There aren’t traditionally a lot of options when it comes to giving birth: There are C-sections, and there are vaginal births. But more and more women are now choosing a kind of hybrid: “gentle C-sections,” also known as “family-centered C-sections.” During these procedures, the screen that’s normally at the mom’s waist blocking the incision may be lowered or transparent, or she may be propped up so she can see her baby being removed. She also may get the chance to hold the baby as the surgery wraps up, before the nurse takes the child away. To make that possible, the baby’s heart monitors are attached to the mother’s back rather than her chest, her hands aren’t strapped down to the operating table (which is normally done to keep her still), and she may receive less sedation. Sometimes the baby’s delivered more slowly so that the chest is squeezed and fluid gets cleared from the lungs the way it does during a vaginal birth.
This approach “tries to simulate as close as possible a vaginal birth, where the mother is actively engaged,” says ob-gyn and maternal fetal medicine specialist Kecia Gaither, M.D. “It promotes a quicker mother-child bonding opportunity, and with skin-to-skin contact.” Babies with early skin-to-skin contact, she explains, have more stable breathing, glucose levels, and temperatures, and cry less often.
Gentle C-sections can also have advantages for the mother, says Candace Howe, M.D., an ob-gyn in Newport Beach, California. Since women get more of a say in their labor process, they’re less likely to experience the anxiety and trauma that sometimes stem from having such a monumental event out of their hands. And moms who are less stressed have an easier time breastfeeding.
After one emergency C-section, Grace decided that if her next vaginal birth didn’t work out, she’d plan a gentle C-section as a backup. She put it in writing in case she wouldn’t be able to communicate it, and sure enough, she needed the paper. The doctors couldn’t lower the curtain due to germ concerns, but she got to see her son being born through a mirror and hold and nurse him right away. “Just meeting my son face-to-face—that was amazing,” she recalls. “It was really hard, both times, to have to opt for a C-section. The visibility and quick skin and nursing made up for that a bit. It felt less clinical and more like something between a mother and child.”
“Having the baby come from my womb to my chest was a huge rush of oxytocin,” echoes Melissa Pizzo, who had a gentle C-section after a “shocking and traumatic” first C-section and two more that left her “sad.”
Clara Wiggins also aimed to have a vaginal birth but put a gentle-C-section plan in place in case that wasn’t possible. She ended up going for the C-section when her baby was 10 days overdue. Her daughter was facing her when she came out, and she loved knowing she was probably the first person she saw, though she found holding her “awkward and uncomfortable.” The biggest advantage was “being able to have some control over the birth and to have made some choices,” she said.
Janice Strong suffered from postpartum anxiety and depression after her first son’s C-section birth, which she believes was largely due to the powerlessness she experienced. “I don’t remember most of the first day except for flashes of being topless in the recovery room surrounded by my family, trying to hold my baby but not having control of my arms,” she says. “I don’t remember seeing my son for the first time.” She delivered her second son via a vaginal birth, but her next pregnancy was with twins, which would be more complicated to deliver vaginally. So she started looking into gentle C-sections.
Though she didn’t have the stomach to watch the procedure and couldn’t hold her babies because they needed intensive care, just having her arms free was a relief. She also had a doula in the room, who was giving her updates on the babies, and figured out a medication plan that would relieve pain but keep her awake. This time she felt like “an active participant” and remembers everything. “I was able to heal so much quicker from the natural C-section too,” she says. “Partially because I didn’t labor first but also because the emotional aspect wasn’t nearly as taxing.”
Dr. Gaither and Dr. Howe say there are no known disadvantages of gentle C-sections—unless you have a weak stomach, in which case you may want to skip the part where you watch the operation—and recommends figuring out a plan with your doctor during your pregnancy if you’d like to consider one.
