Both times I was pregnant, my biggest fear after the usual health concerns every parent has was that I would end up needing a C-section. My youngest was born 10 years ago, and back then, with Facebook still fairly new and not yet teeming with (often conflicting) pregnancy and birth advice, I educated myself via books and magazines. The message I inferred from those sources, a message which remains prevalent to this day as far as I can tell, is that a woman’s body is designed to usher life into the world, and if left to its own natural rhythms, will do so without mishap. Hashtag goddess.
But when I reached the end of my 40th week of my second pregnancy with my daughter’s head rammed up under my ribs rather than pointing down between my legs as it should have been, and when attempts to coax her into position failed and my doctor recommended a scheduled C-section, I was overcome with the feeling that my body had betrayed me. My cousin keened through her perfect, natural, unmedicated labor. What was my problem?
And yet, beneath the feeling of failure, another, quieter emotion festered: relief.
My first birth was traumatic. 24 hours of slow, tedious labor, the introduction of pitocin, my desperate pleas for an epidural, culminating in a violent pushing session that tore my vagina nearly all the way to my anus. Back at home two days later, I kept trying to pee but couldn’t. I would push and nothing would come out. Finally I pushed really hard and felt a dislodging–a blood clot that had been stuck in my urethra. I didn’t understand until my postpartum checkup when my doctor’s eyes almost fell out of her head how dangerous that could have been. My vagina and all my insides did not heal for months. Why do they say six weeks? A man made that up, right? Had to have been a man. How about the person with the vagina gets to decide when to use it again, mkay?
That’s why, as terrified as I was of having a C-section, and as much as it made me feeling like a “failure,” I also felt relief. As it turns out, the C-section, for me, was way easier. I showed up rested and clean, the surgery was quick and painless, and recovery was far quicker than after the traumatic labor I experienced with my son.
Of course, not all vaginal births were traumatic like mine was. Some birthing bodies really do herald life through their vaginal canal like Noah escorting the Israelites across the Red Sea. But some bodies, for various reasons, cannot or should not attempt vaginal birth. For these folks, a welcome trend has been slowly gaining in popularity for the last few years: gentle or ‘family-centered’ C-sections.
With gentle C-sections, parents negotiate with their doctor in advance to make a few adjustments to the traditional cesarean–whether it is planned or comes in as plan B after attempting a vaginal delivery–to make the C-section feel closer to a more traditional vaginal birth and less like an emergent surgical procedure. With gentle C-sections, parents can witness their baby being born via a transparent plastic barrier (or have the traditional barrier lowered at the moment of birth), and the baby is immediately lain on their parent’s chest following birth for skin-to-skin contact. Studies have shown that skin-to-skin contact, especially immediately after birth, promotes bonding, increases blood oxygen levels, stabilizes baby’s heartbeat, and stimulates breastfeeding, among other things.
Traditional C-sections can often feel clinical and sterile, and just too much like a medical procedure. Gentle C-sections soften the process to humanize it and make it feel more natural. Some doctors who assist with gentle C-sections will take steps like lowering the lighting in the operating room (except where necessary for the doctor to see), allowing the family to choose their own music (I had this option and chose hip hop because, yes, I find hip hop music calming), and allowing the birth partner to take pictures.
The gentle C-section is easier accomplished when going directly into the procedure in a non-emergent situation, of course, but it can also be set up as a backup plan. The key is to make sure your doctors and nurses are aware and prepared well in advance, perhaps by having a written-out plan attached to your chart or bed and having your partner, doula, or other birth advocate act as an advocate for your wishes. This advanced preparation is a must since the gentle C-section may require an adjustment in how the operating room is staffed–for example, the neonatal team would need to be present in order to ensure baby gets prolonged skin-to-skin contact but also receives the necessary checkups and care. You may also need to move monitors to different locations to facilitate lying the baby on the parent’s chest.
I didn’t get much skin-to-skin contact immediately following my C-section, but the drape was lowered enough that I could see my baby almost the moment she emerged, and I did get a few minutes of snuggles with her before they whisked her off to complete her neonatal care. I would have loved to have kept her with me and begun breastfeeding right away. That said, I didn’t have to wait long, and we had no trouble getting into the swing of breastfeeding, and it so happened that my daughter who was birthed by C-section scored higher on every condition of the Apgar than did my son who I delivered vaginally after 36 hours of labor.
Doctors are generally opposed to increasing the cesarean rate and do not advocate for planned C-sections absent a medical reason. Still, for me personally, if I were ever to give birth again (not happening) and had a choice between vaginal or C-section birth, I’d choose C-section. This is obviously an emotional reaction on my part, influenced by my traumatic birth experience, and I’m certainly not suggesting anyone should elect to have a C-section. C-sections are major surgery and come with all the risks of such.
All I’m saying is, for the expecting parents who feel like failures because they’re being told they cannot deliver vaginally, I want you to know, it’s okay. And not only is it okay, it might just be every bit as wonderful and amazing and beautiful as the vaginal birth you so desperately hoped for. Talk to your doctor about a gentle C-section. Even if you have no reason to believe a vaginal delivery wouldn’t go off just fine, you still might consider putting a plan in place for a gentle C-section if the need should arise. A cesarean delivery truly can be a beautiful experience. And, with a little advanced planning, it can even be a gentle one.