4 Steps to Prepare for Having a Gentle Cesarean

A gentle cesarean (sometimes called a family-centered birth) includes many features, but its overall purpose is to invoke a peaceful, calm atmosphere that closely mimics what happens during and immediately after a natural childbirth.

Here are four steps to prepare for having a gentle cesarean:

1. Implement your birth plan: Include your wishes for a gentle cesarean, even if you are planning a natural childbirth, in your birth plan, and keep several copies of it handy – in your hospital bag, your car’s glove compartment, and your purse. Everyone involved in your birth (obstetrician, midwife, doula, neonatologist, pediatrician, anesthesiologist, and operating room nurses) should also have a copy and be willing to abide by it.

2. Find a doctor who is open to the idea: Find a doctor who is open to the idea and ideally familiar with the concept of a gentle cesarean. If you are facing a doctor on-call with whom you are not familiar, make sure you have an advocate with you who is willing to voice any concerns you may have. It is well within your rights to take the extra time prior to surgery (barring any emergencies) to put in place a birth team who is willing to make this work for you.

3. Read up beforehand: Read up on your hospital’s policies and procedures beforehand so that you are aware ahead of time of any obstacles that may get in the way of your gentle cesarean. Hospitals sometimes have regulations in place that are different than your doctor’s practices, and hospital rules override even your doctor’s wishes. Hopefully, you can have every aspect of your birth that you desire, but if everything does not go according to plan, take the time to grieve!

4. Remember, this is your birth experience!: Remember, this might just be another day for them, but this is YOUR birth experience – something that you will remember and reflect upon for the rest of your life. Make your wishes known! This is not the time to be shy. A gentle cesarean is the best way to get through a surgical birth with compassion, peace, and grace, and it is often extremely healing for mamas who have been through a previous traumatic surgical birth.

If you prefer a gentle cesarean to the traditional protocol, you’ll want to add the following to your birth plan:
- Mama should request an epidural or spinal block; general anesthesia should be avoided at all costs, barring any emergencies
- Mamas should request that anesthesiologists do not automatically give her extra drugs to relax, so that she can be fully present for the experience
- If mama cannot be conscious, father should be allowed to hold baby skin-to-skin immediately after birth, barring any medical complications with baby
- If mama has EKG or baby monitoring devices, they can be placed in areas that don’t infringe her ability to see, hold or breastfeed baby.
- Mama can watch baby lifted from her belly through a clear drape; if this is makes you squeamish, the drape can be lowered and baby can be lifted above it
- Mama’s gown can be lowered and baby can be placed on mama’s chest while mama is being sutured. To facilitate this, mama must ask that her arms are not strapped down
- Baby can breastfeed immediately while in the operating room
- Parents can request cord clamp/cut delay until it stops pulsing
- Parents can request that the placenta be saved and/or frozen until discharge from the hospital
- Music of the parent’s choice can play in the operating room
- Doctors and nurses are asked to refrain from “shop talk” (I distinctly remember hearing doctors converse about my scar tissue and incisions during my second cesarean) or their weekend plans
- Ask your doctor for a vaginal swab to give your baby the best microbiome possible (see below)
- Baby can be held by mama while wheeled into recovery, and continue to bond with parents there
- Any and all usual post-birth procedures such as cleaning the baby and weighing the baby are delayed until parents are ready
- A doula, grandparent, or friend are permitted to photograph or videotape the birth so that parents can concentrate on bonding.