The Gentle Cesarean SectionheadingContent
I was asked about “The Gentle Cesarean Section” – a new concept and an idea which is interesting. The goal is to create a warm and nurturing environment for birth, even when the birth involves cesarean section (C-section) surgery.
Can a cesarean be “gentle”?
This answer is complex.
C-section deliveries are surgical procedures performed under anesthesia in a sterile operating room (OR). Certain standards must be met:
- Absolute sterility
- Comfortable and cool environment for the patient and doctors
- Adequate lighting and visualization
- Pediatric staff to check the newborn for difficulties
- Adequate anesthesia
Anesthesia is usually regional – epidural or spinal. One partner, normally a family member, is typically present in the OR for support. Safety and good outcomes for both mother and baby are paramount. Modern medicine has done an excellent job with creating safe operative deliveries; complications are now very uncommon.
So, what is done differently for the gentle cesarean?
In the past, after a delivery, the obstetrician handed the baby to the pediatric staff, who in turn took the baby into a warmer area. The baby was examined and kept from the mother until after the C-section was finished.
The gentle concept now encourages the baby to stay with the mother. If the mother is comfortable and awake, the baby is handed to the pediatric staff, who checks the baby for any issues, and then places the baby on the mothers chest, skin-to-skin. The baby then stays with the mother at all times, both in the OR and out.
The gentle cesarean may also allow a family member or the patient, to witness the birth through a plastic curtain, which may be available at some hospitals. It is usually not advisable to lower the standard blue curtain, which is used at most institutions, due to sterility issues. In these instances, the support person may step away and briefly watch the baby’s birth through the abdomen. The entire surgery may not be viewed, as some non-medical personal may misinterpret what is happening and even become ill.
Is the surgery itself more gentle?
The answer is no.
Surgeons already understand this concept. Good surgical technique involves gentle handling of tissues and adequate bleeding control. Optimal skin closures utilize stitches under the skin and glue on top. This cosmetic skin closure technique may not be utilized for all cases; for example, a vertical incision cannot be closed this way.
Are there gentle ideas which have been proposed but are not allowed?
The answer is yes.
Some have also proposed that multiple family members and/ or support persons be allowed in the OR. This is also not advisable. A surgical OR must be sterile and in control. Complications may arise and a “crowd” may hinder both the anesthesiologist and the obstetrician.
In conclusion, “The Gentle Cesarean Section” is a good idea because it promotes mother and baby bonding. But safety must always be a primary concern.