An All-Natural C-Section?

We love these changes to the traditional caesarean-section and think you will, too.
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"It's a boy!" the doctor announces cheerfully, wiping the baby off with a dark blue towel and suctioning out his nose.

Tearfully, the husband and wife exchange a loving kiss, laughing in relief and joy over witnessing the birth of their son.

After a quick assessment from the nurse, their baby is wrapped quickly in warm blankets and placed in his mother's arms. She kisses her son's forehead, and then, like her birth plan dictated, places him on her breast for his first nursing session.

It's a common picture perfect birth moment, with one major exception:

It's taking place in the operating room.

Although numerous medical studies have pointed to the benefits of the natural aspects of childbirth, such as immediate skin-to-skin contact and early breastfeeding initiation, the complications of the surgery room make incorporating natural strategies a little more difficult.

But now, there is a push towards a different kind of c-section, dubbed a "natural" or "gentle" c-section. An article in the British Journal of Obstetrics & Gynecology describes natural c-sections as "woman-centered," but a perhaps more accurate description of the trend may be "family-centered," as they allow for more inclusion of the first family moments together. In essence, a gentle c-section allows parents to incorporate some of the more natural aspects of childbirth that are important to them, such as being able to witness the delivery, holding the infant right away, immediate breastfeeding, and keeping mom and baby together as much as possible.

Dr. Jeff Livingston, an OB/GYN in Irving, Texas described how he recently completed his first gentle c-section with a patient who presented the option to him via a YouTube video.

"It's actually really neat," Dr. Livingston says about the gentle c-section. "It just requires a coordination of care with the nurses, anesthesiologist and pediatrics team."

From both a medical and a parent's perspective, the gentle c-section movement may be a win-win. As Dr. Livingston summed it up, "we were able to give the mom the experience she wanted without compromising the care."

"She was able to breastfeed while we were finishing," Dr. Livingston elaborates. "We dropped the drape after we made the incision so she was able to watch the delivery of the baby; once we cut the cord, the pediatric team did the resuscitation on her chest and the baby looked great, so she was able to [feed the baby right away.]"

As an OB nurse, I am really excited about the prospect of better c-section care for new parents and their babies. So why aren't all c-sections "gentle?" As with any surgery, sometimes there are complications. A mother may require a general anesthesia instead of a regional block, like an epidural, which would mean she would be completely sedated for the duration of the surgery; or a complication could arise after surgery with either the mother or baby. More commonly however, is the fact that many doctors simply aren't aware of the option for a gentle c-section.

"Patients should mention this to their doctor," Dr. Livingston says. "In all honestly, most doctors aren't aware of it as an option, but it doesn't really require doing things any differently; it just requires a different coordination of care."

In many cases, the movement for gentle c-section starts with the patient advocating for herself. In Dr. Livingston's recent case, his patient had a failed VBAC and wanted a more natural experience, so she worked with the in-practice midwife to put a plan in place.

"It was definitely a patient-driven option," says Dr. Livingston.

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