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That moment when your child is placed into your arms for the first time is something you won’t forget. You may have a picture in your mind of how your birth will go or — at least — of how you want your birth to go.

Surgery may or may not be part of that picture, but it’s sometimes necessary. After all, cesarean deliveries, also known as C-sections, represent just under 32 percent of all births in the United States — a significant number.

If you’ve been told you’ll need a C-section (or you’re just preparing for all scenarios), there’s an option you may want to explore. It’s called a gentle C-section.

Here’s more about this growing practice, what it involves, and how you can plan your own experience.

A gentle C-section (also called natural cesarean or family-centered birth) is a surgical birth that incorporates various aspects of an unmedicated vaginal birth.

It’s intended to take the sterile environment of the operating room (OR) and make it more friendly and welcoming to things like immediate skin-to-skin contact, breastfeeding, and overall bonding time in those first moments after delivery.

Gentle C-sections may be particularly attractive to those who have experienced trauma during a previous surgical birth. It’s a way to heal and take back control in a situation in which you may otherwise feel somewhat powerless.

The “golden hour”

The first hour of a baby’s life is sometimes referred to as the golden hour. During this time, your baby may be particularly alert, active, and eager to breastfeed.

Traditional C-sections may involve more separation between you and baby during this short period. A gentle C-section, on the other hand, is all about capitalizing on the bond between you two from the moment baby comes into the world, regardless of the clinical surroundings.

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Other potential benefits of a gentle C-section include:

  • You may feel like you were able to have an active versus passive role in birth.
  • Babies may have a regulated body temperature and heart rate from early skin-to-skin contact.
  • Bonding and breastfeeding (for both of you) may also get off to a more successful start.

How exactly does a traditional C-section differ from a gentle one? Well, the surgery part remains the same, with all the same skills and safety practices in place. It’s the approach and feel of the room that are modified to meet the family’s desired plan.

Here are some of the main differences:

Traditional C-sectionGentle C-section
You wear a surgical gown and don’t necessarily have influence over the environment of the OR.You may choose to wear your own clothing (if the hospital permits) and have music or dimmed lights to set the tone.
Monitors are set up as designated by hospital staff.Monitors, such as the pulse oximeter and electrocardiogram, are purposefully positioned to lead away from the body to allow freedom of arm movement and ample space for skin-to-skin contact after birth.
Surgery is performed with the surgical curtain up to maintain a sterile environment.Surgery is performed with a “peek-a-boo” or clear curtain to allow you to observe baby being born while still maintaining safety.
Baby is delivered quickly; cord is cut promptly after birth.Baby may be “walked out” of the uterus and you may request delayed cord clamping/cutting.
Baby is monitored and weighed by hospital staff in the first window of time after birth.Baby is moved from the uterus to your chest for skin-to-skin contact and early breastfeeding. Assessments are done at a later time whenever possible.

Even if you’re still early on in your pregnancy, you may want to talk to your OB-GYN about their thoughts on a gentle C-section. Some providers may not be familiar with the practice.

Others may know it well, but there may be certain policies in place at your hospital that would make it difficult. Understanding your OB’s comfort level and your hospital’s guidelines will help you plan.

Alternatively, if you feel strongly about a gentle C-section and your situation doesn’t look favorable, you may consider finding a provider or hospital that allows you to have the birth you’re envisioning.

Some questions to ask:

  • Are you familiar with a gentle C-section? Are other doctors in your practice familiar as well (for example, those who may be on call if I go into labor early)?
  • Are there any conditions I have (or that my baby has) that would make any of my requests not possible? If so, what are my options?
  • Does the hospital have any rules in place that would not make my birth plan possible? Who can I contact for specifics?
  • Are additional people permitted in the OR during birth, such as doulas or photographers?

Genevieve Howland, author of the popular blog Mama Natural, outlines a number of areas you can work into your own birth plan if you’re seeking a gentle C-section experience.

During the C-section itself:

  • Request an epidural or spiral block versus general anesthesia. This is a reasonable request unless you must have emergency surgery.
  • Request that your anesthesiologist doesn’t administer any other drugs without your consent. For example, some drugs help calm or sedate you throughout the C-section, but they may make it difficult to concentrate on the birth.
  • Inquire about clear or “peek-a-boo” drapes that allow you to view baby being lifted from your body during surgery.
  • Ask that monitors be placed in areas that facilitate easy movement so you can hold and breastfeed baby after delivery.
  • Similarly, ask if your gown can be moved to allow baby to have skin-to-skin contact as soon as possible.
  • Request to delay cord clamping and cutting until after the cord stops pulsing.
  • Ask for the placenta to be saved or frozen if you plan to encapsulate it or wish to keep it for another reason.

After your baby is delivered:

  • Clearly communicate if you’d like to breastfeed in the OR so the team will be ready to help you get into the best position.
  • Designate your partner (if you have one) as a skin-to-skin contact after birth if you’re unable to do it for some reason, such as in the case of an emergency C-section.
  • Request that post-birth assessments and procedures (like weighing, bathing, etc.) are delayed until after optimal bonding time.
  • Ask if you can hold your baby while being wheeled into the recovery room.

Other considerations:

  • Request that you may play your own soundtrack or dim the lights during the C-section.
  • Ask if a doula or other family member or friend may photograph or film the birth.
  • Inquire about a vaginal swab, which involves your OB collecting a swab of the microbes from your vagina. This swab is then wiped onto your baby’s skin, mouth, or your nipples to supply a healthy microbiome, similarly to when babies are born vaginally.

Again, it’s important to discuss any policies or other rules with your OB and hospital to see what’s possible. Certain rules are in place for a number of reasons, so it’s important to work with your healthcare team to ensure you get the most out of your birth experience.

Related: Why “vaginal seeding” may help babies born via C-section

Even the most detailed birth plans should leave room for the unexpected.

Your healthcare team has your and your baby’s health at the top of their priority list. This means that if something isn’t going smoothly for either of you, they may need to pivot from your birth plan to ensure everything’s OK.

This could involve anything from needing an emergency C-section under general anesthesia to needing to closely monitor baby in a warmer after delivery.

No two births are the same, so it’s helpful to be flexible and understanding as plans potentially change. Your OB-GYN will work with you and try to stick to your desired plan. However, you’ll need to understand if there’s an emergency situation in which doing so may be impossible.

If you’re particularly concerned, consider adding some plan B details to your birth plan. For example, if you need to go under anesthesia, your partner could do skin-to-skin with your baby until you’re awake and ready yourself.

Babies come into this world in many different ways. While you can’t dictate every last detail of how your particular birth will go, you may be able to make parts of your C-section feel less clinical.

Speak with your OB-GYN and contact your hospital to find out what rules you need to take into consideration when making your birth plan. Otherwise, communicate your plan to your partner and your team — and get ready to have your baby!