How to Plan a Gentle Cesarean

Please help me welcome Lynn Turcotte-Schuh, who has written this guest blog post for us today! She is a child birth and parenting expert, and the owner of Happy Mama Wellness. Lynn helps expecting families prepare to welcome their little ones, and care for them after they arrive.
​Thank you Lynn for your wisdom, and for this incredibly informative guest post for our audience. 

​As a first-time expectant Mama, you want to be prepared for anything and everything. The problem is, most of what lies ahead will be out of your control. Rest assured, no matter HOW your baby enters the world (vaginal, traditional cesarean or gentle cesarean) you can still have an empowered birth experience!
The large majority of Mamas are going to enter their birth experience laboring towards a vaginal birth. Nationally, just over 30% of those Mamas will end up having a cesarean birth.

​Hey there! My name is Kelly Maher Carvell, CLC, CLE.
I offer effective telehealth lactation support and education to modern families.  
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What is a cesarean birth?
The American College of Obstetricians and Gynecologists (ACOG) defines a cesarean birth as:
the delivery of a baby through incisions made in the mother’s abdomen and uterus.
https://www.acog.org/Patients/FAQs/Cesarean-Birth

What happens during a cesarean birth?
The procedure itself begins with the doctor cutting a 4-6 inch incision through the skin and the fat layer of the abdomen. Then, they separate and shift the muscles in the abdomen. They will then cut a second 4-6 inch incision into the wall of the uterus.
The baby is delivered through the two incisions. Next, the doctor clamps and cuts the umbilical cord. Finally, the placenta, cord and amniotic sac are delivered through those same incisions. The doctor repairs the incision in the uterus with dissolvable stitches. They repair the outer incision with either stitches, staples or glue.
Generally, from the time the doctor makes that first incision to the time baby is delivered is about five minutes. The remainder of the procedure takes up to one hour.

But Let’s Get Real Here
Defining a cesarean is very different than understanding the EXPERIENCE of a cesarean. So, let’s tackle that.
Most Moms will be heading to cesarean after laboring for a period of time. Even the Moms who have a date and time for their procedure are still feeling all the feels.
Some Moms may be feeling like a failure. Some Moms may feel scared for themselves. Still others may feel scared for their baby.
And in the midst of this, you are signing paperwork, going under anesthesia and undergoing major abdominal surgery. Your stress hormones are probably through the roof and you may be mourning the birth experience you thought you would have.

Enter the Gentle Cesarean
The Gentle Cesarean is an attempt to make surgery feel like birth. The procedure itself (as described above) will not change. The environment and emotions are what can change.
Every hospital (and even by individual doctor) will have their list of things that they are willing to address in a Gentle Cesarean. It’s worth having a conversation ahead of time and adding the things you want into your birth plan.

Here are the most common options/changes you can request during a Gentle Cesarean Birth:

Avoid extra drugs. Some anesthesiologists will provide extra medication to help you feel more relaxed. Those same medications can often make you feel “spacey” or unaware. Avoiding these medications means you have the ability to truly experience and remember the birth of your baby.

No restraints. During a traditional cesarean, your arms are in restraints as it would be very dangerous for you to get your hands into the sterile, surgical area. In a gentle cesarean, especially if you’ve avoided extra medications, you may be more alert and aware of your actions rendering the restraints unnecessary.

Music. Bring your playlist into the operating room and feel the stress levels drop.

Talking. Many medical teams will limit the “chit-chat” during the procedure to allow to hear your music playing and your baby’s first little cry.

Clear divider. Traditionally, a blue “curtain” is hung just below your chest in a vertical direction. This blocks your view of the surgery (which may be something you want) but it also blocks the birth of your baby. You can request a clear divider so you can see your baby be born.

Delayed cord clamping. This is one you may get more push back on as your doctor may be hesitant to prolong your procedure for a delayed cord clamping. Traditionally, the doctor clamps and cuts the cord as soon as baby is out. This doesn’t mean that you can’t make the request.

Immediate skin-to-skin. This requires several adjustments ahead of time. The team places the EKG somewhere other than the chest and they lower your surgical gown to expose your chest. From here, your baby can be brought right to you for TRUE skin-to-skin, breastfeeding and bonding. 

​Newborn procedures delay. With vaginal births (in most hospitals) all newborn procedures are delayed for at least an hour to allow for skin-to-skin. You can request that your baby stay with you doing skin-to-skin until you are ready to go to your postpartum room.
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Doula. Some doctors will override the “one support person” rule and allow a doula in the OR with you and your partner.

Let’s Recap
No matter HOW your baby enters the world (vaginal, traditional cesarean or gentle cesarean) you can still have an empowered birth experience! The way you do that is by:

• Knowing your options
• Advocating for yourself and your baby
• Making the choices that are right for YOU and YOUR baby

If you are faced with a cesarean delivery, remember you have not failed. You grew this tiny human and you will never be anything less than a badass for doing so! Be proud of yourself and trust in whatever choices you make.

Lynn Turcotte-Schuh

Guest Blog Post Author

Lynn Turcotte-Schuh is a CAPPA Certified Childbirth Educator and a Parenting Coach. She is also the Chief Executive Mama at Happy Mama Wellness where she helps Mamas master calm and connection. Lynn is highly passionate about helping Mamas feel empowered in pregnancy, birth and beyond. When not supporting families, she loves to spend time with her own. Her wife, daughter and small farm of animals keep her on her toes. She is a nature lover and tries to go barefoot outside every day (when it's warm enough). She is teaching her daughter to love herself, love life and love Mother Earth.