How to Have a Natural & Gentle Cesarean

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How to have a gentle and natural cesarean section when possible
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One of the single most difficult moments of my life was as I was being wheeled down the hall to an emergency c-section and I hugged my husband good-bye and we said our “I love yous.” He was able to rejoin me just as our little one entered the world, but that day and its difficulties are a painful whirlwind in my memory.

I’m so glad for that experience, especially in hindsight, but as I recounted before, that day was so difficult and there are so many things I wish I’d known to do differently.

That c-section has been good for me as a mother and as a doula. It was humbling and difficult, but it taught be so much.

A Gentle Cesarean?

As grateful as I (now) am for that experience, there are so many things I wish I could do differently for the sake of our son. I hadn’t read any of the books about c-sections because I thought I’d never have one and I wasn’t at all prepared.

Because he was early, he spent 8 days in the NICU and I didn’t get to hold him until the end of that time. I had to pump and he was fed through a bottle or a feeding tube. We didn’t get skin to skin and he definitely didn’t get any beneficial bacteria from me after birth. (As a side note, I’m smiling in that picture because of the happy drugs they gave me since the epidural didn’t work, not because I had a gentle birth!)

After my own c-section I started researching gentle c-sections and how to optimize factors in the event that a c-section is necessary. Having been through it myself, I know how difficult it is, and I wanted to find ways to help other women have a more gentle time (and an easier recovery).

I’ve now had the privilege to be a doula at several cesarean births and to help implement these ideas and I’ve seen the benefit to mom and baby. It is too late for me to have implemented this with my own son at the time of my c-section, but I hope that what I’ve learned since then might be helpful to some of you.

Obviously, natural birth is optimal whenever it is possible (and it is possible much more than the 30+% that it occurs now) but there are times where it is legitimately not possible to deliver vaginally (like my placenta previa) and there are ways that we can make the best of that situation for mom and baby.

Skin to Skin & Bonding

One important aspect that is lost in many c-section births is the vital skin to skin time with mom and baby. I didn’t get this with our son because he was having a slight trouble breathing. I really wonder if we’d had even just a minute of this, if his breathing might have improved and he would not have needed the time in the NICU (some research is showing this is a possibility).

Skin to skin contact between mom and baby helps regulate baby’s temperature and breathing patters and also helps mom hormone levels:

For example, Dr. Camann realized that by using both clear and solid sterile drapes, obstetricians could switch the solid drape for the clear one just before delivery and allow mom to see her baby being born.
“We also allow mom a free arm and place the EKG leads on her back so that she is able to hold, interact, and provide skin-to-skin contact with her baby in the moments following the birth,” said Camann, who teamed up with BWH registered nurse Kathy Trainor, to make this option available to patients and their families.

Kathy Trainor notes that research has shown that techniques such as skin-to-skin contact have important benefits for a mother and her baby.

“Allowing mom and baby to bond as quickly as possible after the delivery makes for a better transition for the baby, including better temperature and heart rate regulation, increased attachment and parental bonding and more successful rates of breast feeding,” she said. (source)

Research is now showing that this skin to skin contact immediately after birth is important for culturing baby’s gut bacteria and microbiome properly.

Microbiome

Perhaps even more important for baby’s health long term is the need to properly develop the microbiome. An excellent new movie called Microbirth delves into the way a baby’s gut bacteria is cultured during the birthing process and how this affects the baby throughout his or her life and can even affect things like cancer and heart disease risk later in life.

The movie points out that a baby born via c-section has 1/3 less variety of bacteria in his or her gut than the gut of a baby born vaginally in an optimal environment. This seems especially disheartening and scary, especially to moms who have no choice but to have c-sections, but the movie also offered some unconventional advice and some hope…

One of the doctors interviewed in the documentary explained how they were able to create the same variety of healthy gut bacteria in a baby born via c-section. They inserted a sterile gauze into the mother’s birth canal for the hour or so before delivery (by c-section). In the time before birth, the mother’s body will culture trillions of bacteria in the birth canal that are passed on to baby as he or she is born. Of course, this transfer doesn’t happen in a non-vaginal birth but this offered a work-around.

