More than 1 in 4 babies are now born via a caesarean section.
And while you might be familiar with c-sections, hospitals increasingly offer natural c-sections – which are much more like a vaginal birth, putting both parents and baby at centre stage.
‘A natural c-section takes a family-centred approach, which emulates as far as possible an experience that you could have with a vaginal birth,’ explains specialist midwife Jenny Smith.
What happens during a natural c-section?
After making the uterine incision, the theatre team lower the surgical drape, allowing you to see your stomach.
As your baby's head slowly comes through the incision, baby will start to breath in air through their little nose and mouth. While their head is popping out, baby will still be attached to the placenta, and their body will remain inside you for a few minutes.
Leaving baby in utero for a few minutes helps push any fluid from their lungs. Once they start crying, the obstetrician will help baby ease their shoulders and arms out.
With the help of the obstetrician, your contractions and some wriggles from your baby, they'll slowly make their way out of the womb, all while you're watching the process.
Once the cord is clamped and cut, your baby will be passed to your midwife who will then place baby on your chest and wrap them in towels to keep them nice and warm. This skin to skin contact and early breast feeding is so important for the bonding process, and it will give the surgeon plenty of time to complete the surgery.
Watch this adorable video of one baby's entry into the world via a natural c-section.
How to have a natural c-section?
There are a number of things you can change and make happen before, during and after your c-section to make it a natural one.
Make your hospital surroundings familiar
One of the simplest things you can do to make your c-section more personal is to bring in something familiar from home. Having your favourite pillow, for example, can make things less daunting. Think about what will make you feel calmer, so you can relax.
Also, think too about how you can make the theatre more homely. ‘You can ask for the lights in the periphery to be dimmed,’ says Jenny. ‘You can also ask for the theatre to be quiet or for a particular CD to be played. Create a playlist for the birth and ask the surgical team to play it. All of these things will help you feel in control of the experience.’
Get your partner involved in your c-section
Another crucial element is your partner’s involvement. A surgeon may be the one delivering your baby, but there are still ways your partner can take part. They will remain with you throughout the experience, and if you want them to, you can ask for them to cut the cord for a second time (the surgeon will make the first cut, as part of the procedure) when your baby has been born. You can also ask for your partner to be the one to tell you your baby’s gender, or for you to discover it for yourself.
Lower the curtain
Traditionally, c-sections were carried out behind a curtain, and mums might only catch a glimpse of their baby while the medical team attended to her. Now you can ask for the material to be lowered at the moment of birth so you can witness your child’s arrival.
‘We lift the baby’s head out and, at that stage, we slightly raise the top of the operating table and drop the drape down, so that Mum can see her baby,’ explains Jenny. ‘We call it walking the baby out. With a little support from the surgeon, the baby will wriggle out with a contraction from the uterus. It emulates the slower pace of a vaginal delivery. Mum can watch the whole of the birth, and she and Dad meet the baby at the same time as the delivery team. You don’t have to watch but you have the choice.’
Delay cutting the cord
You can also request for the cord not to be cut until it has stopped pulsing, as long as all is well with you and your baby. This means your baby benefits from the stem cells and oxygenated blood cells from your placenta after birth.
This is becoming a common request for vaginal births, but there’s no reason why it can’t happen during a c-section as well.
One of the loveliest moments in any birth is the first cuddle with your baby. It’s possible to have this contact within moments of a c-section delivery, if you make it clear that you want to hold your baby while you’re still in theatre. If you ask in advance, the team will prepare you for this.
‘The drip will be put in your non-dominant arm,’ says Jenny. ‘The team will be careful about the epidural, so you have complete control over your arms. You can also ask that the ECG leads used to monitor you are kept away from your chest, so your child can be laid there quickly after birth. One of your arms can be left out of your gown, so the gown can be quickly moved out of the way. That way, you can hold your baby while you are stitched up, and enjoy skin-to-skin cuddles until it’s time to go to the recovery area.’
How to prepare for a natural c-section
Even if you are expecting a vaginal birth, it’s a good idea to think about what you’d like to happen if you do need a c-section; while some mums elect or are advised to have a c-section early in pregnancy, others will only be told they need one when they’re in labour.
By thinking about the possibility beforehand and writing down your thoughts in your birth plan, you will be more mentally prepared.
‘Do some homework,’ Jenny says. There are only two ways a baby is coming out, and it is better to plan for both options in advance.’
Talk to your medical team
Make sure they know the things that matter to you.
‘Write down your wishes in your birth plan, and then go through this with the team,’ says Jenny. You will meet a few of them before you go into the theatre.
‘When you discuss your birth plan, the team may tell you that certain things won’t be possible.’ At all stages of your c-section, they will put safety above your wishes. For example, if your baby is breech, it will not be possible to deliver her slowly.
If your birth doesn’t go to your plan, think about what really matters. ‘I attended a woman who needed to have a general anaesthetic,’ says Jenny. ‘She was upset because she’d wanted to see the birth. We spoke to the surgeons and they arranged for it to be filmed. Everyone was happy!’