Gentle C-section

Dressed in a thin paper gown, you nervously look up at your partner, who squeezes your hand as your doula leads you through calming breaths. Your playlist switches over to a Katy Perry song and you think, Yes—bring it. I am a firework.
Next thing you know, you see your sweet, scrunched-up baby emerging and then her wet little body is placed on your chest. Your heartbeat and hers, seemingly one again.
Think this kind of experience is only for women having vaginal births? Think again. The “gentle C-section,” also called a “family-centered C-section,” is bringing a better birth experience to the operating table—one that focuses on making the delivery both safe and special for the family.
“When I first found out that I was going to have a C-section, I thought, They are just going to take her out of me, and I don’t get to be a part of the birth experience,” shares Jill Doyle, CNM, a mom of one in Arlington, Massachusetts. “But with the family-centered C-section, I was a part of it, and I got to see her, touch her and know her.”
Going gentle
When William Camann, MD, director of obstetric anesthesiology at Brigham and Women’s Hospital in Boston, observed clear drapes being used in other types of surgeries (to enhance communication between the anesthesiologist and the surgeon), it sparked an idea: Why not use them in cesareans, so women can see their babies being born?
For some expectant moms, C-sections can make them feel cheated out of the puffing, pushing, seeing-my-baby-take-her-first-breath moments or getting the chance to bond right after delivery. So Camann and his colleagues started incorporating not only the clear drapes, but also other ways to make the surgery more like natural childbirth. (See “What a difference” sidebar.)
While the surgery itself is the same, the procedures around it are tweaked to make the environment less intimidating and more family-friendly. For example, in a standard C-section you are separated from your child right away, and it usually takes 45 minutes to an hour before you can hold your baby in the recovery room. With a gentle C-section, “Once the pediatrician checks the newborn, the little one can be on mom’s skin immediately or within minutes rather than being whisked away,” shares Camann.
Benefits beyond bonding
Besides making the big moment of your baby’s birth something you and your family can relish, gentle C-sections also have real medical benefits. For instance, babies tend to get cold right after being born. When a mother holds her newborn against her chest, her body temperature will actually increase to keep her newborn warm. It’s a phenomenon called thermal synchrony.
The bonus? This close cuddling also helps your newborn breathe better, reduces stress hormones and decreases crying. Your wee one feels safe enough to relax.
When you get skin-to-skin time with your newborn, it can help breastfeeding as well. Babies will naturally start making pushing movements toward an uncovered nipple, and then lick and root around before attempting to breastfeed. This usually happens around the first hour of life, but only if there’s nothing between you and your baby (i.e., no clothes or blankets).
“You can choose what you want and don’t want in a family-centered C-section,” Doyle explains. “For me, I really wanted to do skin-to-skin contact. I actually got to breastfeed my baby while they were finishing my C-section. It was just so special, and I was so grateful to have had that.”
Is it right for you?
For most women, a gentle C-section is a safe option. However, if your pregnancy has complications, like premature labor, or if there’s any danger to you or your baby, it’s not recommended.
“Most C-sections are not complicated though—they are normal,” assures Camann. “Gentle C-sections can be done in multiple situations including twin deliveries, pre-eclampsia and failure-to-progress labors.”
Although some OBs have been performing gentle C-sections for a few years and word of mouth is spreading, most doctors aren’t familiar with the term and the protocol changes yet. But that doesn’t mean your OB won’t do it.
“It doesn’t require additional training. The modifications needed to do a gentle C-section are really pretty simple,” Camann says, “But the change it brings in the whole environment and the attitude in the operating room make a big difference.”
If you decide to request a gentle C-section, bring this article with you to your next appointment, and ask your OB if she would be willing to accommodate a family-centered C-section. You can go over the aspects of the procedure that mean the most to you, like seeing your baby come out of the womb or getting immediate skin-to-skin contact.
“It’s really up to the patient to advocate for what she wants. You don’t just have to accept the way a traditional C-section is done. Have a conversation, and be a part of the birth plan,” encourages Doyle. “A C-section is still a surgery, and it’s still a birth. And birth is a normal thing. A gentle C-section is a way of trying to preserve the normalcy of birth, as much as you can, so it can be an experience the woman and her family can enjoy.”