Hospitals adopting 'gentle' procedures for C-section to make deliveries more like natural birth


Some hospitals are adopting new approaches to delivering babies by caesarean section that make them more like natural births.

Surgeons who just delivered an infant by C-section almost immediately might hand it off to be placed on the mother’s chest, as often occurs after vaginal deliveries. Breast-feeding might be encouraged while mother and infant are still in the operating room. And clamping of the umbilical cord may be delayed, as is increasingly common in vaginal births.

Some hospitals are going further, aiming to make caesarean delivery more like a birthing experience than an operation. Mothers get to choose options such as dim overhead lighting, soothing music and watching through a clear surgical drape, rather than the usual opaque curtain, as the baby emerges.

In a traditional C-section, the baby is immediately placed in a warmer to be assessed by the pediatrics team before being handed to the mother up to an hour later in postoperative recovery. The practice was founded on the need to quickly determine which newborns require assistance breathing and to maintain sterility during the operation.

Doctors say the new approach, typically offered only for nonemergency C-sections, adopts some practices of vaginal deliveries that have been found to bring health benefits to the mother and child, such as skin-to-skin contact and early breast-feeding. Often called family-centered caesareans or gentle caesareans, the approach also aims to make the C-section birth experience more rewarding for families, they say.

Some doctors are concerned the new approach could make caesarean births more attractive, at a time when U.S. hospitals are under pressure to reduce the rate of C-sections.

“The downside is hospitals may market, ‘Well, we have a high C-section rate but we do it naturally.’ It’s not a normal birth, it’s significant surgery,” says Elliott Main, a leader in the effort to reduce unnecessary caesareans as medical director of the California Maternal Quality Care Collaborative, which represents various state agencies, professional and consumer groups and health-care systems.

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