Not Your Mama's C-Section

Childbirth, Featured Article, Pregnancy
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According to recent statistics, nearly one third of the 4 million American babies born each year are delivered by C-section. In fact, C-sections are one of the most common in-patient surgeries in the United States, and they can be lifesaving for both mom and baby. But whether it’s performed as crisis management if labor doesn’t go to plan, or because it’s a mom’s birth choice, a cesarean is a major operation with a long recovery period. And for many women, it can  take some of the magic out of the first moments they spend with their new baby.

However, that could change in the future, as more moms-to-be and more obstetricians look to a new approach for surgical deliveries. Dubbed the “gentle C-section,” it could give moms who need or want a cesarean the best of both worlds—a safe birth with fewer compromises when it comes to ensuring that the delivery is as natural as it can be.

“A gentle C-section centers on participation for a mom if she wants this,” confirms Daniel Roshan, M.D., a board-certified OB/GYN and maternal-fetal medicine (high-risk) specialist based in Manhattan. “It’s still a surgical procedure, but it’s designed to make birth and the period immediately following birth more like what you would have with a vaginal delivery.”

One of the key differences with a gentle C-section is that you get to see your baby being born, and can share more of precious bonding time in the golden hour after the birth. That was the experience of Amanda Garcia, whose baby Rylee was delivered by gentle cesarean at Cape Coral Hospital, part of Lee County Memorial Health System in South Florida.

Garcia was anxious about her scheduled C-section. “That whole process, and that whole sterile field, and being in this big, white room with bright lights and all these people around you, makes you a little nervous,” she says. But in her gentle cesarean, Rylee was placed directly on Garcia’s chest right after the birth, and the surgical team completed the operation in silence. “It creates such a calming environment, you feel like you’re the only person in the room when it happens,” says Garcia. “You can feel that warmth, you get that immediate eye contact with that child. It is a complete bonding experience.”

There is evidence that the skin-to-skin contact Garcia had with Rylee is important for both mom and baby, says Dr. Roshan. Many experts see those first moments after the birth are a vital time of connection,” he notes. Indeed, there is study data suggesting that skin-to-skin contact helps regulate a newborn’s body temperature and heart rate, reinforces bonding and also may help establish successful breastfeeding. But immediate skin-to-skin contact is hard to accomplish after a traditional C-section—you’re hooked up to monitors while the operating team closes up your incisions, and your newborn is typically whisked away and placed in a warmer so that her vital signs can be checked. It could be several minutes before you see your baby up close, and some time before you get to hold her properly. Unfortunately, many moms who have cesareans end up feeling as if they didn’t take part in their baby’s birth at all—rather that the birth was something that was done to them—and find it hard to celebrate the memory afterwards.

All being well with you and your baby, a gentle C-section is different. You’re still in the operating room, but the atmosphere is more relaxed. You can ask for silence while the surgery is carried out, or ask for your obstetrician to talk you through each step of the procedure. You might be able to have your choice of music playing, and—depending on hospital or maternity center rules and protocol—your obstetrician also may be happy for you to have your doula with you if you wish. The environment still needs to be sterile, says Dr. Roshan, but you can request that a clear drape is used so that you can see the moment your baby is born. “If no clear drapes are available, you can request that the traditional drape is lowered at the moment your baby is emerging,” Dr. Roshan suggests.

If the delivery goes smoothly, your baby will be placed directly on your chest once she is born. “This is possible because in a gentle C-section, the EKG electrodes that monitor your heart rate during the surgery are attached to your back and side,” says Dr. Roshan. This means that there will be space for your baby to nestle on your chest in those first moments of life—and you can hold her close because the blood pressure cuff, IV catheter and any other monitors used during the surgery are put on your non-dominant arm so that you’ll have the other arm free. Your baby’s newborn tests, measurements and checks will be carried out while she is on your chest, and she may even latch on. “We’ve actually had babies start breastfeeding on the delivery table while their operation is still going on with mom, which is amazing,” says Nancy Travis, R.N., nursing director of Labor & Delivery and Women’s Care at Cape Coral Hospital, where Amanda Garcia had her gentle C-section.

Even though this new approach might be viewed as innovative, a gentle C-section is just a slight modification of the way doctors have always performed these surgeries. It enhances the experience for moms and babies—and in one 2014 study, complication rates for gentle C-sections were similar to or lower than those for traditional cesarean deliveries. Even so, while more hospitals are offering this option, it isn’t the norm just yet. Dr. Roshan says that more clinical research into the gentle method could help establish it on a wider basis, but adds that all that is really required for this to happen is doctors thinking a little differently when it comes to how cesareans are performed.

Dr. Roshan does, however, caution that not all doctors and hospitals will be comfortable with or even familiar with these modifications to the traditional cesarean birth. A gentle C-section also isn’t recommended for women who go into labor early, those having emergency C-sections, or those whose newborn may be at risk for having a low Apgar score. But if you are scheduled for a straightforward elective cesarean and would like to try the gentle C-section method, Dr. Roshan suggests that you discuss the possibility as far in advance of your baby’s birthday as you can. Keep in mind though that the birth you get will depend on you and your baby being healthy at the time of the delivery and no unforeseen complications cropping up during the surgical procedure itself.

Tacoya Roberts, whose daughter, Lily, was born by gentle C-section at Texas Health Harris Methodist Hospital Cleburne, knows the difference between the traditional and the modified approach. After having an emergency C-section with her first child, Roberts desperately wanted an instant bonding experience for the birth of her second—and she got it. “It was amazing—an instant connection, along with warmth and comfort for both of us,” Roberts said afterwards. “I would recommend it to every woman having a C-section. It feels more natural, and you get to know your baby immediately.”

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