A gentle, or natural, caesarean section is a way of bringing person-centred care back to a birth when that birth is happening in a theatre. It’s common for people who are choosing caesarean births to feel like they’re ‘relinquishing control’ and that this type of birth is one that ‘happens to them’. But this shouldn’t be the case. A caesarean birth is still YOUR birth. You can still have an environment that feels comfortable for you. Utilising some of the gentle caesarean techniques can help you look back on the birth in a positive way.
The idea of a natural caesarean was first raised in 2008. Some of the things on this list are becoming more popular and embedded in caesarean births anyway. Some of these things might encounter some raised eyebrows or a flat out no from your doctor – but if you want something ask to see the evidence that prevents you from having it because unless there’s a very good reason for it not happening you should be supported in your birth choices. Some of them might be things that you have absolutely no interest in doing – and that’s ok! Your birth your choice. And in the minority of caesarean section scenarios things may move too quickly to get you or your baby safe that it’s not possible to have an in depth discussion about your personalisation of your birth.
Environment: Theatres are by their very nature, very clinical environments that need to be kept sterile. But that doesn’t mean there’s not options for you to make it a bit more oxytocin-promoting. Oxytocin is, after all, the hormone of attachment and bonding so having it in your system as you meet your baby is a good thing. You can have your own music or hypnobirthing tracks playing (or use headphones); music can help distract you, keep you calm, and there’s evidence that it reduces feelings of pain as well! You can ask staff to keep their noise to a minimum and for your voice to be the first one that your baby hears as they come into the world. I’ve also heard birth stories where the peripheral lights are dimmed, and where people have taken small objects of comfort into the birth with them. Just on the subject of the theatre environment during a c-section; sometimes the super shiny equipment can reflect your uterus while they work so if you don’t want to see ask them to give it a nudge!
Drapes: Usually a drape is set up, blocking your view of what’s happening, and remains there for the entire procedure. In gentle caesareans the drapes can be lowered or clear drapes used so you can see what’s happening – if you want to! Lowered drapes also help with facilitating immediate skin-to-skin after your baby’s born.
Delivery: This is where things really start to differ with traditional caesarean sections! After the uterine cut, your baby’s head is gently encouraged to come through the incision with the doctor remaining as hands-off as possible. Once their head has emerged they begin breathing while their body is still inside the womb and connected to the placenta. This slow emerging from your body causes pressure which replicates the pressure of the birth canal, helping to get rid of liquid in your baby’s lungs. Gently supported, your baby wiggles themselves out. They can then be passed over the drapes to you.
Skin-to-skin: Traditionally, when your baby is lifted out of your uterus they’re taken to be examined, weighed and wrapped up before being brought back to you. It’s becoming increasingly more common for your baby to be passed over the drapes and skin-to-skin as well as a first breastfeed to be facilitated in line with WHO and UNICEF guidance. However, this still isn’t something that’s the norm with some doctors refusing on the grounds of ECG and pulse oximeter equipment needing to be present. To create space the pulse oximeter can be placed on your foot so your hands are free and ECG electrodes placed on the back of your shoulders.
Delayed cord clamping: Delayed cord clamping allows your baby’s blood to transfer from the placenta back into their body and is beneficial for nearly all babies to receive. Recent research suggests there are no safety concerns with delaying cord clamping during a caesarean.
Many practices within gentle caesareans are already slowly being embedded within standard caesarean section policies but it’s worth being really explicit what you do – and don’t – want during your caesarean section. Your healthcare provider should be able to discuss the benefits and risks relating to your own individual circumstances.