how to have a gentle* cesarean

*surgery can't ever really be gentle - but we can make it less traumatic

Krystal Trammell

Mar 10, 2016

What should you do if you find out you’re facing a Cesarean birth?

Is it possible to have a gentle Cesarean?

So, surgery in general is going to be perceived by the body as violence.

Instead of using “gentle Cesarean” as a sad euphamism - let’s focus on how to have a less traumatic Cesarean birth.

Okay - imagine for a second that you’ve gotten some upsetting news as an expectant mama:

“You’ll need to have a Cesarean.”

Whoa... This is NOT what I had in mind. What’s going to happen now?

Certainly I can’t speak for everyone, but I think I know how I’d feel, hearing those words…just thinking about it.

I think Cesarean birth is a spectre that haunts many pregnant women, regardless of their actual risk factors that might necessitate having one.

First, just breathe. Yes, really.

Take a deep, slow breath, and exhale, releasing some of that tension you must be feeling. Now, what are the circumstances you’re facing, exactly?

Just because your care provider said “the C-word” doesn’t necessarily mean it’s inevitable – or even in your and your baby’s best interest.

I don’t want to sound overly optimistic, but things can and do change.

Next – get as much information as you can.

Why is your care provider recommending this course of action? Is it possible things will change as you get closer to your estimated due date? Are there other caregivers who may hold a different opinion?

Usually this is worth making a second or third appointment, perhaps elsewhere, depending on your options as far as insurance and/or your local area.

It’s important to remember that birth is a business for healthcare providers.

Cesareans are massively over-used, highly profitable, and typically more convenient for OBs - and so the first thing you’ll need to do is clear your head, and start looking into the research (not just the first page of Google) about what’s going on with your pregnancy and whether a Cesarean really is the best and most reasonable course of action.

Plenty of women are labelled “high risk” and then frightened into major abdominal surgery when really, it’s unwarranted in their case. Cesareans are life-saving, amazing technology - but when one of every three babies is born via surgery, something is amiss.

Okay – so what if you’ve explored the other possibilities and are still faced with the reality of a Cesarean?

The first positive and important thing you can do is to work on NOT feeling like a failure, or disappointed in yourSelf.

Those sorts of feelings do nothing to assist you in moving forward, and keep you stuck in an unhelpful cycle of blame, guilt, or sadness.

It IS what it is.

Accept it, breathe, and step forward with courage.

Acknowledging and exploring your feelings in a holistic, emotionally-based childbirth course may be very helpful in allowing you to come to a place of peaceful acceptance about this change in your birth plan.

You love your baby so much that you are willing to do whatever it takes to ensure his or her safety. That is powerful, sweet mama.

It’s absolutely okay and right to mourn the loss of the birth you had wished for, planned for, truly wanted and desired. Allow those feelings to flow through you, in the form of tears, rage, loss, or whatever you’re moved to feel.

Embrace those feelings of sadness for a time – but try not to let them define you… don’t let them overtake you.

Depending on circumstances, you may not have much control over your Cesarean birth. However, it may help if you have some time to shift your thinking and become more at ease with the idea.

A planned Cesarean does have more potential to be calm and family-centered than an emergent one.

Now, some of these suggestions might not be helpful or possible for your unique situation – so take what’s useful to you and don’t worry about what’s not…and let's explore how you can have an empowered Cesarean birth!

Preparing for your gentle Cesarean birth:

Even with a Cesarean birth, it’s best if your body begins labor on its own. The onset of labor contractions is a strong indicator that baby is truly ready to be born, with adequate lung development. Also, the unique ocean of hormones that are released once labor begins affects both you and your baby: the brain, heart, internal organs, etc. Allowing these hormones to release and work in harmony as nature intended aids in bonding, establishment of your milk supply, baby’s rooting and other reflexes.
Read birth stories about women who’ve had compassionate, respectful, empowered Cesarean births – there are many stories out there!
If you must set a date for the Cesarean instead of waiting until labor begins – barring further complications, schedule it as close to your due date as possible. One more week in the womb can make a lot of difference in terms of giving baby the most time for unhindered development.
One discussion to have with your care provider is the type of incision and suturing they will use for the surgery. Vaginal birth after Cesarean (VBAC) is absolutely possible - and many women have homebirthed and freebirthed after a Cesarean (or three!). The rate of VBAC success is quite high - make sure you get the facts. A low, transverse incision with double-layer sutures carries the least risk for future vaginal births.
Look into ways to make your Cesarean birth as peaceful and calm as possible. Make sure to have a written, clear, simplified birth plan, including details about what you’d prefer to have happen immediately after baby is born.
Many OBs are open to using a clear drape in the OR, having a doula with you and your partner in the operating room, and playing music of your choice via your smartphone! You can also ask that voices be hushed, that there aren’t any unnecessary staff in the room, etc. Don’t be afraid to speak up and expect that your requests are honored. It’s your birth, and it’s entirely resaonable for you to want it to feel more like a sacred transition, and less like a procedure.

