When a C-Section is Unavoidable...

Hi! I'm back from my vacation! In one of my last articles, I was talking about the risks of cesarean section, and gave some tips to put all the chances on your side in order to avoid it. But sometimes, a cesarean section can become unavoidable and can make the difference between life or death...

The good news is that if we take care of some elements, a surgical birth can be less traumatic for mother and child. We are talking here about gentle cesarean, sometimes called ''natural cesarean''. The gentle cesarean consists in taking some elements into account in order to make it as close as possible to a natural birth. You can talk about the possibility of a cesarean section with your health care practitionner, and of how you would want it handled in the case it happened. You can even add a ''in case of cesarean section', to your birth plan.

Here, for starters, is a short video explaining the concept of ''natural cesarean''.

So here are some demands you can make for a gentle cesarean:

- If possible, ask to wait until labor has started on it's own, so that the baby can recieve and take advantage of the hormones of birth. These hormones help prepare the baby for life outside the womb and help with the transition. Letting labor start on it's own also lets us know the baby is really ready to be born. 

- Epidural anesthesia during the surgery allows the mother to stay awake during surgery and is now the preferred method everywhere. General anesthesia is only used in case of an extreme emergency. 

- Asking to have the I.V installed in your non-dominant arm, so that it won't be too much in the way when you hold your baby. 

- Asking that the receptors to monitor your heart and breathing be installed away from your chest, but on your sides and shoulders instead (they still allow for good monitoring), leaving the chest area free for putting the baby skin-to-skin. 

-Asking to have a towel or piece of cloth put over the blood pressure cuff so it will be more comfortable for baby when she is on mom. 

- Asking for the baby to be taken out of the womb as slowly as possible, to allow him to evacuate all the liquid in his lungs during the expulsion. This also encourages the uterus to contract to help the baby out. 

- Once the head is out, the curtain between the mom and baby can be taken down so that the mother can and father can see the birth of their baby. The baby is then gently born, looked over by her parents, who can also be the first to announce their baby's gender! And even with the cutain down, the mother won't see the open wound because her big belly is in the way! 

- It is possible to wait a little before cutting the umbilical cord, allowing he baby to get a good amount of his blood back. During that time, the baby can take his first few breaths while still recieving oxygenated blood through his cord. 

- As for the cutting of the cord itself, it is possible to ask for the cord to be left relatively long, so that the father can re-cut it himself later. 

- Once the umbilical cord has been cut, the baby can be passed straight onto the mother's chest, skin-to-skin. Sometimes, some babies even start breastfeeding in the operating theater! The baby is left on the mother throughout the rest of the surgery, and all the way to the recovery room. In the case of a general anesthesia, the father can be the one doing immediate skin-to-skin with his baby, or in the event the father is absent, it can be a relative or the doula doing the skin-to-skin. 

All these precautions can help diminish the negative impacts a surgical birth can have on mother and baby, and allow for a gentler birth. Immediate skin-to-skin also helps establish breastfeeding and helps with the bonding between mother and child. 

However, it is important to keep in mind that even if some women can deal very well with having had a cesarean section, for a good number of mothers the experience of a surgical birth can be very traumatic and hard to deal with, especially if they were planning for a natural birth. A new mother in this situation will need a lot of support and love to help with her recovery, both physical and emotionnal, and to deal with her deception and grief of not having the natural birth she dreamed of. Having a healthy baby, of course, is very important, but it is important to aknowledge the women in their experience, and not to neglect how it can impact them. 

Telling your story is a good way to help making peace with this kind of trying event. Write a journal, or a letter to yourself or to your baby, or participate in a red tent to share with other women on this subject. It is also possible to seek postpartum support, like a postpartum doula, who comes at home to help, wether it's house chores, baby care, or taking care of the older children in order to help the new mother get back on her feet. She is also there to listen and offer psychological support if needed. It is also possible to have a dialog with the baby, telling the baby the story of his birth, and having the mother explain to him how she felt with everything that happened, what she would have wished the birth to be like, and allowing the baby to make peace with his birth too. Note that these suggestions are also good for any type of birth that may not have gone as expected. 

Here are a few articles/testimonies: