Gentle Cesarean: How To Have A More Natural C-Section

This is a guest post from natural mama Abby Deliz. Abby is a mother of three children (Luke, 8; Hannah, 5.5; and Landon, 7 months), and she is also a Master’s student at Claremont Graduate University. Abby has contributed several other wonderful articles on this site on the topic of c-section recovery.

Enter Abby

For women who wanted a natural childbirth, it can be disheartening – and even traumatic – to end up having a cesarean section. This was surely my experience, especially after my first child (an emergency cesarean) and my third (a planned VBAC birth after two cesareans that ended in another surgery).

What are the repercussions of a cesarean?

C-sections come with plenty of negatives – a longer hospital stay, weeks of recovery time, and lifting and driving restrictions. Emergency cesareans often come with added emotional trauma and increased rates of postpartum depression and anxiety.

A cesarean mama might feel that her birth experience didn’t measure up to what it was “supposed” to be, to what her friends experienced, or to what she heard about in the media. She might have been completely unconscious when her baby was born with her arms strapped down and loved ones out of the room. Baby might have been 10 feet away, surrounded by doctors, or even taken to the NICU.

Mama might not meet her newborn, let alone breastfeed him or her, until hours later.

Does a cesarean have to be a traumatic experience?

No. The answer is simple. You can make your surgical birth experience almost everything you dreamed of when you planned a natural birth. It’s thankfully a new trend we’re seeing in some hospitals and the practice is called Gentle Caesarean.

A gentle cesarean can be part of your birth plan if you know you’ll need a c-section, or it can be part of a back-up plan if your intended natural birth and/or VBAC fails.

The best part about a gentle cesarean is that you can pick and choose which aspects will create your ideal birth atmosphere.

What is a “Gentle Cesarean”?

A gentle cesarean (sometimes called a family-centered birth) includes many features, but its overall purpose is to invoke a peaceful, calm atmosphere that closely mimics what happens during and immediately after a natural childbirth.

If you prefer a gentle cesarean to the traditional protocol, you’ll want to add the following to your birth plan

  • Mama should request an epidural or spinal block; general anesthesia should be avoided at all costs, barring any emergencies
  • Mamas should request that anesthesiologists do not automatically give her extra drugs to relax, so that she can be fully present for the experience
  • If mama cannot be conscious, father should be allowed to hold baby skin-to-skin immediately after birth, barring any medical complications with baby
  • If mama has EKG or baby monitoring devices, they can be placed in areas that don’t infringe her ability to see, hold or breastfeed baby.
  • Mama can watch baby lifted from her belly through a clear drape; if this is makes you squeamish, the drape can be lowered and baby can be lifted above it
  • Mama’s gown can be lowered and baby can be placed on mama’s chest while mama is being sutured. To facilitate this, mama must ask that her arms are not strapped down
  • Baby can breastfeed immediately while in the operating room
  • Parents can request cord clamp/cut delay until it stops pulsing
  • Parents can request that the placenta be saved and/or frozen until discharge from the hospital
  • Music of the parent’s choice can play in the operating room
  • Doctors and nurses are asked to refrain from “shop talk” (I distinctly remember hearing doctors converse about my scar tissue and incisions during my second cesarean) or their weekend plans
  • Ask your doctor for a vaginal swab to give your baby the best microbiome possible (see below)
  • Baby can be held by mama while wheeled into recovery, and continue to bond with parents there
  • Any and all usual post-birth procedures such as cleaning the baby and weighing the baby are delayed until parents are ready
  • A doula, grandparent, or friend are permitted to photograph or videotape the birth so that parents can concentrate on bonding

What is a vaginal swab, and how does it help my baby?

When a baby goes through the birth canal during a vaginal birth, he or she is exposed to a plethora of microbes – in baby’s mouth and on the skin. These bacteria help build a healthy microbiome for your baby, which could reduce his or her risk of inflammatory illnesses like Crohn’s disease, heart disease, infections, and much more.

The absence of this bacteria transfer in cesarean babies might explain why some studies have found that cesarean babies have higher rates of asthma, allergies, obesity, and other health concerns.

Does a cesarean mean that your baby has to go without the benefits of these microbes?

Not necessarily. With a gentle caesarean, your doctor or midwife can collect a vaginal swab and wipe it on your baby’s skin and in his or her mouth to contribute toward a positive microbiome. Another option is to take a swab of our vagina and wipe it on your nipples before baby breastfeeds.