In the operating room and recovery:

In almost all non-emergent cases, newborn procedures can wait. Or, they can be done with baby placed skin-to-skin on your chest, immediately afterward, while they’re still closing your incision.
Depending on how you feel, you may even be able to get started with your baby's first breastfeed in the OR. If you find that you are not up to that, however, please don't worry or feel guilt. You must take care of yourself as well as your baby, and while the first latch is important, so is your recovery process!
Make sure you’ve got the number of a lactation consultant or your local La Leche League leader for help with potential breastfeeding issues in the first hours and days (this is crucial, because the first 12-36 hours are so important to catch little problems in, before they swell into much bigger issues!).
Sometimes Cesarean mamas experience their milk being a bit slow to come in (especially if you did not get to experience the onset of labor). This is typically NOT an issue, as colostrum is highly nourishing and the ideal food for newborn babies in the early days. Generally, if your milk isn’t quite in yet, baby’s not that hungry—! You and your baby are more intimately connected than you can imagine. Make sure to check in with an LC or breastfeeding counselor about any concerns.
Sometimes it’s tricky to find comfortable nursing positions that don’t put pressure on the incision. The football hold or side-lying positions will be great to learn. The postpartum nurses are sometimes very well-trained in breastfeeding (but sometimes, not!). If it feels right, you can ask for their help.
It’s worth mentioning here that in many Cesarean births, it’s still possible to obtain your placenta for encapsulation. You can discuss this with your care provider and nurses beforehand – but it is possible! The benefits of placenta encapsulation include increased milk supply, extra energy for healing, and less risk of developing PPD, which are all especially important for Cesarean mamas.

Once you're home and healing:

Make sure to have good, reliable helpers enlisted for while you’re in the hospital, and especially as you recover at home. Ask friends or family to start a meal train or bring over meals, help with household chores, etc.
Please, please consider hiring a postpartum doula. Friends and family are great, but there's nothing quite like a seasoned professional who specializes in helping you to care for baby, rest, and heal.
Make sure to be mindful and aware of the signs of postpartum depression (which sometimes feels more like anxiety or a state of near-constant alertness). Recovering from childbirth is not always easy, and when you’re recovering from Cesarean birth, you’re also healing from major surgery.
Look into Arvigo Maya abdominal massage. It helps your internal organs to heal and return to their proper places.
Get a nice healing balm for improved comfort at the site of your Cesarean incision. Try herbalists on Etsy!
Look into the ancient technique of binding your belly (Bengkung) to support your muscles & midsection as your body recovers.
Eat plenty of nourishing, warm, and healthy foods - soups, herbal teas, and healthy fats. (Ask friends or family to cook for you - they may be delighted to help!)
Rest in your own comfy bed with fresh linens and a soft robe.
Fill your room and house with fresh flowers or green plants (clean-air plants) - or ask any visitors to bring you some!
Use aromatherapy with high-grade essential oils in a cool mist diffuser.
Get some sunshine and fresh air on your face and/or body daily, even if it’s only for a few minutes.
Focus on simply being with your baby - nurse often, and be skin-to-skin as a family frequently. Make sure you’re all getting lots of cuddle time!

Finally, be so very kind and gentle with yourSelf, sweet mama.

Be aware of your emotions and feelings, and let them flow through you as you integrate this experience, in all its beauty and difficulty.

In order to truly heal and accept ourselves, we must feel deeply, but acknowledge those feelings as a passing state – not a definition of who you are or what you’re capable of.

You are still moving forward into this momentous journey of motherhood – just, your path has been shifted slightly from what you’d originally planned. The road may be different, less than ideal, but it is still your journey to savor.

Cesarean birth is a blessing in many circumstances, and we can do what we can to reclaim it, even if it wasn’t the birth experience we wanted.

Thankfully, many care providers are becoming more aware of the emotional impact of Cesarean birth, and are willing to work with your family to create a positive and peaceful experience.

So, even if a Cesarean was not what you originally planned on – please know that it’s absolutely possible to have an empowered Cesarean birth!

Need more support? Get my Birth Plan Kit - which includes sections on induction and Cesarean birth, and is ideal for those who had a more natural birth experience in mind!