Cesarean Birth

Gentle C-Section: Should You Ask for One?

written by: Lo Mansfield, RN, MSN, CLC

Have you heard about gentle c-sections yet? You need to! Whether or a not a cesarean is part of your birth plan right now, I highly suggest that you read this whole blog. Then, go ask your provider about a gentle c-section in a prenatal appointment. Dig into what practices you are or are not interested in. Figure out what will and won’t be available at your facility. Ask lots of questions until your provider can get you the answers.

What is a gentle c-section?

Let’s back up and answer that first big question: what the heck is a gentle c-section? Gentle c-sections may also be referred to as gentle cesareans or family-centered cesareans. They are still operating room (OR) births done via an incision in your uterus. And, they are still major surgery! But, the goal of a gentle c-section is to bring elements of “traditional” (vaginal) birth into the OR. This includes things like leaving the maternal arms free or doing skin-to-skin immediately after birth.

“The ‘natural’ caesarean technique…has evolved as a series of measures to mimic the situation at vaginal birth, where birth attendants encourage early skin-to-skin contact, facilitate physiological resuscitation, but most of all, engage the parents as active participants in the birth of their child.” Source

The hope is that these types of practices can give families more control over their experience. Often, the cesarean experience leaves mothers and families feeling as if they had their choices and voices taken away from them. So ultimately, family-centered cesareans can do a great job of slowing the process down and reorienting the parents back into the center of the birth story.

What happens during a gentle cesarean?

Like I mentioned, a gentle cesarean is still a sterile procedure that happens in an operating room. But there are quite a few different things you can ask for that can make the space feel warmer, less sterile, and more like a birthday party!

Here are some of the different ways you can ask about incorporating gentle cesarean practices onto your birth plan and/or into your cesarean.

Gentle c-section checklist

  1. Utilizing spinal or epidural anesthesia: These medications should mean you are awake and alert for the birth and that any partner can be with you.
  2. Ask that anesthesia not administer any relaxing drugs into your IV unless requested by you.
  3. Ask about a clear drape that allows for you to see your baby be born. You can also ask about them lowering the drape and lifting baby up if you don’t want to see all of it. 
  4. You can request that monitoring devices or lines be placed on your non-dominant arm or in areas that don’t interrupt skin to skin or your ability to breastfeed. This may include things like ECG monitors, a blood pressure cuff, or an IV line.
  5. Ask that your arms not be strapped down on arm boards. 
  6. Request to do skin to skin in the OR while your incision is being closed. If you cannot do skin to skin for some reason, then ask that any partner be allowed to instead.
  7. Ask that you be free to breastfeed in the OR, and that there be some nursing support and help if possible. 
  8. Ask about delayed cord clamping for as long as it’s medically safe to do so. You can also request that your support person get to trim the cord when the umbilical clamp is placed. 
  9. You can request music of your choice to be played in the OR.
  10. Ask that staff working the OR avoid “shop talk” or other personal conversations. 
  11. Request that all newborn procedures be delayed until after you and your support person have gotten to bond and do skin to skin. 
  12. Ask your provider about vaginal swabbing. This involves swabbing the vagina to collect some of the microbes baby would’ve picked up during vaginal birth. This is then wiped on baby’s skin and/or in his or her mouth. 
  13. Ask about anyone else being in the OR to film and document, like a doula, or a photographer.

My full birth plan can help you think through all of this (and more). You can snag a copy of that here.

How do I ask for a gentle cesarean?

If you noticed above, I mentioned incorporating these things into your birth plan. I think this is important for everyone, whether or not a cesarean is the known (prenatal) plan. The vast majority of cesareans in the United States are actually non-emergent. This means that they are unplanned (but not emergencies). So, if you end up in a situation where your labor turns into an unplanned cesarean, I would love for you to know how the cesarean could be “gentle” and/or what to ask for!

To plan for these things or to know what may be available to you, ask your provider about it all at a prenatal appointment. Basically, this would be a “If I end up needing cesarean birth, can we talk about the gentle cesarean practices that we could do…” and you can go from there. I’d encourage you to also have your birth support person caught up on all of this too. If needed, they can help advocate for these things at that time.

Should you have a birth plan for a gentle c-section?

Yes, yes, yes! I think everyone should have a birth plan. I don’t think these make you a “better” parent – not at all! But I think birth plans, if you do them right, make you learn. And that is SO important. As you fill out a birthplan (again, you can snag mine here), don’t just check the boxes. Ask yourself:

  • Why is this choice on birth plans?
  • What are the two sides of this choice?
  • Do I understand the pros and cons of this choice?

There is a theory, a purpose, or a hope behind nearly everything on a birth plan. And though there are not right or wrong answers about what to want, it is important to know why you are choosing something!

the takeaway on gentle c-sections

As you consider gentle cesareans, pay attention to what things feel the most important to you. The best way to ensure a gentle c-section is to discuss it with your provider long before you are ever in the OR. Prioritize the different possibilities, and make sure your partner and your provider understand your hopes. Unless a cesarean situation is extremely urgent, hospitals can provide many of these things to their cesarean families. I hope you have a beautiful experience!

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About the Author

Lo Mansfield RN, MSN, CLC, is a specialty-certified registered nurse + certified lactation consultant in obstetrics, postpartum, and fetal monitoring who is passionate about families understanding their integral role in their own stories. She is the owner of The Labor Mama and creator of the The Labor Mama online courses. She is also a mama of four a University of Washington graduate (Go Dawgs), and is recently back in the US after 2 years abroad in Haarlem, NL.


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