While this is a relatively new practice, (indeed, I missed out on it with my three kids – a shame since I suffer from Crohn’s and its related enemy, arthritis), research is currently underway to study the efficacy of the practice.

Here are four steps to prepare for having a gentle cesarean

1. Implement your birth plan

Include your wishes for a gentle cesarean, even if you are planning a natural childbirth, in your birth plan, and keep several copies of it handy – in your hospital bag, your car’s glove compartment, and your purse. Everyone involved in your birth (obstetrician, midwife, doula, neonatologist, pediatrician, anesthesiologist, and operating room nurses) should also have a copy and be willing to abide by it.

2. Find a doctor who is open to the idea


Find a doctor who is open to the idea and ideally familiar with the concept of a gentle cesarean. If you are facing a doctor on-call with whom you are not familiar, make sure you have an advocate with you who is willing to voice any concerns you may have. It is well within your rights to take the extra time prior to surgery (barring any emergencies) to put in place a birth team who is willing to make this work for you.

3. Read up beforehand

Read up on your hospital’s policies and procedures beforehand so that you are aware ahead of time of any obstacles that may get in the way of your gentle cesarean. Hospitals sometimes have regulations in place that are different than your doctor’s practices, and hospital rules override even your doctor’s wishes. Hopefully, you can have every aspect of your birth that you desire, but if everything does not go according to plan, take the time to grieve! Even in the best of circumstances, we all have our “Mama Wound”.

4. Remember, this is your birth experience!

Remember, this might just be another day for them, but this is YOUR birth experience – something that you will remember and reflect upon for the rest of your life. Make your wishes known! This is not the time to be shy.

A gentle cesarean is the best way to get through a surgical birth with compassion, peace, and grace, and it is often extremely healing for mamas who have been through a previous traumatic surgical birth.

How about you?

If you had to have a cesarean, did you take any specific steps to make it a gentle one? Share with us in the comments below!

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28 Comments

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  1. After my first (emergency) C-section I was given Vicodin and had a very painful two weeks of constipation and trapped gas all over my body that was similar in strength to my contractions. I talked to a few people and realized narcotics just shut down some people’s digestive systems.

    For my second (emergency) C-section I talked to my midwives and ended up just using naproxen. My recovery was amazing, I felt better after 3 days with the second than I had after weeks of recovery with the first. Pooping on day 2 instead of day 14 does a body good 😉
    So, talk to your doctor about pain medication options! They matter!

  2. Hello- I saw that you graduated fr Claremont and was wondering if you know of any hospitals around the area that are open to this type of c- section. I live in Claremont and have called the 3 closest hospitals with no luck of holding the baby in the Operating room while they close me up. One won’t even let me see her till after recovery. I’m feeling very discouraged since I was planning on having her at a birthing center and she is still breech and my midwife will not diliver naturally. I’m 9months pregnant.

  3. I had an unplanned c section with my first Sept 2014. Thankfully, the hospital did most of these things already! They gave me baby immediately, insisted on skin to skin, and encouraged breastfeeding within mins of her being born while in recovery. It was as gentle as I could have imagined, arms were not strapped down either. I am currently pregnant with #2 and will talk to my Dr about vbac, but leaving myself open to the very good possibility of another c section. I love the idea of the vaginal swab and will absolutely do that! Thanks for your articles!

  4. I have had two planned C-sections up till now and I am 38 weeks pregnant of my 3rd son. It will be another schedules C-section in one week and a half. My previous C-sections were about 10 years ago and there was no option to get a Gentle C-section. I have traumatic memories of the birth of my two oldest sons as they came into the world “the classical C-section” way. I saw them for a minute and then they were sent off with the father for weighing etc on another floor. I needed to wait to get stitched up and recover before I could hold my babies – which took about 1 hour and a half.
    This time I found myself a hospital which does Gentle C-sections and I am hoping my experience will be different. I am looking forward to this new way of operating! I have just added some of your points in my birth plan, hoping for the best!