The sterile gauze was removed from the mother just before the baby was born and placed in a sterile container. As soon as baby was born, the gauze was wiped in the baby’s mouth, nose, and all over the face and skin of the entire body. This exposed the baby to the mother’s beneficial bacteria first and in a five year follow-up, babies who went through this process had similar gut bacteria to babies born vaginally and had lower rates of obesity, allergies, eczema and more.

It sounds strange, especially at first, but it certainly isn’t any more strange than the way the transfer happens during a vaginal birth where baby comes fully in contact with the bacteria in the birth canal, getting it in his or her mouth and nose.

I highly recommend the movie Microbirth to any expecting parents, but especially to those who must deliver via c-section. I’m purchasing several copies to pass on to doctors I know to spread the word about this important topic. As Toni Harman explains:

As the fetus grows in the womb, it develops in a near-sterile environment relying on its mother for protection. But when the baby emerges, it is entering a world of bacteria, some of which are bad (pathogens) but some of which are good.

In the weeks and days leading up to birth, specific species of good bacteria are migrating to key locations in the mother’s body and are transferred to the baby during and immediately after birth via the birth canal, immediate skin-to-skin contact and breastfeeding. The role of these good bacteria is to train the baby’s human cells to distinguish between what is “friend” and what is “foe” so that its immune system can fight off attack from pathogens. This process kickstarts the baby’s immune system and helps to protect the infant from disease for its entire lifetime.

However, with interventions like use of synthetic oxytocin (Pitocin / Syntocinon), antibiotics, C-section and formula feeding, this microbial transfer from the mother to baby is interfered with or bypassed completely. For babies that enter the world by C-section, their first contact could be with bacteria that is resident in hospitals and from strangers, i.e. not with the special cocktail of bacteria from the mother.

The latest scientific research is now starting to indicate that if the baby is not properly seeded with the mother’s own bacteria at birth, then the baby’s microbiome, in the words of Rodney R Dietert, Professor of Immunotoxicology at Cornell University, is left “incomplete”. Consequently, that baby’s immune system may never develop to its full potential, leaving that infant with an increased risk of developing one or more serious diseases later in life.

This area of research is very much still in its infancy but as research develops, I know many families that are attempting this method of culturing baby’s gut bacteria since there is no documented downside and baby would naturally encounter these bacteria during birth anyway. Baby is usually wiped off and dried anyway, there isn’t a reason this could not happen with a gauze that had been exposed to the mother’s gut bacteria.

A Gentle Cesarean Birth Plan

When c-sections are needed and especially pre-planned, there are some factors that families can discus with their doctors and birth team to try to create a more gentle environment if circumstances allow. Things like:

  • Dropping the drape or using a clear drape so that mom can actually witness the birth of her baby (especially since she won’t be able to see the incision because of its placement
  • Immediate skin-to-skin once baby is born and while mom is being repaired if possible. If not, dad can have skin to skin with baby while mom is being repaired.
  • Fostering of the early nursing relationship by having baby on mom’s chest during the rest of the procedure so baby can start to nurse if he/she desires
  • Using a specially cultured gauze to swab the baby and expose him/her to mom’s beneficial bacteria
  • Letting the dad cut the cord if circumstances allow
  • Keeping mom, dad and baby together in the recovery unit to let nursing and bonding happen
  • Allowing for an extra person (doula, grandparent, etc) to be there to photograph the birth so that mom and dad can both interact right away
  • Have music of choice playing if possible
  • Having all IVs, straps, etc on the non-dominant arm so that mom can touch and hold baby once he or she is born
  • Performing all newborn tests on mom’s chest if possible
  • Ensuring that all medications are approved for breastfeeding, if possible
  • Letting the cord continue pulsing after birth if possible

Have you ever had a c-section? Did you try any of these things?

