What is a natural caesarean?

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What is a natural caesarean?

More than 1 in 4 women now has a caesarean section, but the ‘natural caesarean’ or ‘gentle caesarean’ is growing in popularity.

First introduced ten years ago, the natural caesarean offers mothers who undergo surgical delivery the chance of the women-centred, family-friendly approach used at vaginal birth.

To be clear, a gentle C-section is still surgery. But it puts the parents at the centre of events, allowing them to witness the slow, gentle birth of their baby, discover his/her gender, and enjoy immediate skin-to-skin contact. Safety and sterility are assured.

As a paper for the Royal College of Midwives

has highlighted, all childbearing women need nurturing and this can be enhanced during C-section births by “introducing some ‘normality’ to a profoundly abnormal situation.”

What is a natural caesarean?

A natural caesarean is a “slowed-down section” with benefits that might include improved bonding between mother and child, easier breastfeeding and calmer infants.

The idea was introduced by Professor Nicholas Fisk, consultant obstetrician at Queen Charlotte’s Hospital in London, in a research paper

in 2008. He and his colleagues – Dr Felicity Plaat, consultant anaesthetist, and Jenny Smith, a senior midwife and author – saw the need for a new approach to C-sections that could benefit women and babies. Their paper – The natural caesarean: a woman-centred technique – explained: “Caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding.”

Instead, their approach unfolds as follows.

How does a natural caesarean work?

  1. After making the uterine incision, the theatre team lower the surgical drape and raise the table head so the mother can see what is happening.
  2. As the baby’s head comes through the incision, she begins to breathe air through her nose/mouth while still attached to the placenta.
  3. The baby’s body remain in utero for a few minutes, because this pressure helps push the fluid from her lungs.
  4. After she starts to cry, the obstetrician eases out her shoulders and she lifts out her own arms.
  5. Observing vital signs, the obstetrician supports the baby so her mother can see her.
  6. The obstetrician supports the baby’s head as she is expelled through uterine contractions and by wriggling out.
  7. After the cord is clamped and cut, the baby is passed to a midwife who places her on her mother’s chest and covers her with warm towels.
  8. Skin to skin and early breastfeeding begin, as the obstetrician completes the surgery.

The Royal College of Midwives

National Institutes of Healths

Mothers say they have felt definite benefits, although these are hard to prove with scientific precision. Charlotte Philby has written persuasively in The Independent about her gentle caesarean following two emergency C-sections: “It’s impossible to say for certain quite what the impact of this delivery was, but I can honestly say that of all my three children (all equally delightful, of course), this baby has been by a long shot the most calm and contented, latching on to the breast with ease and hardly ever grizzling or crying. And despite juggling three kids, and all the rest of it, I’ve never felt calmer as a new mother.”

How to make a C-section personal

For all mothers who know their delivery will be by C-section, there are ways to make the experience more personal. Taking something familiar from home to the hospital or birthing unit, such as a favourite pillow, can make it less daunting. Favourite music brought along to be played in theatre can also make mothers feel calmer and more relaxed.

Dimming the lights in the periphery can make the theatre more homely, while there are proven benefits to delaying cutting and clamping of the cord, as long as mother and baby are well. This means the baby benefits from the stem cells and oxygenated blood cells from the placenta after birth. And encapsulating your placenta is still possible with a caesarean, so those benefits can last for months.

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