  5. Here in the UK C Sections are done different to that of the USA in that a mums arms are never strapped down as this practice has never been done in the UK.
    As that kind of restraint is illegal here.
    Also most hospitals here don’t use armboards they just lay the moms arms on her chest and mom is free to move her arms.
    As you see in this video here of a mum having her C Section in a London NHS hospital
    https://www.youtube.com/watch?v=tK5RybbmbrI

    Notice also they let her partner stay with her in the OR while she got her Spinal.
    The few hospitals that do have the armboards just lay IV arm on it but the arms are not strapped or tired to the armboard and mom can still move her arms if she wants.
    Moms here are also given their babies right away to hold in the OR and many moms also have skin to skin in the OR.
    Although not many C Sections are done here without the curtain in most C Sections the curtain is lowered for the mom to see the baby being born if that’s what she wants.Also some hospital have a low curtain where you can see the OR staff but not the actual OP.
    Also some C Sections here are done under general anesthetic if the mom is very nervous(although most mums chose to be awake) unlike the US where GA is not done at all anymore. So it is different here in the UK to the US and it seems hospital in the UK treat women better than US hospitals.
    Betty.

    • You are wrong. I had an emergency c-section in Sheffield, England in 2014 and both of my arms were pinned down as I had canulas in both hands. I had my baby on my chest for part of the time whilst I was being stitched up but because I didn’t have the use of either arm and I was vomiting, my partner had to do skin to skin instead.

      • You are lying. If you did have C Section (which I don’t think you did) it certainly was not in the UK. No NHS trust would permit any Doctor to strap a woman down to the bed. Such an action would be assault and battery and all those involved would be struck off the medical register and sent to prison.
        I am a nurse and have worked in 6 NHS hospitals in different parts of the UK and have been present at hundreds of C Sections. And I have never seen any woman with her arms tied down.

        I have never been to the US and there it could be different but this does not happen here in the UK.

  6. I love this thank you! If we’re blessed with another child I will be having a C section thanks to some big ol’ forceps and a 4th degree tear, so this is great to read.

    I’m interested in the vaginal swab, is it still possible if you test positive for Strep B?
    I did last time and was supposed do some sort of vaginal rinse but didn’t get around to it, I was a bit ummm busy!

    • I would also be interested in whether you’d still do the vaginally swab of you are GBS positive or were in a previous birth.

      • That’s a tough one! Although there’s research suggesting that swabbing of vaginal secretions on a baby born by cesarean may help to set up healthy gut flora, there has not been significant research done specifically for GBS. GBS positive status in a previous pregnancy is not an indication that you’ll be positive this pregnancy—it can change pregnancy to pregnancy and even week to week or month to month, so I wouldn’t worry a lot about a previous GBS positive status if you’re GBS negative now. However, as far as knowing you are GBS positive with the current pregnancy and deciding whether or not to do vaginal swabbing, that’s a conversation to have with your provider. Overall, the likelihood of infants contracting GBS is very low, especially if your baby is otherwise healthy and full term. Not many providers are familiar with vaginal swabbing, so it may be hard to get good feedback on that. And know that if you aren’t able to do the vaginal swabbing, you can still do plenty of skin to skin and breastfeed, which will help set up healthy gut flora. You might also consider requesting the baby go right to you or your partner upon emerging from the uterus rather than the infant warmer—contact with hospital supplies and staff increases the chance they’ll pass on “hospital-type” flora to your baby. Good luck!

      • Personally I wouldn’t risk it. GBS infection, if it does occur, is life threatening for babies and can lead to permanent disabilities. We do not know if swabbing carries a greater or lesser risk of contraction compared with a normal delivery. I would stick with the other safer ways of setting up healthy gut flora mentioned by Genevieve

  7. Hello. I’m wondering if you have any similar information for when a mama is facing a (medically necessary) induction?

  8. I want to keep this great article for future reference, or to pass on to others. I’ve tried on two different days to pin this to pinterest but got this error message: “We’re having some trouble talking to mamanatural.mamanatural.netdna-cdn.com. Please try again later!” Not sure if something needs to be fixed on your end, Mama Natural? Thanks!

  9. I was so sad and distraught that it had too have a emergency c section i was so looking forward to having a vaginal birth the way God had intended. My birth was so awful i felt like my wishes where pushed aside and what i wanted didn’t matter I’m only 23 and i do plan on having more kids.I’m going to try a gentle c section. My second time around.i was already told i can never have a vaginal birth my body is just not equipped that way. Which brakes my heart but i had to except it.For as many sanity went my c section made me sad and full of depression. Not to mention the gastrointestinal distress was the worst thing i ever been through. Thanks for letting me know there are ways around the horror of c sections..