Sources

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Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

72 responses to “How to Have a Natural & Gentle Cesarean”

  1. Kelly Avatar

    Thank you so much for always bringing important topics up in your blog. I love reading everything on your site!

    My question is re your research into the study mentioned in Microbirth with the sterile gauze. Have you read the complete documents? I haven’t been able to find it available online, and was curious if you had any luck and could share the link?

    Thank you,
    Kelly

  2. Jen Avatar

    I had to have a c section with my child because we found out at 41 weeks that she was in a breech position. My water broke before i could try a version so i was left with no choice. I was pretty much able to have a gentle c-section, but the doctor only allowed 1 minute of leaving the cord in tact after birth. And that was only because I cried so hard when she said it would only be 30 seconds! I’m grateful for my gentle c section, as it really helped me deal with the grief of not getting an unmedicated home birth like I had wished/planned for.

  3. Stephanie Avatar
    Stephanie

    Katie,

    Thank you for all of your posts. This is kind of a misplaced comment, but could you please publish a book / booklet on childcare (preferably by December – just kidding – sort of). I have had my mind blown by a few of the things that you have posted, such as not bathing the baby and letting the baby feed itself when solid food is started. These are both great to know, but very contrary to how I thought things were supposed to work. I basically know nothing about kids, but I have one coming up soon and I need to cram. I will buy the pregnancy / nursing book, but from the description it doesn’t seem to cover details like feed and bathing (or not bathing) the baby, or similar things. It would be great if you could put much of this information into a paper book (or something that one can print in the format of a paper book), because I for one really need this reference.

    To give you an idea of how much we (my husband and I and surely others) need this – we don’t even know if the baby is supposed to wear clothes. It is my impression that the answer is no, that one just uses a swaddling blanket, but my husband thinks that a onesie is required since the baby will not have bedding in the crib. I mean, we really don’t know the first thing about what to do after the baby is born. Our median age is over 40. We have lots of life skills, but zero of these pertain to children. Thank you for all that you have already taught us!

    Thank you!

  4. victoria Avatar
    victoria

    can you give any insight on what drugs to allow/not allow? Have a c-section planned in less than a week because baby is breech. Tried everything to get him to turn including ecv.

  5. Lesly Sotelo Avatar
    Lesly Sotelo

    I tried on how to make lip balm and it was burning my eye because i use peppermint scent. But it turn out good .

  6. Clare Avatar

    I really like this blog. where is the lovely film of the gentle C-section you used to have on here please? Thanks

  7. Kristen Avatar
    Kristen

    I’ve had 2 C sections & will be having my 3rd shortly. My uterus is shaped differently so my babies don’t turn head down, they are breached. Both babies came early- my water breaks. I would like to do the bacteria gauze thing, but don’t know when to put it in….after my water breaks, does that mean the good bacteria “trickles” away? Should I put the gauze in as soon as my water breaks?

    1. Wellness Mama Avatar

      Good question. While I was waiting on my last little one (born vaginally but breech), I cultured a gauze each day (before labor/water breaking) and threw it out and made a new one if it wasn’t needed.

  8. Kathleen Avatar
    Kathleen

    I am so fascinated that you were “allowed” to vaginally deliver two breech babies. I’ve had 3 c-sections. The first two babies were frank breech and I was given no option: automatic c-sections. By the time the 3rd baby came along, my doctor wouldn’t hear of a VBAC and my local midwives group wouldn’t see me because of my risks (protein S deficiency, thryroid disease, multiple miscarriages, etc.)

    I SO wish I’d explored other options instead of accepting my mainstream OB’s decision for a c-section. I didn’t know then half of what I know now as a much more natural mama.

    Thanks for spreading the word about natural options for natural mamas!

  9. Mira Avatar

    Would you be able to share any info you have on the procedure around immediate skin to skin when the baby comes out after c-section? I am hoping to not have one, but between a low lying placenta and a HSV virus I’ve decided it’s better to be educated than not.
    There is only one hospital to birth at here and they don’t do immediate skin to skin after c-section. When I brought it up with my midwife she didn’t know about it, and wasn’t sure how it would work to keep the Dr sterile after passing off babe.

