How To Have A Gentle C-Section Birth

Both elective and nonelective C-sections are on the rise in the United States. Knowing this, it is important to know what your options are during the process so that you can stay empowered the entire time.

What is the current rate of C-sections in the United States?

According to the World Health Organization, 32.3% of mothers in the United States will have a C-section. This means that one out of every three mothers will give birth in a cesarean manner.

To contrast, the C-section rate in 1970 was 5%. In 1988, it was 24.7%. In 1990, it was 23.5%.

There are multiple reasons for this rise in C-section rates. One reason is that induction rates are increasing. About 45% of pregnancies are being induced, which puts you at a greater risk of going through the cascade of interventions (more on this here).

Another reason is that the cost for a C-section is more expensive than a vaginal birth. Whether you want to acknowledge it or not, hospitals need to make money too, and the policies set in place are not always for your benefit.

A C-section is a major surgery, so you will need more medication such as anesthesia and pain killers afterwards. Your OB/GYN will also have to operate on you and will bill the hospital for those services. Your length of stay will also be longer because your recovery will take a longer time. All of this will add to your medical bill.

What does a normal C-section look like?

The Day Before/ Morning Of

Either the day before or the morning of surgery, your provider may ask you to take a shower at home using antiseptic soap. Your abdomen will also be cleaned at the hospital.

At The Hospital

A catheter will be placed into your bladder to collect your urine. An IV will be placed in your arm or hand to provide fluid and drugs.

Most C-sections are done under regional anesthesia, which will numb all sensations on the lower half of your body. This is done with either an epidural or spinal block, which is helpful because you do not necessarily want to feel everything that is happening down there.

Some C-sections might require general anesthesia to be administered. In this instance, you will not be awake during the surgery. It is important to note that you may experience some unwanted side effects, such as shaking and nausea. You may also experience mouth clenching.

Depending on need, oxygen may be administered to you via an oxygen mask. Your arms may also be restrained.

Different hospitals have different policies on this but there may be limitations on who can be with you in the operating room. For example, your doula, birth photographer, and birth videographer may not be permitted in the birth room.

The entire procedure will take about 20-30 minutes. The doctor will start by making an incision in the abdominal wall, and then a uterine incision. The baby will be delivered through the incisions. The placenta will then be delivered shortly after, and incisions are closed with sutures.

After The Procedure

After the procedure, you will be given pain medication in the form of narcotics, Tylenol and ibuprofen. Your health care providers should go over different options with you. Even if you are intending to breastfeed, you can still take medication at the same time.

When the anesthesia wears off, you will be encouraged to drink fluids and walk. Fluids help to prevent constipation, and walking helps to prevent deep vein thrombosis. Your catheter will also be removed.

Throughout your stay, your health care team will monitor your incision and make sure it is healing well with no infections.

As previously mentioned, recovery will be slower than vaginal birth, and you should expect a hospital stay for two to three days.

When you are discharged from the hospital, you’ll want to be patient with yourself and take it easy. You may need help from family members during the recovery period to do things such as making meals, laundry, and even sitting up.

If you don’t have any family near you, I would suggest hiring a postpartum doula if you have the ability to afford one. They are worth their value in gold to help you with that initial transition as a family.

How to avoid an unnecessary C-section?

If you are looking to avoid an unnecessary C-section, the best thing you can do is avoid an unnecessary induction.

To do this, you need to get educated on when inductions are necessary and when they are not. A good birth course can really help to inform you.

If you’re not sure how to choose a good birth course, I’ve written a blog post about that here!

What is a gentle C-section?

A gentle C-section can also be called a family-centered cesarean or a family-centered birth. A gentle C-section will have elements that mimic what happens during a natural birth and is a more patient-centered approach to a normal C-section.

The goal of a gentle C-section is to empower mama to create her ideal birth atmosphere. It gives the parents some control in the decision-making process, and the providers who practice gentle C-sections more often respect the physiology of childbirth.

Who would be a good candidate for a gentle C-section?

