Giving birth

How to have a gentler C-section

How hospitals are revolutionizing the experience of delivering by Caesarian.

How to have a gentler C-section

Photo: @ashleymarstonphotography via Instagram

After a long labour, Shannon Connors had her first child by C-section. A planned VBAC with her second didn’t work, and she ended up with another Caesarian. Connors was awake for both procedures but upset that the babies were taken across the room as she was being stitched up. “I felt really detached from the whole experience.” When she was expecting her third, Connor’s midwife told her about “skin-to-skin C-sections”—where the baby is placed on the mother’s chest immediately after birth. Sunnybrook Hospital in Toronto was about to offer the first Caesarian sections like this in Canada. Connor was in. Her son, Leif, “came right from my belly into my arms,” she says. “I held him; we breastfed on the operating table. It was amazing.”

Connors’ OB/GYN, Jon Barrett, pioneered the option at Sunnybrook. “It’s a more beautiful experience for the mom and for everyone in the room,” he says. This isn’t the only way Caesarian sections are being reborn. If you’re preparing for a C-section, here are some of the developments to ask your OB/GYN about.

1. Go skin to skin Holding your new baby on your bare chest sounds simple, but it’s the most widely offered advancement in C-sections and the most medically important. Studies have found that it encourages breastfeeding, reduces crying and likely helps bonding (although this is hard to measure). It also improves babies’ temperature regulation and blood sugar, says Barrett, which is especially beneficial to C-section babies, who are more likely to be premature. If your hospital doesn’t offer skin-to-skin—or a medical issue means it’s not possible (a baby in distress; a mom who is vomiting from the anaesthesia)—the baby can also benefit from skin-to-skin time with your partner.

2. Delay clamping the cord Waiting to clamp the umbilical cord after a C-section is a less common option, because Caesarian babies may need more immediate medical attention. But many doctors do wait 30 to 60 seconds, because it’s helpful to preterm babies and reduces the risk of hemorrhage by nearly 50 percent. Waiting up to a minute also seems to lower the risk of anemia in full-term babies, though the research is less solid. Ask your OB about this option.

3. Drop the drape Connors asked the doctors to lower the chest drape as her son was being born. She could see every moment: “They slowly coaxed him out and let him emerge. My husband was at my head, taking pictures of him coming out,” she says. Other hospitals may have drapes with a flap that opens or a see-through version. In Australia, a country that has led the way on gentle C-sections, news reports (and breathtaking photos) depicted one fearless woman who helped pull her twins out. But some doctors worry that lowering the drape increases the risk of infection, so it isn’t an option everywhere. If you or your partner would rather not see the play-by-play, that’s fine, too!

4. Try vaginal seeding A baby born by C-section misses out on picking up good bacteria from the birth canal. This bacteria is thought to be the beginnings of a baby’s gut flora and helps protect against problems like obesity, asthma and allergies. Vaginal seeding or swabbing—in which a piece of gauze is put in the mother’s vagina before the baby is born and then rubbed over the infant’s ears and nose, and the inside of the cheek after delivery—is still a very new technique, and researchers are studying its safety and health benefits. Ask your hospital if they will assist with the swabbing.

5. Call the midwife Just because you’re going into the OR doesn’t mean your midwife (if you have one) can’t come with you. She can support you as the anaesthesiologist inserts the epidural and can explain exactly what’s happening during the operation. Even though you won’t feel pain, there can be a lot of pressure, and the anaesthesia makes some women feel nauseated, breathless or shaky. “I coach them through that, just like I would coach them through pushing,” says Alix Bacon, president of the Midwives Association of British Columbia. Midwives can also help with the emotional side of things. “A lot of people mourn the loss of having a vaginal birth, so it’s really important to make this birth special,” says Bacon. “We’ll let the parents call out the sex of the baby, or sometimes we’ll even sing ‘Happy Birthday.’ It’s a reminder that this is not just a surgery.”

Did you know 27% of all births in Canada are by C-section.

This article was originally published on Nov 19, 2016

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