Gentle Cesareans – how to feel part of the c-section circus

These past few weeks I’ve had the most wonderful revelation that even though I’m having another planned c-section, I can also have a real birth plan. And I’m so excited!

We had an elective c-section with Baby Bee. It wasn’t the fear of a ‘normal’ birth that led me to that choice and he wasn’t breech or anything worrying like that. It was simply my bonkers levels of anxiety. I was pathologically terrified of losing him when we had come so far – there wasn’t a day of my pregnancy with Baby Bee when I wasn’t living in a state of fear and I could not believe that something tragic wouldn’t happen in those final days and hours. My consultant took one look at my history and ticked the box and we were booked in for Baby Bee’s due date. And so, as we were having a c-section, I blithely ignored all of the stuff about birth plans during our NCT course because why did I need a birth plan? I was simply going to be unzipped.

And on the day, everything about the process was fine – we were treated well, had a friendly consultant perform the procedure, and we were given the option of delayed clamping of the cord and skin-to-skin in the theatre. Baby Bee also stayed with me when we were wheeled back to the recovery room. I have absolutely no complaints.

My first cuddle with Baby Bee – look at the size of his paws!

Which is why, from the start, I’ve been clear with midwives and consultants that we’re going to go the same route with number two. If I go into labour before my due-date then fine, but I’m not risking this absolute bloody miracle on chance. Thankfully, this was approved at our first consultant appointment and that, I thought, was that.

And yet.

And yet. I couldn’t help reflecting back on Baby Bee’s birth. While everyone in the room was very nice and it was uncomplicated and relaxed I couldn’t help but feel a bit of a wallflower at the party. Like we were the boring neighbours they’d felt compelled to invite or else we’d complain about the noise. I felt completely uninvolved. Deliciously off-my-face on morphine but equally aware that something hugely significant was happening to me and I had no real say in how it happened.

I regularly said, and I still feel this too, that I didn’t feel like I’d given birth. I felt someone else had done this for me. And while I’m glad for that when it comes to the dog walker or the men building our extension, I’m less keen around such profound moments as giving birth.

I’ve been talking recently with a Doula about post-natal care – more on that another time – and I mentioned this feeling to her and her eyes brightened. ‘Have you heard about gentle cesarean?’ she asked.  And so began my understanding that just because you’re having a c-section, it doesn’t mean you can’t have a) a birth plan; b) an important part in how it’s performed; c) the sense that you have actually given birth – not just been handed one they found in the corridor while they distracted you with lots of yummy drugs.

Gentle cesareans have been around for a little while now. There were definitely elements of their core value involved in our section with Baby Bee – the delayed cord clamping and the skin-to-skin – but there’s a whole lot more that can be done to make your birth feel, well, like a birth.

Sometimes called a natural cesarean, the basics of a gentle cesarean in the UK are:

  • The drape is lowered at the moment of birth and you can see the delivery of your baby. You can be propped up too.
  • A smaller incision can be made so that your baby ‘walks’ out of the womb – this really helps to squeeze all the gunk out of its little lungs as it would if it were coming out your lady parts (Baby Bee was gunk city for months after his birth)
  • The baby is delivered onto your chest as they would with a ‘normal’ birth before the cord is cut (length of cord permitting)
  • Delayed cord clamping
  • Breastfeeding is initiated while they sew you up and the baby stays with you with skin-to-skin for as long as possible.
  • In the US there’s an emphasis on not having your arms strapped down but as they don’t strap your arms down anyway in the UK, there’s no need to request it.

I think that’s it. There are other things such as music and turning the lights down at the moment of birth, but they’re not essential parts of the process, they’re part of the birth plan.

These don’t sound like earth-shattering alterations but imagine how different the experience would be if you could actually see the little human being you’ve been growing for so long come out and hold them as soon as they emerge. With Baby Bee they kind of dangled him around the drape shouting from the other side ‘it’s a boooyyy’ while he screamed and then whisked him off to weigh him while I lay there in shock.

Whatever, words can’t do justice to how beautiful a gentle section can be so here’s an incredible (and bloody) video that went viral a few years ago of a woman’s gentle section in Nottingham City Hospital (not for the faint hearted, but definitely for the curious).

Nottingham City Hospital Gentle Cesarean

Since having that life-changing conversation with the Doula, my research has made me positively giddy: I am going to be as much a part of this birth as I possibly can. I am going to be a voice in a room where last time I felt that no-one was listening (it was absolutely silent for Baby Bee’s birth because the team had taken the piss out of the anaesthetist’s choice in radio station so he’d just switched if off – that silence was terrifying – no-one told us what was happening and it seemed to go on for ever).

The process for requesting a gentle cesarean is straight forward: I spoke with my midwife who has referred me to see the Supervising Consultant Midwife* for our Trust. She will then work with me to develop our birth plan* with the consultant. I’m going to have a birth plan! I’m also going to request a specific consultant who I’ve heard wonderful things about and who has already performed a gentle at another hospital within the Trust. I mean: how empowered is THAT?!

I never thought I’d have a say in how our baby came into the world once I’d confirmed our choice of a cesarean. But I do. All women who choose this route do. You’re not wussing out. You’re not giving up your right to belong at your own child’s birth. You are your child’s mother and you have every single right to be present, to be heard and to be a significant part of those magical first moments of life.

*Can I just say this again: there are Supervising Consultant Midwives as well as Supervisors of Midwives (who are also just as dynamic but don’t have the time to run clinics) and anyone can request their support in the planning of their birth. I mean – WHY DON’T THEY TELL US THIS STUFF FROM THE GET GO?!

*Also: I found this brilliant sample cesarean birth plan which includes pretty much all of the tenats of a gentle apart from the smaller incision on the NCT website when I was just this minute googling. I will definitely be taking this to our meeting.


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