How to Have a Gentle Cesarean – A Checklist
February 14, 2014

What do you think of when you picture having a Cesarean birth? Bright lights? Being surrounded by doctors and surgical equipment? A feeling of powerlessness, of panic, or of failure?

Well, it doesn’t necessarily have to be that way!

Few mothers plan on having a C-section, but birth is complex and sometimes unpredictable. Whether you’re planning a C-section or a vaginal birth, it makes sense to be prepared for any possibility. Although vaginal birth is generally best for mother and baby, there are many valid reasons why someone might need or choose to have a C-section. Consider the following scenarios:

  • Say you’re planning a completely natural delivery, but when your water breaks, the baby’s umbilical cord comes out first, with the baby’s head pressing on it. This is called cord prolapse, and usually requires an emergency C-section.
  • Or suppose you had a C-section with your first child, and want to try a vaginal birth for your second. But there are no doctors or midwives in your area that will support your decision to try a VBAC (vaginal birth after Cesarean.) You feel like you have no choice but to have a repeat C-section.
  • Or perhaps you suffered sexual abuse or birth trauma in the past. You know it’s best to give birth vaginally, but the psychological impact of having multiple vaginal exams, of being exposed in front of strangers, and of pushing the baby out is simply unthinkable. You opt for a C-section instead.

The thought of undergoing any type of major surgery, including a C-section, can be scary. Mothers who are planning a natural, vaginal birth often feel that having a C-section means they have given up or failed in some way. But you may have more control over the circumstances of your Cesarean birth than you think you do.

Many hospitals are now offering the option of a “Gentle Cesarean”, which brings the feel of a more natural birthing environment to the operating room. You can often keep many of the elements from your birth plan, like immediate skin-to-skin and breastfeeding, having your partner cut the cord, and even having the drape lowered so you may witness your child emerging from the womb.

However, not all hospitals or doctors are familiar with Gentle Cesareans. They may be used to doing things a certain way, and may be resistant to changes in their usual protocol. In addition, babies born via C-section have a higher chance of requiring intensive care immediately following birth, and may need to be whisked away. But assuming that you and your child are healthy and safe, and your doctor is receptive to your wishes, you may be able to have a C-section that is as close to your original birth plan as possible.

Here is a checklist of things you may request in the event of a Cesarean birth. If possible, give a copy of this checklist to your care provider prior to birth so that they can be aware of your preferences. Feel free to modify and share this checklist.

_____ I would like to keep playing my own music (or listen through headphones.)

_____ I would like to have the lights as dim as possible.

_____ I would like to have two people from my birth support team in the operating room with me. Person 1: _______________   Person 2: _________________

_____ I would like my arms to be free, not strapped down.

_____ I would like to have as few sedating medications as possible.

_____ I would like any medications I am offered to be safe for breastfeeding.

_____ I would like a warm blanket during surgery if possible.

_____ I would like the surgery to be explained to me step-by-step as it happens.

_____ I would like photos / video to be taken of my Cesarean birth, if hospital policy allows.

_____ I would like my IV and blood pressure cuff placed on my non-dominant hand, so I can hold my baby easily.

_____I would like my heart monitor leads placed on my sides, not the front of my body, to allow skin-to-skin contact.

_____ I would like my hospital gown placed so that it opens in the front, to allow skin-to-skin contact.

_____ I would like to have the drape lowered so I can watch the baby come out.

_____ I would like to have skin-to-skin contact with my baby immediately after birth.

_____ If I am unable to hold my baby, I would like my partner to have skin-to-skin contact with my baby immediately after birth.

_____ I would like APGAR scoring, initial assessment and ID bracelet to be done while my baby is having skin-to-skin contact.

_____ I would NOT like my baby to have a hat placed on her/his head.

_____ I would like to delay the clamping of the umbilical cord for at least ______ minutes after the baby is born.

_____ I would like my partner to cut the cord.

_____ I would like to keep my placenta and take it home with me.

_____ I would like time to breastfeed before the pediatrician examines my baby.

_____ I would like to delay vaccinations and eye ointment until after I breastfeed.

_____ I would like to delay bathing of my baby until ________________________.

_____ I would like to bathe my baby myself, or have my partner bathe the baby.

_____ I would like to keep my baby with me at all times.

_____ If my baby must be taken to the nursery or NICU, I would like my partner to stay with the baby at all times.

_____ I would like my partner/doula/__________ to remain with me in recovery.