  10. Lara Avatar

    Hi,
    I ended up with an emergency c-section after planning extensively for a drug-free birth. I say “drug-free birth” instead of “natural” because I want to include myself and other women who have had c-sections in the category of natural deliveries (you do what is best for your baby which is the most natural thing a momma can do!)

    I met with the surgeon before my surgery and stated that I wanted all the ingredients to a gentle c-section (skin to skin, immediate contact, lower curtain, baby weights and measures done after bonding time, etc). Nothing was honored.

    What is very important to remember a is that the pediatrician has to be on board. The surgeon did not communicate with the pediatrician so she did not honor our wishes either. Just a head’s up for anyone planning. And share with your husband or doula so they can be your voice in case of an emergency c-section.

  11. Kim Avatar

    I’m wondering why seeding wasn’t demonstrated in this video and how this woman was allowed to have both an OB and a midwife in the room. As far as I know this isn’t a choice in Canada but would love to know more. Great article!

    1. Melissa Avatar
      Melissa

      I has a midwife and OB in the hospital room for the birth of our twins but they were delivered vaginally. I’m in Canada

  12. Diana Avatar

    Hi. I had 2 c-secs, the first one was a nightmare. They rushed me to the OR because the Dr. was at the end of her shift so she didn’t want to wait a second. They didn’t let my husband to at least kiss me, they took me thru a back door without informing him ofanything. He was so worried because no one was telling him why the rush?! In the OR, they also rushed the epidural and it went wrong, seems like they didn’t aim for the spinal cord, so I had breathing difficulties and my heart rates were all wrong. They got scared and in the middle of the drugs they started asking me lots of questions about my heart’s history but they never said or asked my husband about the incident. When my mom asked they said was nothing and is not in my Medical Record Notes. After that chaos, I passed 2 hours jumping in the bed, I couldn’t control my body and it was super painful, I guess that was a side effect of the epidural. After the Recovery, they had me drugged for 36 hours with Morphine and something else because I can’t remember those hours. I could not breatsfed my son, I tried so many options but nothing worked with him. He was always sick of his stomach, the first 6 months were a true nightmare, unil I met a Homeopathic Dr. Anyway for my 2nd c-sec, I was so scared that I didnt show up for the first appoinment, they set me for the c-sec at 37 weeks and I kept saying No until my 42 weeks, that I met this German Dr. and he truly heard me and understood my fears. He made the c-sec, they let my husband be inside with me at the OR holding my hands, as soon as the baby was out they placed him in my chest for like a minute and then daddy help to clean him and cutted his cord. Right after that he was back to my chest and nursed almost immediately and they never took him from my side, not even for his tests. A very different experience and beautiful under the circumstances. I wish I would know before about the microbes and the gauze technique.

  13. Ashley Avatar

    Hello! I was told I had strep B, so for my 2 vaginal births, I was given antibiotics. That probably killed all the good bacteria too, didn’t it? 🙁 Are there any other options that you know of if someone has this? Thank you!

  14. Heather Avatar

    Thank you so much for this article. I hope all soon to be moms read it. I have had 2 c-sections. The first was with my little girl and it was unplanned and I too was un-prepared. I never even considered that I would need a c-section. After several hours of pushing and no baby the doctor recommended c-section(although baby’s heart rate was fine and she seemed to be tolerating labor ok). After delivery she was wisked off to the NICU and she and I were put on a strong antibiotic because there was maconeum in my uterus from labor. I had no skin on skin contact and they would not even let me leave my hospital room to see her or breastfeed her until almost 12 hours later. I was heartbroken. She had been bottle fed in the NICU and nursing was a struggle the entire time I breastfed her. My second baby was also a c-section but a planned one. It went a little more smoothly. I was able to hold him almost immediately after he was born and made sure all of the doctors and nurses knew I would be breastfeeding and not to give him a bottle. I definitely recommend all moms have 2 birth plans, one for vaginal delivery and one for c-section. And be sure your doctors know your wishes and will try to accommodate you. If they won’t, then find a doctor who will. I wish I had been more prepared.
    and p.s. I HATE how they strap your arms down and you can’t even move them or touch your baby when they show them to you after birth!

