by Megan from Birth-ed (@birth_ed)
In this piece birth educator and former midwife, Megan of Birth-ed, talks us through various considerations for planning a gentle c-section.
Whether planned or unplanned, there are many reasons why you may give birth to your baby by caesarean. It may be for the physical or emotional health of you or your baby, it may be something you choose or something totally unexpected. Whatever the reason, it’s important to consider what would be important to you when giving birth in this way, so that you stay centred in possibly the most transformative experience of your life!
A helpful place to start is considering your birth from a point of physiology. Sounds weird when you’re making caesarean plans right? But there are many benefits of physiological birth that we can draw from when making our caesarean birth plans. Never forget that this is still your birth and you deserve to feel safe, loved and supported throughout. So, what exactly might you ask for?
Planning a Gentle C-Section: Ahead of the Birth
- Colostrum harvesting: Sometimes (not always) caesarean birth can impact milk supply after birth. Colostrum harvesting involves collecting some breast milk antenatally which you can use if you were planning to breastfeed and required any extra milk in the very early days.
- Cannula in non dominant hand: When you are planning a gentle c-section, request that the cannula is inserted into your non dominant hand so you are able to handle baby and initiate breastfeeding more easily, if that is your plan.
- ECG dots on your back: Your heart will be monitored with small stickers usually placed on your chest during the birth. These can be placed on your back instead to leave your chest free for skin to skin and breastfeeding immediately after birth.
Choose a Comfortable Environment
- Birth partner to be present: You can ask that you are not separated from your birth partner at any point during your caesarean, including whilst your epidural/spinal is sited. This is so that you feel emotionally safe and well supported.
- Dim lighting: Whilst the area the doctors are working on must be brightly lit, the rest of the room could be dimmer. This helps to support oxytocin production in your body, aiding relaxation, establishing breastfeeding and bonding and making baby’s transition into the world more gentle. Let your healthcare team know that you are planning a gentle c-section so they can accommodate.
- Essential oils: Some people find essential oils help them to relax, particularly familiar smells. A drop or 2 on your gown or a tissue/muslin can make this a helpful option for using them during a caesarean birth.
- Ask for quiet (or distraction): Consider whether you would like peace and quiet and to feel undisturbed, or whether a bit of chit chat might make you feel more at ease. You can ask for personal conversations to be left out of the birth room, particularly after baby is born, when it can sometimes feel like the birth is ‘over’ (but it isn’t!)
- Music: Whilst preparing for a gentle c-section, have a playlist of songs that make you feel good to play during the birth! You may also reach for guided hypnobirthing relaxations in headphones, if you prefer.
During a Gentle C-Section: The Birth
- Slow birth of the baby: When a baby is born vaginally, they are squeezed tightly as they pass through the birth canal. This squeezing helps clear their lungs, nose and sinuses of amniotic fluid and surfactant. Babies born by caesarean can be ‘mucous-y’ for a few days after birth. By slowing their emergence from the womb, this can mimic the squeezing they would usually have and help to reduce this mucous.
- Lower the screen: During your gentle c-section, you may like to see your baby be born. (Don’t worry you can’t see any of your insides!) Lowering the screen at the point of birth means you can see baby’s head and body emerge as they are born.
- Maternal assisted birth: Not common in the UK at present, but starting to happen in places like Australia, this involves you directly receiving your baby from the womb. ‘Scrubbing’, so that your hands are sterile, lowering the screen and lifting your baby to your chest straight from your abdomen. Certainly not something everyone would want, but an option to explore!
- Consider what you’d like to do with the placenta: It may be as simple as asking to SEE it! The organ that has been your baby’s life line for the past 9 months. Some women choose to keep the placenta and bury it or ingest it.
- Take photographs and videos: Precious memories of the moment you become a mother to this baby!
- Delayed cord clamping: At the point of birth around 1/3 of baby’s blood volume is in the placenta. Ensuring they receive their full blood compliment reduces the rates of anaemia and raises birth weight. It is recommended that this is delayed for at least 1 minute, even with caesarean birth, but all being well you can certainly ask for longer, or even for baby to be born attached to the placenta. (This is particularly beneficial for babies born prematurely).
- Skin to skin: Having baby brought straight to your chest, skin to skin, helps regulate their body temperature, breathing and heart rate; builds oxytocin production in mother and baby. This is crucial for bonding and establishing breastfeeding and helps to transfer bacteria from mum’s skin to baby’s mouth/nose to build their microbiome. If for whatever reason this can’t be with mum right away, skin to skin with a partner will have many of the benefits. You can reach for skin to skin at the earliest opportunity, and the benefits remain throughout LIFE!
- Support to feed in theatre: During your gentle c-section, if baby is showing signs that they are ready to feed (rooting, nuzzling for the breast) and you are hoping to breastfeed, this can be supported in theatre. You do not have to wait until the caesarean is complete.
- Vaginal seeding: When a baby is born vaginally, they pass through the vagina and usually come out with their nose facing your bottom! On this journey they pick up millions of bacteria, which goes on to form the microbiome of their gut (a diverse microbiome influences things like allergies, asthma and other long term health conditions). Vaginal seeding involves placing a swab inside of the vagina, then rubbing this on baby’s face/mouth/nose and hands to ‘seed the microbiome’. There is currently limited evidence to support or condone the safety of this practise.
- Delay weighing and dressing: The golden hour after birth is important for a caesarean birth too. Don’t feel you must rush into separating from your baby until you feel ready. They are YOUR baby after all!
The availability of some of these options may depend on your individual circumstances. Some doctors will receive these preferences with ease and enthusiasm; others may be more resistant; but I promise you will never regret pushing for what is most important to you; you only get to give birth to this baby once!
Megan is an antenatal teacher with a qualification in Hypnobirthing offering support to pregnant women. She is able to provide advice and guidance antenatally during pregnancy, labour and delivery, encouraging a positive birth experience through online and in-person courses.