How to Plan for a Gentle Cesarean

Approximately 1 in 3 babies is born surgically; making cesarean sections the most common surgical procedure in the United States. Many new moms who have given birth by cesarean section feel cheated, disappointed and may even they feel like they didn’t give birth at all. Studies show that women who give birth via cesarean section are often less satisfied with their birth experience and are at an increased risk for postpartum depression. They may also have difficulty bonding, and experience breastfeeding problems. Unfortunately, complications during pregnancy and birth do arise. Labor does not always go as planned. Medically necessary cesarean births save lives.

Cesarean birth can feel violating and defeating or it can be empowering and beautiful in the same ways a vaginal birth is. Gentle cesarean birth also called “family-centered cesarean birth”, or “natural cesarean birth” considers a new family’s psychological, emotional and spiritual needs while managing their medical care.

Although we don’t like to think about the possibility of things going wrong when we are giving birth, the best way to achieve an outcome that you feel good about is to plan for possibilities. Even if you expect to have a natural, unmedicated and spiritual birth using the Birth Like a Goddess program, you can still lay out your wishes should you require a cesarean section for your safety or the safety of your baby.

Consider adding your wishes for a gentle cesarean section to your birth plan. Discuss them with your care provider early in your pregnancy and establish which of your wishes your care provider and the hospital can accommodate. Many care providers and hospitals are becoming familiar with gentle cesarean births and are already prepared to accommodate a family-centered experience.

What’s different about a gentle cesarean?

The goal of a gentle caesarean is to create a peaceful and family-centered birth experience. Although a c-section is still a major surgery, minor changes can be made to accommodate your family’s non-medical needs. Below is a list of considerations that you may choose to request. Your hospital and primary care provider may be comfortable with some, all, or none of these choices so talking about your wishes early in pregnancy is important. Gentle cesarean sections are a relatively new concept and many hospitals and obstetricians are open to learning more about it (while some are not).

You may want to:

  • choose the support people (partner, doula, other support person) that accompany you into the operating room
  • have music during your birth
  • take photos or video
  • have your arms free and not strapped down
  • request that your IV is placed in your non-dominant arm allowing you to better embrace your baby
  • request an epidural rather than general anesthesia so that you can be alert to meet your baby
  • have the doctor ask if you are ready to meet your baby
  • request that a clear drape, or mirror is used allowing you to see your baby being born (dropping the drape may also be an option)
  • have the EKG monitors placed on your side or back instead of the chest allowing for skin to skin immediately after birth
  • request that the umbilical cord clamping be delayed until it has stopped pulsing
  • breastfeed in the operating room
  • request a ‘vaginal swab’ so that the baby can have a better chance at establishing a healthy ‘microbiome’ (see here for more details)
  • have newborn tests and procedures performed with baby on your chest (so long as your baby does not need any immediate medical care)
  • be given non-drowsy anti-nausea medication following your baby’s birth so that you can be alert and bond with your baby
  • have minimal separation from your baby
  • delay your baby’s first bath
  • be free to eat and drink as soon as possible after your baby is born
  • have your catheter removed as soon as possible after your baby is born
  • be up and walking as soon as possible

What are the benefits of planning a gentle caesarean birth?

It can be difficult to talk about provisions for a caesarean section when you are planning a natural, vaginal unmedicated birth. You may worry that by even considering the possibility you could manifest the need for a surgical birth. Let me reassure you that expressing your desires in advance should a caesarean section become necessary isn’t manifesting it to be so. Planning is prudent and it is not setting intentions. Don’t dwell on the possibility of a c-section, just know that the possibility is there and the best way to ensure you have a fulfilling experience is to establish your wishes in advance. What I like to encourage women to do is to meditate on what their core desired feeling is for their birth. Then I ask them, “How can you still make this desired feeling a reality if things don’t go as planned?” Knowing about a gentle cesarean can help you in this process, should you need one because of medical reasons. 

When compared to a traditional caesarean birth, a gentle or family-centered caesarean is thought to:

  • Reduce the risk of postpartum depression
  • Improve breastfeeding rates
  • Support parent and infant bonding
  • Improve satisfaction with your birth experience
  • Improve baby’s microbiome establishing a foundation for good health

Many women who have experienced both a traditional c-section and a gentle caesarean describe feeling more positively about their gentle caesarean experience. They felt more empowered during the birth of their baby by implementing their desires.

Planning a gentle caesarean birth is also a wonderful option if you are expecting to have a repeat caesarean. If you have had a prior caesarean birth you may need to choose a repeat caesarean section for medical reasons. Regardless of your reasons for deciding to have a c-section, you can arrange for a birth experience that is emotionally and spiritually fulfilling, and that still feels like a sacred birth experience. Incorporating the suggestions above and combining them with hypnosis techniques and other natural coping strategies may be just what you need to feel empowered by the birth of your baby.

Remember, while your physical health and your baby’s physical health are always the top priority, your emotional and spiritual wellbeing matter. A lot. You deserve to have a birth experience that you feel proud of!

What if my doctor or hospital are not willing or able to accommodate my preferences for a gentle caesarean birth?

As I mentioned above you should discuss your wishes early in your pregnancy. If your primary care provider or hospital are unwilling or unable to accommodate your birth wishes you should connect with other primary care providers. You have a right to choose your care provider and birthing place.

Should you be willing, it might be worthwhile to present some information about gentler surgical birth options to your care provider or hospital administrators. By advocating for yourself in this way you may be able to create positive change within your local birth community.

It’s been decades since much has changed about the way surgical births are performed. These changes were much needed and I can not wait to see more hospitals and care providers embrace gentle c-sections. A cesarean section doesn’t have to be cold and spiritually sterile.  With some small considerations, you and your new family can begin your life together feeling honored and empowered!

Nancy Lucina

Nancy Lucina

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