    • Many Moms are told by “experts” that they can never have a Vaginal delivery. I’m so sorry to hear that you were told this. It’s complete hog wash. ICAN, the International Cesarean Awareness Network, is committed to helping Moms who would like a VBAC (Vaginal birth after cesarean). Evidence-based medicine has shown VBACs to be low risk. In cases of a normal pregnancy, a VBAC carries far less risk than a repeat cesarean, which can up Mom’s possibility of death by 6 times. Whenever you’re ready for baby #2, please reach out to your local ICAN chapter. They can help you with a vaginal birth! Up to 80% of Moms who try for VBAC will be successful.

      • Unless you are her doctor you are nota qualified to tell her that the medical advice she received is hog wash based on assumptions. Its dangerous to make assumptions like this.

  10. Thank you for posting this. It’s great to know that having a c-sec can be lovely too.

  11. Grateful that here in rural Newfoundland, I was able to have a cesarean that included skin to skin in operating room and delayed clamping (supposedly the first time for both but happened w/o a fight 🙂 and baby breastfed in recovery w/in 30 minutes of delivery. It took a long time for me to come to terms with the way he was born as I had imagined things much differently but things usually work out in the long run. And even though I say unfortunately the next will be c-section, I’m happy there are things like those pointed out in the article that are still possible. The psychological impact of c-sections for those who really don’t want them needs to be talked about more and maybe if these practices become normal place, it won’t be so difficult on moms.

    • So glad you were able to implement some of these strategies! Xo

  12. I also had a tramatic birth experience that ended in a C section, I just wouldn’t dilate, I went into labour myself and made it to 4 cm, but after 16 hrs I still hadn’t progressed, I am thinking in the end it was a justs how it was meant to be, I do have a option to VBAC, so that is on my agenda to research before we start trying again!!!! my LO is 14 months and so wonderful!!! the c section is my mama wound as well

  13. While I was dreading it with all my being, I ended up with a C-section. I was a little bummed about it, but I think the difference for me was that everyone at the hospital was WONDERFUL. I was actually surprised at how “progressive” the hospital was. Everyone was so kind and helpful and understanding. I never felt rushed during my long labor (pre C-section). My husband and doula were welcomed into the operating room and my doula was able to capture some beautiful photos. As soon as I was wheeled back into my room (which was pretty quickly), they put baby on my chest and I was able to love on her for a little while. Unfortunately, she had dangerously low blood sugar and had to be rushed to the NICU. They rolled me down to the NICU shortly thereafter so I could reach my hand in her little isolet and touch her. I wasn’t able to go back to see her until the next day when the anesthesia wore off enough for me to get out of bed. It was hard not having her with me.

    I would encourage all women to try to find a “progressive” hospital. Ask friends and family for recommendations. I believe more hospitals are coming on board with more natural methods. In the NICU, there were signs recommending “kangaroo care (skin-to-skin contact)” with your baby daily. While I was still in the operating room, the nurse asked me if I was keeping my placenta. Even when I told her I wasn’t, she asked if I wanted to see it. It just surprised me. Despite the fact that I ended up with a C-section, the hospital experience was so wonderful that it did not end up being traumatic.

    • Wow, so glad your hospital was so progressive! What a gift… thank you for sharing your experience, Chantel!

  14. This post is amazing!!! As a homebirth mama, I had planned for all different kinds of outcomes … Thankfully, I live in Portland, Oregon, which is known for it’s progressive birth culture. One resource that’s amazing for mother’s who plan an unmedicated or vaginal birth, and ends with a cesearan is: http://homebirthcesarean.org/ … I’m on a mission to use “unmedicated/vaginal” versus “natural”, as all births are natural!! 🙂 Thank you so much for this post … this information is amazing.

    And, for mamas who had a traumatic birth experience, the link above includes resources for working through the grief.

    • Thank you go the part that you said all births are natural, makes c section mommies not feel like they did something wrong! Still end up with a beautiful baby!!!

  15. Thank you so much for posting this! My LO is 3 months old and I planned a natural birth, but ended up in a c section. They showed her to me twice before taking her to the OB floor, which was nice. Our hospital doesn’t do VBAC ‘s (small town), so with future children I have to have a scheduled c section, which is my mama wound. But knowing we still have options and a voice helps.

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