  15. Shalome Avatar

    Hey Katie,

    I love love LOVE this article – such an empowering and informative insight into how Caesarean Mamas can have an awesome birth experience. I wondered if I would be able to republish it in the Rockstar Birth Magazine? I have a Caesarean-specific issue coming out in December and would love more mamas to receive this info. The Rockstar Birth Magazine is a digital mag and available to members only (via the issuu platform) so the share will not affect your SEO rating as it will not come up in google.

    Either way, thanks so much for sharing your won personal experience. I believe pregnant mamas need more amazing insights like yours so they can rock their birth, their way.

    Cheers Shalome

    1. Wellness Mama Avatar

      Hi Shalome, I don’t allow my posts to be republished elsewhere. However, you can quote from an article as long as attribution is given and you link back to the original post. Thanks for reading!

  16. Kristi Mikkelsen Avatar
    Kristi Mikkelsen

    Katie, I’ve wanted send you a note since first reading your wonderful blog a year ago. This post finally gave me the impetus to write it. We are currently pregnant with our third baby and trying to decide what type of birth is best for both me and baby. I’m high risk after losing our infant at 40 + 5 weeks last summer due to complications with the placenta and umbilical cord. My first daughter was born via emergency C-section, and little Saint Sophia was born via what I can only describe as a “crash” C-section. We’ll never know, but an elective C-section prior to my due date MAY have saved her life. Now having had two C-sections, we’re weighing the risks on all sides. I’ve been lucky with my recovery after both surgeries, but I desperately want to do what’s healthiest for little Theodore in this case. Sometimes I think that this is natural birth, but given our history, this is pretty terrifying. Reading your thoughts here — and knowing how naturally minded you are — yet feeling the gentle compassion of this article has eased my stress a bit if we do decide to go the surgical route. Thank you for the information about seeding (it was the gut biome that I worry about the most), so I’m grateful for this information to pass on to my MFM (Maternal and Fetal Medicine specialist — fancy speak for a high risk OB.) Luckily, my doctor is spectacular and is even open to a VBA2C, but we’re praying for guidance on what is best. Your words here have soothed my heart that it is OK if I do decide that a C-section is the way to go. THANK YOU!

    P.S. The fact that you are supplementing with an R. Paul curriculum in your homeschool is spectacular. 🙂 Prayers for you and your family from our home in Poland!

  17. Peta Avatar

    Hi Katie,
    Thank you for such an interesting and informative article.
    I am expecting DCDA twins in December, and am considering an elective c-section due to a previous stillbirth at term.
    I was just wondering if delayed cord clamping was possible for twins in a c-section?
    Thanks in advance.

    1. Wellness Mama Avatar

      Congrats on your twins! I am not sure… You would want to talk to your doctor about that. Even with a single birth, some will do it but some may not. Definitely ask!

  18. Selena Avatar

    Hi Katie,

    I am anticipating an early c-section delivery and time in the NICU due to some complications with my pregnancy. My question is, if my baby will be receiving antibiotics in the NICU will this completely negate the passage of any good bacteria passed from the gauze? If so, is the good bacteria in the vagina during birth different than down the road? In other words, could I do the gauze myself after baby is discharged from the hospital and off all of the antibiotics?
    Thank you so much for sharing these ideas they were so helpful!

    1. Katie - Wellness Mama Avatar

      Good questions. I’m going to email a doctor and see what he thinks. I would think that an immediate transfer with the gauze would still be helpful since the antibiotics would be IV and the gauze would help culture the GI tract. You could also repeat once you get home though. Best of luck for delivery and quick recovery.

  19. maria Avatar

    Hi i will be going through my fourth c-section and i am ver nervous and scared…… ?what can i do.

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