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Your Baby

A Kinder, Gentler C-Section Birth

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When it comes to having a baby, whether a woman delivers vaginally or by cesarean section, the one thing they have in common is the desire parents have to hold their newborn.

Many women who have had a cesarean section will tell you that the surgical procedure left them feeling like they missed the pivotal moment in giving birth; the physical connection between mother and child.

Oftentimes, the baby is whisked away moments after birth leaving the mother without her newborn.

While C-sections have leveled off in the last couple of years, they are still up 500% since 1970. The reasons for cesarean delivery have changed dramatically from ancient to modern times.

The origins of the cesarean birth are somewhat clouded in mystery, but according to the U.S. National Library of Medicine, “… the initial purpose was essentially to retrieve the infant from a dead or dying mother; this was conducted either in the rather vain hope of saving the baby's life, or as commonly required by religious edicts, so the infant might be buried separately from the mother. Above all it was a measure of last resort, and the operation was not intended to preserve the mother's life. It was not until the nineteenth century that such a possibility really came within the grasp of the medical profession.”

These days C-sections are performed for a variety of reasons. In most cases, doctors perform cesarean sections when problems arise either for the mother or baby or both during birth. However, there are also times when possible health issues are known ahead of time and a C-section can be scheduled to prevent complications.

For the most part, the procedure hasn’t changed much since it began being used in modern times.

During a planned traditional C-section, the woman is given medications to dry the secretions in her mouth, her lower abdomen is washed with an antiseptic solution and possibly shaved. She is given an anesthetic and a screen is placed in front of her face to keep the surgical field sterile – blocking her view of the delivery. She may or may not be able to hold her baby immediately after birth.

A new approach to C-section deliveries may offer some families an option they never dreamed possible.

Doctors and nurses at the Center for Labor and Birth at Brigham and Women’s Hospital (BWH) have developed new procedures to make the C-section more family-centered. Dr. William Camann, Director of Obstetric Anesthesiology, explained that the goal of the family-centered cesarean, or “gentle-C,” is to make the delivery as natural as possible.

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.

Skin-to-skin touch isn’t just an emotional fulfillment for the mother, research has shown that normal term newborns that are placed skin-to-skin with their mothers immediately after birth do better physically and psychologically as well.

“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,” Trainor said.

With the updated procedure, dads can also hold and touch their newborn. 

Camann acknowledges that changes in the traditional cesarean section require some readjusting from the hospital medical staff.

“It requires (doctors and nurses) to just think a little bit differently than the way they have usually done things,” Camann said. “Once they see this, they usually realize it’s really not that difficult.”

Nationwide, the procedure is starting to take hold as more hospitals begin offering the "gentle-C".

Camann says that the procedure isn’t recommended for every C-section birth. He also emphasizes that it’s not in any way meant to promote more C-sections.

 “We would all like to do fewer C-sections. But there are women who need a C-section for various medical reasons and if you do need a cesarean, we want to make this a better experience,” he said.

Sources: http://healthhub.brighamandwomens.org/the-gentle-cesarean-a-new-option-for-moms-to-be#sthash.hxehc5es.dvbG5DgD.dpbs

A. Pawlowski, http://www.today.com/parents/family-centered-gentle-c-section-turns-birth-surgery-labor-or-2D80542993

http://www.webmd.com/baby/features/what-to-expect-cesarean-delivery

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