Hello. Welcome to episode five of C-section support by OT in motherhood podcast. Today, we're going to talk about how to have a gentle C-section. You might be wondering what is a gentle C-section. So it's not a specific way of doing the surgery, but more of a gentle approach to the birth. It aims to make the experience more like a vaginal birth with the baby going to the mother as soon as possible, and it also promotes early initiation of breastfeeding. The approach involves the family and also provides more choice and control over the experience. It aims to have the C-section more like a personalized birth experience rather than just a surgery experience where it values the emotional side of birth as well.
I've realized that a lot of aspects of my own births had a gentle approach. I hadn't actually heard of this term before I had my oldest daughter. Because my birth was a planned C-section I was given the opportunity to fill out a birth plan by the hospital and on that, it had tick boxes and some space to fill in comments, and it had some choices that could easily be incorporated into the birth. And since then, I've also heard of approaches that might be possible depending on your provider and your obstetrician as well. So today I'm going to talk about a few common options and choices that you might be able to incorporate into the birth of your baby.
The first one is having your support person with you for as much as possible of the birth experience. So for me, my husband was with me while I had my spinal anesthetic, and then he was apart from me for that brief period where I was taken into the theater. So the hospital where I gave birth, the anesthetic happened in a room off to the side and that's partly because the hospital had one theater that was just for C-sections. So it was a bit of like a revolving door of women going in. So one woman would be getting the anesthetic while another would be in the theater, having their baby. And I actually heard a baby's first cries when I was getting my anesthetic sorted out from in the different room. So yeah, he was apart from me just for that time that I was wheeled into the theater and then moved onto the actual operating table. And everything was set up and then he was brought in and was able to sit right by my head, basically. And then obviously he was there throughout the actual birth. And then while I was moved into recovery, he was with me there as well, until I was taken all the way up to the ward and then stayed with me for several hours after that.
I gave birth to both of my babies in a public hospital, so my husband wasn't able to stay overnight, but he stayed for the duration of the visiting hours after I'd had both of my babies. It was really important and valuable for my husband to be there throughout the birth because obviously it's the birth of his kids as well, and it was a great emotional support for me. Um, and he remembers different things than I do - there's some parts I just can't remember and he's able to remember those. So that's really special as well.
Another thing that's quite easy to do is to have music playing during your births. Uh, so I think for my daughter, we, uh, I went into labor early. And we hadn't actually sorted out a playlist, and for my son we had but I don't even remember if we handed over the phone to get the playlist played because I have no idea what music was playing during the birth. I think they did ask us and even for my daughter as well, they did ask us what we wanted playing like what radio station or what type of music? Um, I don't remember what I said and I would have no idea what song was playing. I think I was just so focused on my baby that, yeah, I didn't hear any music at all, but that might be something that you really value. Maybe you have some music that you find really relaxing or that you just want to associate with the birth of your baby going forward. Uh, and you can make up a playlist on Spotify, there’s existing playlists you can look into and see if any of those suit you.
One aspect of a gentle C-section that I don't think I had and is, uh, obviously up to the surgeon is actually having a slower delivery of the baby. So I've heard that they can deliver the baby’s head first and then slowly let the rest of the body birth out the incision, so it's more closely mimicking a vaginal birth. And the benefit of that is that it can help the fluid be squeezed out from the baby. One thing that does happen in c-sections is that babies can have a little bit more fluid. Which again, I didn't know with my first daughter until it was the first night and she was making funny noises. And then the midwife was saying, yeah, it was because she had extra fluid. So that could be something that, you know, you need to speak to the obstetrician about and see what can be done okay.
Another is having the drape dropped. So you have a, a drape or a big sheet put up around the level of your chest so that you can't see the surgery. Um, and this is obviously partly also to create that sterile surgical field as well. They don't want to introduce any germs because you are obviously open on the table, and they don't want to increase that risk of infection. So what happened with my son, we opted to have the drape dropped as he was born. So I wasn't able to see my open incision because of just angles and everything. But just before he was pulled out, there was a staff member on each side of the drape and they dropped it down so that we could see him lifted up. Associated with that, we were able to find out his sex ourselves. We didn't know in advance if we were having a boy or a girl. Um, and with my daughter, they tried to do that. The pediatrician brought her around the drape, but I honestly couldn't even tell if she was a boy or a girl because of where the pediatrician's hands were. So in the end, he actually announced it was a girl. Um, but with my son, yeah, the pediatrician held him up and we could see that he was a boy and were able to, you know, make that discovery for ourselves, which was pretty special.
I have also heard of the possibility of having a clear drape. So still maintaining that sterile field, but you can see more of the process. Again, that's going to depend on what's available at your hospital. Um, so that's something that you can talk about with your provider.
