automatically give her extra drugs to relax, so that she can be fully present for the experience
  • If the mother cannot be conscious, father should be allowed to hold baby skin-to-skin immediately after birth, barring any medical complications with baby
  • If the mother has EKG or baby monitoring devices, they can be placed in areas that don’t infringe her ability to see, hold or breastfeed baby.
  • The mother 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
  • The mother’s gown can be lowered and baby can be placed on the mother’s chest while the mother is being sutured. To facilitate this, the mother 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 the mother 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. “