The Rise Of The 'Gentle C-Section'
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links."
During her son’s birth via C-section in May, Jenna Jonaitis watched her baby come out of her body. She held him skin-to-skin afterward, then started breastfeeding right away.
If this all sounds uncharacteristic of a regular C-section, that’s because it is. Jonaitis had what’s known as a “gentle C-section.” Compared with standard ones—in which the mother’s view is blocked by a drape, she is mostly uninvolved, and the baby and mother often aren’t united right away—this modernized version comes with the goal of making cesareans more humane.
This family- and patient-centered approach to surgical birth has been practiced in the U.S. for about 15 years but has only recently become more common. Cesareans account for almost one in every three births, and some women find the experience traumatizing or alienating, saying the surgery makes it feel more like a medical experience than a major life event. Gentle C-sections, on the other hand, can help women regain control and agency.
“It was very powerful and emotional,” says Jonaitis, a 36-year-old Michigan-based writer, who has had three previous C-sections that looked very different from this fourth birth. “I was able to be present with this one.”
What A 'Gentle C-Section' Entails
Developed in the early 2000s in the United Kingdom by an obstetrician, a consultant anesthesiologist, and a midwife, a gentle cesarean incorporates aspects of vaginal birth in order to emphasize the mother’s participation in the experience and support her relationship with her newborn.
For starters, surgical teams swap out the opaque blue drape—erected to keep the surgical field sterile—for a clear drape, or a drape that has a clear window so the mother can watch the birth. (“No, you won’t see your insides with a clear drape—just the baby as it comes out,” Jonaitis explains.)
And gentle C-sections often also include placing the baby skin-to-skin with the mother right in the OR, as well as helping mothers breastfeed as soon as possible.
Why It All Matters
Skin-to-skin and early breastfeeding, which most often occur after vaginal births, can have significant positive health impacts for C-section mothers and their babies. Early physical contact with their baby reduces mothers’ chance of developing post-traumatic stress disorder, according to a 2022 study, and the practice also promotes mother-child bonding and breastfeeding. For Jonaitis, holding her baby on her chest also just “made that birth feel real. It made me feel like I really am a mother,” she says.
Promoting breastfeeding is especially important for C-section moms because surgical birth can make breastfeeding more difficult. There appear to be a few reasons why this is the case, but experts don’t have a full grasp on the exact cause. One factor that seems to come into play is that it’s often harder for women to move around after a C-section—which includes getting into a good position for breastfeeding—than after a vaginal birth, and mom and baby are more typically separated during a C-section (which gentle C-sections seek to rectify). Some researchers also think the stress caused by a C-section, especially if the procedure was unplanned, might delay milk production (a.k.a. lactogenesis, or the initiation of milk production).
While a gentle C-section relies on the same surgical procedure as a regular C-section, the doctors’ and nurses’ emotional approach differs. “What you need is a change of attitude,” says William R. Camann, MD, director emeritus of obstetric anesthesiology at Brigham and Women’s Hospital in Boston. “It’s just the way [we] behave in the operating room.”
To this end, providers might put EKG leads on the mother’s side, or on her back, rather than her chest, and place the blood pressure cuff on the mother’s nondominant arm, so she can hold her newborn (again, getting that early skin-to-skin contact). A nurse might help to steady the baby in the mother’s arms, or drape a blanket over the baby, because operating rooms are kept cold to inhibit bacterial growth.
And while some operating rooms are too small to fit more than one other person (like a spouse or partner), hospitals that practice gentle C-sections may welcome a second support person, like a doula, into the room.
Lauren Cross, who delivered her twins by planned gentle cesarean in 2018 at UC San Diego Health, had a doula who brought essential oils with her. Cross, who’d previously had a traumatic cesarean, was determined to have a “joyful belly birth” this time. Still, she started to shake when she smelled the OR. That’s where the doula stepped in, putting peppermint oil on a cotton wool ball for Cross to inhale and giving her a massage through her gown. Cross says she appreciated having “someone there who could support me while my husband was able to be present at his children’s birth.”
How To Advocate For Yourself
Not every hospital advertises gentle C-sections, even if providers are willing to adopt some of the practices that make a surgical birth “gentle.” But asking about them, and even specifying details such as what kind of music will be played in the OR, is important, says Emily Likins-Ehlers, a doula in Illinois who works with C-section mothers. Some mothers, Likins-Ehlers says, may feel that “if you end up in the operating room, you have abdicated all of your power.” But making these requests—and seeing them honored—can restore a mother’s sense of agency. Jonaitis certainly felt that way. “These things helped the births feel ‘more my own,’” she says.
And while you can plan for a scheduled cesarean, unplanned C-sections still happen—which can be chaotic, scary, and overwhelming for a woman who wasn’t planning on going into surgery. But it may still be possible to have skin-to-skin and early breastfeeding, provided mom and baby are both stable, Dr. Camann says.
Perhaps most critical is talking to your provider during prenatal care about what is most important in your birth experience, says Erica Holland, MD, an ob-gyn at Boston Medical Center, where gentle C-sections are her standard of care. She recalls a woman who underwent a planned C-section who’d expressed concern about being physically exposed in the operating room. So, when Dr. Holland’s surgical team placed the woman’s catheter, her gown was pushed only above her knees, rather than up to her waist. That small yet meaningful action represents a type of patient-centered care that should be the goal not only during gentle cesareans, but whenever possible, Dr. Holland says.
For moms who may find themselves needing a cesarean they didn’t expect, and who may feel “real disappointment and sense of loss that they’re not going to have the experience they wanted,” Dr. Holland asks the mom which parts of the birth she thinks will feel important, and which of those elements can be carried into the operating room. It’s a reminder that giving birth via cesarean can still be rich and meaningful, and that the mother’s experience can play the central role.
Rachel Somerstein is a journalist whose new book, Invisible Labor: The Untold Story of the Cesarean Section, examines the state of maternal health care in the U.S. and explores alternatives to the current standard of care, including a new method of cesarean called a ‘gentle C-section’. Somerstein was inspired to research and write the book after her own experience with an unplanned, complicated C-section with her first child.
Photographed by Joe Lingeman. Prop styling by Andrea Bonin.
You Might Also Like