Immediate skin to skin is something that's really valuable and that can happen quite often in a vaginal birth, but can be more of a barrier during a C-section birth. Obviously skin-to-skin has great benefits for the baby's wellbeing, but also the mother as well. Now I didn't have immediate skin to skin. Basically for my son and my daughter though, both were held up so I could see them. Then they were taken off to the side, just checked over and you know, vitals taken and any sort of essential measurements taken. And then my husband went over and cut the cord, which again is something that can be really special. They will ask, uh, generally if your support person does want to cut the cord. So they will cut the cord and then the baby will be brought over to the mother. So it's generally a couple of minutes. Generally not more than five minutes. Of course, this depends on if the baby needs any extra assistance. But they will be brought over to you and you’ll be able to have skin to skin. Now something to be aware of ahead of time, if you do want to have skin to skin, is they might prepare you beforehand by making sure that your gown is on . . . So I think I put my gown on back to front for my daughter, so it could be easily opened like at my chest. And the leads that are placed on you to monitor your vitals during the surgery can be placed potentially on your back or just on areas that it's not going to get in the way of, you know, when the baby is placed on your chest. So that happened with my daughter. I had skin to skin straightaway.
With, like the location of the drape, there’s really not much space between basically your head and where the drape is. So my daughter was placed quite high on my chest, pretty much under my chin, really. So I couldn't really see her because I couldn't move my head. Um, and I think they placed her there just because, you know, to maximize the skin to skin with me to keep her warm. And they put the blanket over the top of her because operating theaters are quite cold. With my son, he was actually wrapped up and I'm not sure why, because we did request immediate skin to skin, you know, as soon as possible. And I do actually regret not sort of realizing and asking at the time, you know, can he please be unwrapped and placed on my chest? So because he was wrapped up, he was more placed like in my arms so I was able to see him more clearly.
Both times my baby stayed with me as I was wheeled into recovery, and then throughout the time in recovery, and then wheeled onto the ward. I was also helped and encouraged to breastfeed in recovery, which I was able to do successfully for both babies. I've heard of this being promoted in theater but I think in some ways it would be a little bit more difficult. And like I said, partly the logistics of how high the drape is placed, that there's not much space to actually place the baby. Uh, whereas in recovery, of course, you've had the drape removed, there’s more space that the baby can be positioned on your chest. And you've got the midwives there that they've got a little bit more time and space to help you initiate that breastfeeding as well.
Something else that's really valuable is getting photos taken. I don't have photos of my baby's birth, like during the actual birth process. It was very clear instructions to my husband, that he had to stay seated at my head until he was told otherwise. So obviously with him cutting the cord, he was able to go over to the little bassinet and cut the cord and then come back to me. But otherwise he was told - you’re not to stand up and you're not to move. I think they've had probably too many instances of support people fainting. I know that one midwife said that that's definitely happened before. So it might not be possible to get photos of the actual birth. It might depend on the staff. So you might be able to ask a midwife there, or you might be able to have an additional support person, whether that's a doula potentially, or an additional family member. Or something that you might be able to have is a student. I didn't have a student for my eldest, but I did have a student throughout my pregnancy for my son. Unfortunately, she was unwell on the day of my birth. So she wasn't actually there. But if you do have a student, you can hand them your phone and tell them that, as much as possible, they’re responsible for taking photos. I do have photos though, that were taken in theater. And that was when my babies were born and they were in my arms. And then the staff member took our first family photos, which are really special. So on that note, it might be a good idea if you are having music as well to have two phones. So have your support person have big pockets and have both your phone and their phone in their pocket - one for music and one for photos as well.
All right. So that's just an introduction of some fairly common ways that you can have a gentle C-section and some choices that might be available to you. There are some other things that I've heard of that are probably a little bit more rare and a bit more niche. And again, not all hospitals would be open to those - I think I’ll talk about them in another episode, so stay tuned. For now, if you haven't had your baby yet, then it can be a good idea to talk to your partner or your support person about what options you might want to pursue during your birth experience. Write a list, take it to your next appointment with your provider to discuss what might be possible. As I've mentioned earlier, each hospital and obstetrician will have their own guidelines. So it's good to know what is possible, and also have that opportunity ahead of time to advocate for your preferences. And obviously the earlier that these things are discussed, then the more time you've got to advocate for what you want. And for the hospital or the obstetrician to make those considerations for you.
Thanks for listening today. Feel free to contact me at ‘OT in motherhood’ on Instagram, if you have any comments or suggestions for upcoming episodes. Don't forget to subscribe below, check out the show notes and I will see you next time. Bye.