Moving towards a more natural Caesarean birth

The words natural and Caesarean don’t, at first glance, seem like they should fit together. Although the terms “natural Caesarean” or “gentle Caesarean” sound like a contradiction of terms, some hospitals are starting to implement a more natural approach to Caesarean birth.  
 
This approach includes the baby being lifted out more slowly, over several minutes, mimicking the process of vaginal birth where the baby is squeezed on their journey through the birth canal, clearing out fluid from the lungs and stimulating their nervous system. Natural Caesareans are also more family-centred, placing the parents at the centre of the experience and facilitating early bonding and skin-to-skin.
 
If you are planning a Caesarean birth you might like to consider asking your caregiver for a natural Caesarean. You can also ask for the following things, which help make the experience gentler for you and for your baby:
 

• The head of your bed to be raised and the screen to be lowered so that you can watch your baby’s birth. Many parents of babies born by Caesarean are so happy to have been able to witness their baby being born.
• The sex of the baby to be left unannounced. You may prefer to discover this for yourself, or for your partner or doula to be the one to tell you.
• Immediate skin-to-skin with your baby following their birth. This helps to regulate your baby’s breathing and temperature, and encourages early breastfeeding. To facilitate this, you can ask for any electronic monitoring pads to be placed on your back rather than your chest, ask for a heartrate monitor to be clipped to your toe rather than your finger, and leave your hospital gown open for easy access to your chest. Putting it on back-to-front, or leaving one arm out of the gown are good solutions.
• The baby’s umbilical cord to be left unclamped and intact for as long as possible. This gives the baby all the benefits of receiving as much of the placental blood as they can, which is linked to positive long-term health outcomes.  

 
Some hospitals also have facilities for music of your choice to play during the birth, or for certain lights to be dimmed, although this is not always the case. It might be worth considering asking everyone in theatre to be quiet during the birth so that the first voices your baby hears are yours or your partners.
 
You might also like to spend some time prior to your baby’s birth with a cellular or other cotton blanket close to your skin. This blanket can be taken to hospital and used to cover your baby as soon as they are placed on your chest, which in turn helps to cover baby in your “friendly” bacteria (a process which happens automatically during vaginal birth). We know that this early colonisation of the gut by friendly bacteria has positive implications for lifelong health.  Some women even go as far as swabbing their newborn baby with their vaginal fluids after the Caesarean to ensure their baby’s tummy gets colonised by microbiomes.  This should protect the baby from developing future diseases such as obesity, diabetes and asthma, which statistically, babies born by Caesareans are at an increased risk of developing.
 
It is worth seeking a meeting with your consultant well in advance of the birth to discuss your preferences so that they can find out more about a natural Caesarean.  Arranging to see a Supervisor of Midwives could be helpful if you are meeting resistance when discussing your birth preferences.  Sadly, not all consultants and not all hospitals will be keen to facilitate a gentle Caesarean, so you may have some persuading ahead of you.
 
It is much easier to plan a natural, or gentle, Caesarean in advance, rather than asking for the above during an unplanned, or emergency, Caesarean, as many obstetricians are not yet trained in this relatively new procedure. I am hopeful however, that in the future, most Caesarean births will be “natural” ones, as there are so many benefits to having what is as close to a physiological birth as possible.
 
If you’d like to find out more about natural and gentle Caesareans, you might enjoy the following videos:

The natural caesarean
Gentle caesarean birth
How to have a gentle caesarean