Family-centered cesarean: The future of C-sections

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Published January 26, 2014

| FoxNews.com

A cesarean section can make even the most calm of pregnant women to feel nervous, anxious, and straight up terrified, whether it’s scheduled or not. What’s more, women who have C-sections sometimes feel cheated and disappointed and may miss out on early bonding with their babies.

Some hospitals in the U.S., however, are realizing that a new approach—family centered C-sections—can make the experience easier and more beneficial for moms, their babies, and even their partners.    

A calm environment
A C-section is major surgery, albeit one you’re usually awake for, but “there are ways that you can make it less medicalized,” according to Dr. William Camann, director of obstetric anesthesia at Brigham and Women's Hospital in Boston, Mass, one of just a handful of hospitals he estimates who offer family-centered C-sections.

One of the major differences is a change in the operating room, which is typically loud and busy. “Everybody has a job to do in there and nobody is really communicating to the couple what is going on,” according to Tara Poulin, a doula and founder of Birthing Gently.  

With the family-centered approach, the physicians and hospital staff have a quiet demeanor and pay more attention to the patient. The mother can also request music in the operating room to calm her nerves. At Brigham and Women's Hospital, mothers are even encouraged to bring their own iPods.

Early skin-to-skin contact
During a typical C-section, babies are immediately whisked away to be weighed, examined, and get ID bands, which could keep mom and baby apart for an hour or more. Yet early skin-to-skin contact has been shown to stabilize baby’s heartbeat and breathing, decrease crying, help baby sleep, increase weight gain, and help with breastfeeding.

In fact, a recent American Academy of Pediatrics study found that skin-to-skin contact in the delivery room in combination with a mother’s intent to breastfeed, increased the chances that she would exclusively breastfeed.

With the family-centered approach, the monitors can be adjusted so mom has a free arm to hold the baby. Plus, baby can be placed on the mother or the father within minutes.  

Poulin said babies who are delivered with the family-centered approach are usually more calm and cry less. “They’re feeding better and they’re feeding longer,” she said.

At Brigham and Women's, women are also given the option to have a clear drape so they can see the baby being born. The baby can also be placed immediately on the mom’s chest, although briefly and through the clear drape, because the baby is still part of the sterile surgical field, Camann said.

Doulas in the OR
Women can have an additional support person or a doula in the operating room, another change that’s happening as “most people realize that it can be done, it can be done safely, and it’s good for the patient,” Camann said.

Pre-operatively, the doula may talk to the mom about what to expect during surgery or massage her. During surgery, the doula is a familiar voice among strangers who can talk about what’s happening,  or re-assure the mom that the sounds she hears, for example, are normal. Moms with doulas in the OR have strong vital signs, are usually calm and less likely to need anxiety medication, Poulin said.

The partners are usually more relaxed, too, and feel more involved, empowered, and supported, according to Poulin. “Families are really able to have a better birth experience even though it’s a surgical delivery,” she said.

Not always a sure-thing
The family-centered approach isn’t appropriate for emergency C-sections or if there are complications. Also, moms who planned to have a vaginal birth may not be as welcoming to the approach, Camann said.

For moms who are open-minded about the family-centered approach, however, they’re able to make it their own, even if it wasn’t their choice, and have the childbirth experience that every woman deserves: to feel supported, in control, and calm. “They really enjoy their birth and they’re not fearful,” Poulin said. “There’s higher satisfaction overall with their birth experience.”

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