Most women are good candidates for having a gentle C-section, so it is easier to discuss who may not be good candidates instead.

You may not be a good candidate for a gentle C-section if:

• Your baby needs immediate medical attention.
• You are under the influence of drugs, and you cannot safely hold your newborn. In this case, your partner should be able to hold your baby immediately.
• There are complications with the surgery itself.

What are some things to include in my gentle C-section birth plan?

Anesthesia: Some moms want minimal amounts of drugs so that they can be fully present for the experience. You have the option to avoid general anesthesia. You can also request that no narcotics be given.

Music: You can choose to have music of your choice playing in the background. If you have a birth playlist you were hoping to use with affirmations, you can still have that on as you birth your baby.

Explanation of the procedure: If you find it beneficial, you can request that the doctor explains birth as it is happening to you.

Conversation: You can request to have respectful conversation in the operating room. For example, you may not want to hear your team discussing lunch plans as they’re operating on you.

Less restriction: You can request to have your arms free and unrestrained. You can also ask to have IVs placed on your nondominant arm.

Skin to skin: You may not be able to have immediate skin to skin time with baby, but your partner should be able to.

Monitoring: C-section mamas can ask that monitoring devices are placed in such a way that they do not hinder her ability to see, hold, and feed her baby.

Breastfeeding: If a mom wishes to breastfeed, she can request to do so immediately while in the operating room. Her gown can be lowered, and the baby can be placed on her chest while she is being stitched up.

Clear Drapes: Normal procedure has drapes so that mama does not see what is happening. However, you can request clear drapes or for the drape to be lowered. You’ll need to ask ahead of time if clear drapes are an option.

If you are squeamish, you can request that baby be lifted above the drapes when they are born.

Slower Procedure: In a vaginal birth, baby has a little bit more time to prepare for life outside of the womb. When baby is being born, amniotic fluid in their lungs gets squeezed out as they are passing through the vaginal canal.

However, in a C-section birth, baby does not necessarily have this time to transition. You can request for baby to be removed more slowly so that they have time to clear their lungs.

Vaginal Seeding: Babies born via C-section have different microbiomes than babies born vaginally. There is evidence to suggest that one of the reasons for rising rates of immune disorders is due to the rising rates of C-sections.

Vaginal seeding is the practice of inoculating a cotton swab or gauze with vaginal fluids to transfer the vaginal flora to the mouth, nose, or skin of a newborn infant.

To date, there is conflicting evidence on whether this is beneficial. However, I do suggest doing your own research on this if it is something you are interested in.  

Placenta: Parents can ask for the placenta to be saved until they are discharged from the hospital.

Delayed Procedures Post Birth: Many procedures that can be delayed during a vaginal birth can also be delayed during a cesarean birth. This includes taking the baby’s weight and delayed umbilical cord clamping. Some hospitals will not allow delayed cord clamping but may offer “milking” the cord as an option.

How To Implement Your Gentle C-Section Birth Plan

Regardless of how you plan to give birth, you need to make sure that you have a team behind you who supports you. To do this, you need to get very comfortable advocating for yourself and your wishes.

By “team” I am referring to EVERYONE involved in your birth. This includes your husband, OB/GYN or midwife, doula, and even the nurses and anesthesiologist.

If you know that your provider is not familiar/comfortable with gentle C-sections, you are well within your right to switch providers.

This also applies to the place you are giving birth. For example, if your hospital’s policies and procedures state that they can not honor delayed cord clamping and that is a non-negotiable, you may want to explore other hospitals.

Make sure that you have multiple copies of your birth plan with you and have gone over it with your provider ahead of time.

Conclusion

C-sections do not have to be traumatic.

Having a gentle C-section as part of your birth plan can be a great option whether you are having a planned C-section or creating a back-up plan if your vaginal birth or VBAC fails.

Remember that no matter what, you are in charge of your birth. Your voice matters and this is your experience, so do not be afraid to speak up for what you want.

Further Research

If you’re looking for more information on this topic, I highly suggest this post written by UT Southwestern Medical Center!