Giving birth via Caesarean section is a contentious issue in today’s society. Statistics issued by the Australian Institute of Health and Welfare cite that 35 percent of births in Australia were surgical in 2018.

Many health professionals and social commentators are quick to deem this number too high, comparing our country’s statistics to Nordic countries who fall into the WHO recommendation range of 10-15 per cent.

As a result of this generalised view of surgical birth, women who have a caesarean often receive a lot of of criticism. They can be made to feel as though they failed because they couldn’t birth vaginally, but this is not the case at all. It can be a lifesaving surgery performed with the health and wellbeing of mother and baby taking priority.

These negative connotations can affect the way a new mother experiences her caesarean birth, how she feels after giving birth, and during her transition into motherhood. 

This type of birth shouldn’t be a taboo – women should be able to talk about caesarean births without feeling shame, guilt, or as if they have failed. To put this in context, when you look on Instagram the hashtag #caesareanbirth has 9,004 posts, while #naturalbirth has 450,287. That’s a huge difference of around 441, 283 posts. Sadly #gentlecsection only has 1,605 posts.

I remember feeling so elated after the birth of my third child via caesarean. Even though my attempt for a VBAC (vaginal birth after caesarean) didn’t work out, I was ok with that.

I felt brave for allowing someone to cut me open while I was awake and deliver my baby. 

A few weeks later I was online and clicked on a birth story written by a woman who felt she had failed because she had given birth via caesarean. Her hopes of having an unmedicated and unassisted birth were shattered; she said she was on a downward spiral and couldn’t bond with her child because she felt ashamed.

This hit me and I started to compare my story with hers. Soon enough my feelings of elation and joy were overshadowed as I started second-guessing my decisions. 

I felt sad for this woman and her belief that she was broken because she needed help to birth her child; an unfortunate common mindset perpetuated online.

I also felt compassion towards her because part of her sadness stemmed from her loss of control over her birth experience. I understood where she was coming from.

After experiencing three caesarean births and dreams of extending my family in the future, I knew I had to be ok with birthing via caesarean but felt a more participatory approach might help me in any future births.

That’s when I came across the new ‘woman centred’ approach to birthing via caesarean, designed to give women a greater sense of control in their birth experience.

NSW Obstetrician, Dr David Addenbrooke, says this woman centred approach to birthing has several benefits over a caesarean performed the traditional way.

The ‘woman centred approach’ (which can also be referred to as the ‘natural caesarean’ or a ‘gentle caesarean’) is performed with the idea of keeping the focus on the mother and her experience of the birth.

“The main principle of a natural caesarean section is to try and eliminate all the barriers that exist in an operating theatre environment against allowing the couple to experience the moment of the birth – regarding both physical contact and intrusive elements in the environment around them,” says Dr Addenbrooke.

This includes thoughtful placement of the IV lines, blood pressure cuff and heartbeat sensors.

“The second element is the sterile field which can be commenced lower on the woman’s abdomen, below the naval as opposed to up near the rib cage, giving more space for the woman to receive the baby on the torso.”

“My goal with a natural caesarean is to make the medicalisation of an operating theatre as unobtrusive as possible and to put the focus of the moment back on the woman’s experience of the birth,” says Dr Addenbrooke.

Dr Addenbrooke says it requires extra planning to pass the baby directly to the mother without compromising the sterile environment of the operation. The needs of the baby must also be considered when planning for a gentle caesarean.

Direct skin to skin with the mother is top priority with a gentle caesarean, which is typically done with a vaginal birth.

Dr Addenbrooke says the birth is carried out in the following steps:

  • Drapes are dropped once the head is crowning on the skin of the abdomen.
  • The woman has her shoulders lifted so she can see over her bump.
  • The baby is allowed to slowly emerge from the womb with the Obstetrician assisting the chin and each shoulder whilst turning the baby so that it faces the parents. The parents are able to see their baby open its eyes and take its first breath.
  • Once the baby is out it is placed immediately onto the mother’s chest, with the cord still attached.
  • A Midwife is able to support the mother and help stimulate the baby.

Most of the benefits are related to the woman’s experience and memories of the birth, says Dr Addenbrooke, particularly if a caesarean was not part of the original birth intention.

“My goal with a natural caesarean is to make the medicalisation of an operating theatre as unobtrusive as possible and to put the focus of the moment back on the woman’s experience of the birth,” says Dr Addenbrooke.

Despite a woman centred approach to a natural caesarean not being well known, making caesarean birth options better publicised should be a priority says Dr Addenbrooke.

“This can help women regain some of the empowerment and autonomy they lose when a caesarean birth is deemed necessary.”

When my son was born via a gentle caesarean six years ago, I felt like I was participating in the birth. The curtain was lowered as I saw him emerge, he was placed straight onto my chest and the midwife didn’t take him off to be weighed until I was ready. 

And the fact the midwife asked my permission to take my son for his check was the game changer. 

The acknowledgment that I was able to make decisions helped me gain a greater sense of control and I felt respected and an integral player in the birth of my child. 

So, if you are about to give birth via caesarean or are hoping to give birth in the near future and want to plan for all birthing modes just in case the unexpected happens, you should consider trying for a gentle caesarean. 

Some maternity units aren’t equipped to do so because of hospital policy, so you need to discuss this with your midwife and doctor. 

“And if there are emergency circumstances, such as a baby who is in distress or the need for a general anaesthetic, then these elements may not be offered,” says Dr Addenbrooke. 

Either way it’s worth having the conversation with your midwife and doctor because this gentle approach to birthing via caesarean made me connect to my experience on a deeper level.

It’s important for women to feel empowered, no matter which way you decide to give birth. And for me, this woman centred approach made me feel active in the birth process and not just a bystander. 

Have you had a gentle caesarean? What was your experience like? I’d love to hear your story.

Your friend and parenting peer.

Cherie x